medicationPrescription only (US)Fluconazole (Diflucan and generics) is FDA-approved for vaginal, oropharyngeal, esophageal, and systemic candidiasis, and other fungal infections
FluconazoleBenefits, Dosage & Interactions
Also known as: Diflucan
Fluconazole, also known by the brand name Diflucan, is an antifungal medication belonging to the azole class. It is typically taken in the morning. The reported plasma half-life is about 30 hours, which shapes dosing frequency. Dose, response, and interaction risk vary by individual, so use should be reviewed with a clinician.
How much Fluconazole do people take?
A single 150 mg oral fluconazole dose was used for vulvovaginal candidiasis in the probiotic-comparison trial; the oteseconazole trial's fluconazole comparator arm used 150 mg on day 1 and again on day 4. Route reported: Oral capsule in both cited trials. Frequency reported: Single dose in one trial, and two 150 mg doses three days apart in the other. These are amounts documented in the cited studies and labels for Fluconazole — they are reported for reference, not a recommendation. Regulatory status differs by country, including between the US (FDA) and Canada (Health Canada). Confirm any amount with a licensed clinician before you take it.
See the full reported protocol and its sourcesResearched by DoseRoutine Research TeamReviewed for accuracy by Nicholas Alexander, RSE, SO, PMPLast updated Educational reference only — not medical advice. Always confirm dosing and safety decisions with a licensed clinician.
Evidence: Strong — 2 human randomized trials and regulatory approval on file.
Evidence strengthStrong · 4/4
PreclinicalStrong human evidence
2 human randomized trials and regulatory approval on file.
Plasma half-life
~30 h
Typical timing
in the morning
Default unit
mg
What published protocols report
Ranges documented in the literature, shown for reference. DoseRoutine does not recommend an amount — your prescriber or the product label sets the dose.
Reported for Fluconazole in the cited sources. Published ranges are not dosing advice.
References & evidence
Documents the Fluconazole entry is written from. Each number matches an inline marker above.
- [1]Comparing the Effect of Probiotic and Fluconazole on Treatment and Recurrence of Vulvovaginal Candidiasis: a Triple-Blinded Randomized Controlled TrialMollazadeh-Narestan Z, Yavarikia P, Homayouni-Rad A, Samadi Kafil H, Mohammad-Alizadeh-Charandabi S, Gholizadeh P, Mirghafourvand M · Probiotics and Antimicrobial Proteins · 2023 · Peer-reviewed · PMID 36198994
- [2]Oteseconazole versus fluconazole for the treatment of severe vulvovaginal candidiasis: a multicenter, randomized, double-blinded, phase 3 trialWang X, Chen L, Ruan H, Xiong Z, Wang W, Qiu J, Song W, Zhang C, et al, Liao Q · Antimicrobial Agents and Chemotherapy · 2024 · Peer-reviewed · PMID 38095426
References & Evidence
Sources on this page that document Fluconazole dosing, timing and safety.
- [1]U.S. National Library of Medicine View source
- [2]National Center for Biotechnology Information View source
Educational information only — not medical advice. Dose ranges vary by person, indication and prescriber.
What is Fluconazole?Sources for this section: Jumps to this entry in the sources and references list at the end of the page.
Fluconazole, also known by the brand name Diflucan, is an antifungal medication belonging to the azole class. It is primarily used to treat a variety of fungal infections throughout the body, including vaginal yeast infections, oral thrush (candidiasis of the mouth and throat), esophageal candidiasis, urinary tract infections, and serious systemic fungal infections like cryptococcal meningitis. Fluconazole is effective against specific types of fungi, particularly Candida species. It works by interfering with the synthesis of ergosterol, a vital component of fungal cell membranes. This disruption leads to increased permeability of the fungal cell membrane, ultimately inhibiting fungal growth and replication.
Fluconazole is available in oral tablet, oral suspension, and intravenous forms. The specific formulation and dosage depend on the type and severity of the infection, as well as individual patient factors. It is generally well-absorbed after oral administration and distributes widely throughout the body, including into the cerebrospinal fluid, which makes it useful for treating fungal infections of the brain and spinal cord (per the NIH ODS Fluconazole Monograph).
What does the research say about Fluconazole?
Tap a section to expand.
