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Diflucan (fluconazole)

MagazineJanuary 1995 (Vol. 5 Issue 10)Diflucan (fluconazole)

Diflucan (fluconazole) was sold to doctors as the "elegant" way to deal with vaginal thrush (yeast infections)

Diflucan (fluconazole) was sold to doctors as the "elegant" way to deal with vaginal thrush (yeast infections). A single 150 mg pill would rid their patients of this common annoyance, without the messiness, leakage and vaginal irritation of the usua

This assurance of safety has caused many doctors to use Diflucan for early treatment of systemic candida, particularly patients who are immunosuppressed or receiving chemotherapy drugs. Because they can be given orally as systemic drugs (unlike nystatin and amphotericin B, which are highly toxic if they pass through your liver, rather than simply your gut, as they are mostly taken) fluconazole (and the other "azoles" ketoconazole and itraconazole) are now the drugs of choice for systemic candida infections.

However, some studies have shown that the urinary tract infections or candida can develop resistance to fluconazole, particularly in those receiving oral steroids (The Lancet, 30 March, 19 January and 29 June 1991), or cause other candida species, such as candida krusei, to overgrow (The N E J of Med, 31 October 1991).

As for side effects, studies have shown it can cause rash, the skin disorder Steven Johnson syndrome, nausea andvomiting, elevation in blood levels, headache,seizure and, rarely, hepatitis. Because of the potential for Stevens-Johnson system, even in patients given a short course of the 150 mg daily pill, doctors from Bronovo Hopsital in the Hague, Netherlands, cautioned: "Webelieve that fluconazole should be used with caution for conditions that can also be treated with topical non absorbable antifungal drugs" (The Lancet, 13 July 1991).

It is also known to interact with drugs for hypoglycemia, steroids, carbamazepine, phenobarbital, the thiazide diuretics and cyclosporine.

Victimisation of the female patient

Caveman meddling

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