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.
Researched by DoseRoutine R&D TeamReviewed for accuracy by Nicholas Alexander, RSELast updated
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
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
How to track Fluconazole doses
Tracking Fluconazole well takes four fields and a habit. Here is what to record so the log is still useful in three months.
- 1
Add the dose and unit
Log Fluconazole with its dose in mg so totals stay comparable over time — including days when you split the dose or skip it.
- 2
Set the time of day and food rule
Typical timing is morning. Reminders fire at that time and can export to your calendar.
- 3
Check it against the rest of the stack
Run Fluconazole through the interaction checker against everything else in the routine — supplements, peptides, hormones and prescriptions — before it becomes a daily habit.
- 4
Log adherence, not intentions
Mark each dose taken, skipped or delayed as it happens. Weeks of honest logs are what make an adherence rate or a trend line meaningful; retrospective guessing is not.
- 5
Review against outcomes
With a reported half-life around 30 h, effects and timing shifts show up over days rather than instantly. Review Fluconazole alongside your logged metrics and any relevant blood work every few weeks before changing the dose.
What to log each time
- Dose in mg
- Time of day
- Taken / skipped / delayed
- Any side effects or notable changes
References & Evidence
Sources on this page that document Fluconazole dosing, timing and safety.
- [1]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.
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.
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.
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.
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.
What interacts with Fluconazole?
| Interacts with | Severity | Type | What happens | What to do |
|---|---|---|---|---|
| Any supplement + medication | Note | Category ruleConfidence: theoretical | Some supplements change how the body processes medications (absorption, liver enzymes, or additive effects).Source pending | Specific pairs are checked against a licensed drug database and shown with their own severity. Always confirm with your provider or pharmacist. |
| Any vitamin + medication | Note | Category ruleConfidence: theoretical | Certain vitamins interact with specific medications (e.g., vitamin K with blood thinners).Source pending | Specific pairs are checked against a licensed source; confirm with your provider. |
Frequently asked questions about Fluconazole
Fluconazole is a medication. It is also known as Diflucan. What follows is drawn from peer-reviewed literature indexed on PubMed, FDA label text where a label exists, and NIH reference records.
Fluconazole is commonly discussed in the context of the goals discussed on its profile page. Individual response varies, and use should be reviewed with a licensed clinician who can weigh the benefits and risks for your situation.
For Fluconazole, it is typically taken in the morning and its approximate half-life is 30 hours, which influences dosing frequency. Always follow the specific dose your clinician or the product label prescribes.
Fluconazole carries potential side effects and drug interactions, documented in NIH, Mayo Clinic, and FDA label sources. Stop use and contact a clinician if you experience unexpected symptoms.
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
With a plasma half-life near 30 hours, a single missed dose of Fluconazole usually has a smaller effect on overall exposure than an irregular pattern of missed doses does. Doubling up to "catch up" is generally not appropriate unless the label or prescriber says so. Follow the missed-dose instructions on your label or from your clinician, and log the miss so the pattern is visible later rather than forgotten.
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.
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.
- 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.
- MedlinePlus(publisher search, opens in a new tab)U.S. National Library of Medicine · publisher search
- 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
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.