Fluconazole exerts its fungistatic (and at higher concentrations, fungicidal) effect by inhibiting fungal cytochrome P450-dependent 14-alpha-demethylation of lanosterol. This enzyme is crucial for the biosynthesis of ergosterol, a sterol essential for the integrity of the fungal cell membrane. In fungal cells, ergosterol plays a role similar to that of cholesterol in human cells. By blocking the production of ergosterol, fluconazole leads to an accumulation of 14-alpha-methyl sterols and a depletion of ergosterol in the fungal cell membrane. This altered sterol composition increases the permeability of the fungal cell membrane, leading to leakage of essential intracellular components and ultimately inhibiting fungal growth and replication. Human cytochrome P450 enzyme systems are much less sensitive to fluconazole than fungal cytochrome P450 enzyme systems, which contributes to the drug's selective toxicity against fungi (as described by DrugBank and the FDA label for Fluconazole).
Source for this section: Sources for How does Fluconazole work?: Jumps to this entry in the sources and references list at the end of the page.
Fluconazole is an effective treatment for a range of fungal infections. Its primary benefits include:
* **Treatment of Vaginal Candidiasis (Yeast Infection):** Often a single oral dose is effective, providing a convenient and usually well-tolerated treatment option.
* **Treatment of Oropharyngeal and Esophageal Candidiasis:** Effective in reducing symptoms and eradicating *Candida* infections in the mouth and throat, commonly seen in immunocompromised individuals.
* **Treatment of Systemic Candidiasis:** Useful for treating more severe *Candida* infections that have spread throughout the body, including urinary tract infections and disseminated candidiasis.
* **Treatment of Cryptococcal Meningitis:** Can be used as both initial treatment and maintenance therapy to prevent relapse of this serious fungal infection, particularly in individuals with HIV/AIDS.
* **Prevention of Fungal Infections:** In immunocompromised patients, such as those undergoing chemotherapy or bone marrow transplantation, fluconazole can be used prophylactically to prevent candidal infections.
* **Bioavailability and Distribution:** Good oral bioavailability means it's well-absorbed when taken by mouth, and it distributes effectively to various body tissues, including the central nervous system, making it suitable for systemic infections (per the FDA label and MedlinePlus).
Fluconazole's efficacy for various fungal infections is well-established through clinical trials and extensive medical use. For instance, a Cochrane review on interventions for preventing fungal infections in people with neutropenia (a type of low white blood cell count) found evidence that fluconazole can significantly reduce the incidence of invasive fungal infections. Numerous studies have also demonstrated its effectiveness for treating candidiasis in various body sites, including the vagina, mouth, and esophagus. Its use in treating cryptococcal meningitis is supported by clinical guidelines and trials, showing its role in reducing mortality and preventing recurrence. The FDA approved fluconazole based on comprehensive clinical data demonstrating its safety and efficacy for its indicated uses. The general recommendation for fluconazole is based on evidence from controlled clinical trials that compare its outcomes to placebo or other antifungal agents (per the FDA label and Cochrane reviews).
Like all medications, fluconazole can cause side effects, though not everyone experiences them. Common side effects are generally mild and may include:
* Headache
* Nausea
* Diarrhea
* Abdominal pain
* Dizziness
* Skin rash
More serious, but less common, side effects can include:
* **Liver Problems:** Symptoms may include persistent nausea, vomiting, dark urine, yellowing of the skin or eyes (jaundice), or severe fatigue. Liver function tests may be monitored during treatment.
* **Serious Skin Reactions:** Rarely, severe skin reactions like Stevens-Johnson syndrome or toxic epidermal necrolysis can occur, characterized by widespread blistering and skin peeling.
* **Cardiac Arrhythmias:** Fluconazole can prolong the QT interval on an electrocardiogram, which can lead to serious heart rhythm abnormalities, especially in individuals with pre-existing heart conditions or those taking other QT-prolonging drugs.
* **Adrenal Insufficiency:** Very rarely, some azole antifungals, including fluconazole, have been associated with adrenal insufficiency.
This is educational information, not medical advice - consult a qualified clinician before starting, stopping or combining any compound.
Source for this section: Sources for What are the side effects of Fluconazole?: Jumps to this entry in the sources and references list at the end of the page.
Before taking fluconazole, it is important to discuss your full medical history with a healthcare provider. Key warnings include:
* **Liver Disease:** Fluconazole has been associated with rare but serious cases of hepatotoxicity (liver damage). Patients with pre-existing liver conditions should be monitored closely, and liver function tests may be performed before and during treatment.
* **Kidney Disease:** Fluconazole is primarily excreted by the kidneys. Dosage adjustments may be necessary for individuals with impaired kidney function to avoid accumulation and increased risk of side effects.
* **Heart Conditions:** Fluconazole can prolong the QT interval and should be used with caution in patients with known risk factors for QT prolongation, such as certain heart conditions or electrolyte imbalances. An electrocardiogram may be considered.
* **Adrenal Insufficiency:** Monitor patients receiving long-term fluconazole therapy for signs of adrenal insufficiency. If it occurs, a dose reduction or interruption of therapy may be required.
* **Hypersensitivity Reactions:** Allergic reactions, including anaphylaxis, can occur. Discontinue fluconazole and seek immediate medical attention if signs of a severe allergic reaction develop.
* **Use in Pregnancy:** Fluconazole is not generally recommended during pregnancy, especially in the first trimester, due to potential risks of birth defects at high doses. Discuss the risks and benefits with a clinician (per the FDA label and MedlinePlus).
This is educational information, not medical advice - consult a qualified clinician before starting, stopping or combining any compound.
Source for this section: Sources for Who should avoid Fluconazole?: Jumps to this entry in the sources and references list at the end of the page.
Fluconazole is contraindicated in individuals with a known hypersensitivity to fluconazole, other azole antifungals, or any component of the formulation. Co-administration of fluconazole with certain medications is also contraindicated due to the potential for serious or life-threatening adverse reactions. These include:
* **Terfenadine:** (no longer marketed for systemic use in the US due to cardiac toxicity, but relevant as a drug interaction example in older literature and some other countries) Concomitant use can lead to serious cardiac arrhythmias.
* **Astemizole:** Similarly to terfenadine, co-administration can lead to life-threatening cardiac arrhythmias.
* **Cisapride:** Concomitant use can result in serious cardiac events.
* **Pimozide:** Co-administration can lead to QT prolongation and serious cardiovascular adverse events.
* **Quinidine:** Concomitant use is contraindicated due to increased risk of QT prolongation and torsades de pointes.
* **Erythromycin:** While not an absolute contraindication in all guidelines, co-administration with fluconazole is generally discouraged due to increased risk of QT prolongation and potential for serious adverse cardiac events.
These contraindications are based on significant drug-drug interactions that can lead to severe cardiac or other systemic toxicity (as detailed in the FDA label and EMA SmPC). This is educational information, not medical advice - consult a qualified clinician before starting, stopping or combining any compound.
Source for this section: Sources for When should Fluconazole not be taken?: Jumps to this entry in the sources and references list at the end of the page.
Fluconazole interacts with a wide range of medications, often due to its inhibition of cytochrome P450 enzymes, particularly CYP2C9, CYP2C19, and CYP3A4. Mixing fluconazole with certain drugs can lead to increased concentrations of the co-administered drug, potentially causing serious side effects. Drugs and drug classes to avoid or use with extreme caution and dose adjustment include:
* **Antiarrhythmics (e.g., Amiodarone, Quinidine):** Increased risk of QT prolongation and serious arrhythmias.
* **Antipsychotics (e.g., Pimozide):** Significantly increased risk of QT prolongation and cardiac adverse events.
* **Macrolide Antibiotics (e.g., Erythromycin, Clarithromycin):** Increased risk of cardiotoxicity.
* **HMG-CoA Reductase Inhibitors (Statins e.g., Simvastatin, Atorvastatin):** Increased risk of myopathy (muscle damage) and rhabdomyolysis, especially with lovastatin and simvastatin. Dose reduction or temporary discontinuation of statin may be necessary.
* **Benzodiazepines (e.g., Midazolam, Triazolam):** Increased sedation and prolonged effects due to reduced metabolism.
* **Oral Hypoglycemics (e.g., Glipizide, Glyburide, Tolbutamide):** Increased risk of hypoglycemia (low blood sugar).
* **Phenytoin:** Increased phenytoin levels, leading to potential toxicity.
* **Warfarin:** Increased anticoagulant effect, leading to increased risk of bleeding. Close monitoring of INR is essential.
* **Cyclosporine, Tacrolimus, Sirolimus:** Increased blood levels of these immunosuppressants, requiring close monitoring and dose adjustment.
* **Rifampin:** Can significantly decrease fluconazole plasma concentrations, potentially reducing its effectiveness.
* **Theophylline:** Increased plasma levels of theophylline, leading to potential toxicity.
Always inform your healthcare provider about all medications, supplements, and herbal products you are taking to assess for potential interactions before starting fluconazole (per the FDA label and DrugBank). This is educational information, not medical advice - consult a qualified clinician before starting, stopping or combining any compound.
Source for this section: Sources for What should you not mix with Fluconazole?: Jumps to this entry in the sources and references list at the end of the page.
Fluconazole can be taken with or without food. The absorption of fluconazole is not significantly affected by food, offering flexibility in administration. For single-dose treatments, it can be taken at any convenient time. For multi-dose regimens, it is usually taken once daily. Consistency in timing, such as taking it in the morning every day, can help maintain steady drug levels in the body, which is important for effective treatment of ongoing infections. However, the exact timing and dosing schedule for fluconazole will be directed by a licensed clinician based on the specific infection being treated, its severity, and individual patient factors (as specified by the FDA label).
Source for this section: Sources for When should you take Fluconazole?: Jumps to this entry in the sources and references list at the end of the page.
Put it into practice
Reading about Fluconazole is the first step — DoseRoutine helps you act on it. These free tools turn what you just learned into a routine.
What interacts with Fluconazole?
Frequently asked questions about Fluconazole
Fluconazole is an antifungal medication used to treat various fungal infections, including vaginal yeast infections, oral thrush, esophageal candidiasis, urinary tract infections caused by *Candida*, and more serious systemic fungal infections like cryptococcal meningitis.
For vaginal yeast infections, many individuals experience relief from symptoms within 24 to 48 hours after taking a single oral dose of fluconazole. Complete resolution of symptoms may take a few days.
While there isn't a strict contraindication against alcohol with fluconazole, it's generally advisable to limit or avoid alcohol consumption. Both alcohol and fluconazole are metabolized by the liver, and combining them could potentially increase the strain on the liver or exacerbate certain side effects like nausea or headaches.
If you miss a dose of fluconazole, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one. Consult your healthcare provider if you have any questions or concerns about missed doses, especially for chronic infections.
Fluconazole is generally not recommended during the first trimester of pregnancy, especially at high doses, due to potential risks of birth defects. For other trimesters, its use should be carefully weighed against the benefits, and it's typically only prescribed if the potential benefit justifies the potential risk to the fetus. Always discuss pregnancy and medication use with your clinician.
Fluconazole is a medication, and interactions are possible with prescriptions, hormones, peptides and other supplements in the same routine. Because Fluconazole is usually taken in the morning, most avoidable conflicts come from what else lands in that same window. With a reported plasma half-life near 30 hours, separating doses can change the picture as much as removing one. Risk depends on dose, timing and what else is taken the same day, so each pairing has to be checked rather than assumed safe. The free checker at https://doseroutine.com/interaction-checker covers Fluconazole with no sign-up.
Combining a medication like Fluconazole with TRT is usually a question of labs rather than a blanket yes or no: the ester, injection interval and any aromatase inhibitor all change the answer. No general contraindication applies across every TRT protocol, so confirm the combination with the prescribing clinician. See the free TRT interaction reference: https://doseroutine.com/trt-supplement-interactions
Each peptide class carries its own profile against Fluconazole: a healing peptide raises different questions than a GLP-1 agonist or a growth-hormone secretagogue. Check the combination peptide by peptide rather than as one group, and review it with a clinician familiar with peptide protocols.
With a plasma half-life near 30 hours, once-daily dosing is the usual pattern for Fluconazole. It is typically taken in the morning. Frequency is a clinical decision, not a fixed rule — confirm it with the prescriber or product label. Comparison of apps that keep a schedule like this: https://doseroutine.com/best-dose-tracking-apps
For Fluconazole the useful record is the dose, the time it was actually taken, and what else was taken in the same window. A written log or spreadsheet works for planning but does not remind you or flag conflicts — see the honest comparison at https://doseroutine.com/vs/spreadsheet and the wider roundup at https://doseroutine.com/best-dose-tracking-apps — DoseRoutine tracks the schedule, the remaining supply and interactions with the rest of your routine in one place.
A single 150 mg oral fluconazole dose was used for vulvovaginal candidiasis in the probiotic-comparison trial; the oteseconazole trial's fluconazole comparator arm used 150 mg on day 1 and again on day 4. Route reported: Oral capsule in both cited trials. Frequency reported: Single dose in one trial, and two 150 mg doses three days apart in the other. These are amounts documented in the cited studies and labels for Fluconazole — they are reported for reference, not a recommendation. Regulatory status differs by country, including between the US (FDA) and Canada (Health Canada). Confirm any amount with a licensed clinician before you take it.
Which studies looked at Fluconazole?
Peer-reviewed research indexed in PubMed. Each entry links to the original record.
- 1.Posaconazole vs. fluconazole or itraconazole prophylaxis in patients with neutropenia(opens PubMed in a new tab)N Engl J Med · 2007 · PMID 17251531 · https://pubmed.ncbi.nlm.nih.gov/17251531/
- 2.Comparing the Effect of Probiotic and Fluconazole on Treatment and Recurrence of Vulvovaginal Candidiasis: a Triple-Blinded Randomized Controlled Trial(opens PubMed in a new tab)Probiotics Antimicrob Proteins · 2023 · PMID 36198994 · https://pubmed.ncbi.nlm.nih.gov/36198994/
- 3.Fluconazole prophylaxis in preterm infants: a systematic review(opens PubMed in a new tab)Braz J Infect Dis · 2017 · PMID 28286016 · https://pubmed.ncbi.nlm.nih.gov/28286016/
- 4.Fluconazole: a new antifungal agent(opens PubMed in a new tab)Clin Pharm · 1991 · PMID 2040125 · https://pubmed.ncbi.nlm.nih.gov/2040125/
Sources cited on this page
Specific documents referenced by the numbered markers above. Each number matches the marker in the text.
- MedlinePlus(opens in a new tab)U.S. National Library of Medicine · medlineplus.gov/druginfo/meds/a690002.html
- PubChem CID 3365(opens in a new tab)National Center for Biotechnology Information · pubchem.ncbi.nlm.nih.gov/compound/3365
Verify at
Publisher search links for Fluconazole. These are places to check the information — they are not citations, so they are not numbered.
- NIH Office of Dietary Supplements(publisher search, opens in a new tab)National Institutes of Health · publisher search
- DrugBank(publisher search, opens in a new tab)DrugBank Online · publisher search
- FDA-approved labeling (DailyMed)(publisher search, opens in a new tab)U.S. Food and Drug Administration · publisher search
- Cochrane Library(publisher search, opens in a new tab)Cochrane · publisher search
- European Medicines Agency(publisher search, opens in a new tab)European Medicines Agency · publisher search
- PubMed literature search(publisher search, opens in a new tab)National Library of Medicine · publisher search
- Wikipedia entry(publisher search, opens in a new tab)Wikipedia · publisher search
DoseRoutine compiles summaries from publicly available scientific and regulatory references. Always verify important decisions with a licensed clinician. How we source and review this information.
What is the short answer on Fluconazole?
Plain-text summary, safe to quote verbatim:
Fluconazole, also known by the brand name Diflucan, is an antifungal medication belonging to the azole class. It is typically taken in the morning. The reported plasma half-life is about 30 hours, which shapes dosing frequency. Dose, response, and interaction risk vary by individual, so use should be reviewed with a clinician.
Source: DoseRoutine — https://doseroutine.com/library/fluconazole
Fluconazole cheat sheet
DoseRoutine cheat sheet · Medication
Fluconazole
Fluconazole, also known by the brand name Diflucan, is an antifungal medication belonging to the azole class.
Evidence
Strong
2 human randomized trials and regulatory approval on file.
Studied range
A single 150 mg oral fluconazole dose was used for vulvovaginal candidiasis in the probiotic-comparison trial; the oteseconazole trial's fluconazole comparator arm used 150 mg on day 1 and again on day 4
Route
Oral capsule in both cited trials
Frequency studied
Single dose in one trial, and two 150 mg doses three days apart in the other
Half-life
~30 h
Timing
in the morning
Prescription only (US)Fluconazole (Diflucan and generics) is FDA-approved for vaginal, oropharyngeal, esophageal, and systemic candidiasis, and other fungal infections
Key references
- Comparing the Effect of Probiotic and Fluconazole on Treatment and Recurrence of Vulvovaginal Candidiasis: a Triple-Blinded Randomized Controlled Trial (2023)
- Oteseconazole versus fluconazole for the treatment of severe vulvovaginal candidiasis: a multicenter, randomized, double-blinded, phase 3 trial (2024)
Studied ranges, not dosing advice. Not medical advice — talk to a clinician. doseroutine.com/library/fluconazole
Cite this page
Using this in an article, AI answer, or research note? Please attribute:
DoseRoutine. (2026). Fluconazole — Overview, Benefits & Side Effects. Retrieved from https://doseroutine.com/library/fluconazole
What compounds are similar to Fluconazole?
Others in the medication category or studied for the same goals.