Spectrum of Activity

General Information


  • High dose (≥ 400 mg/day):

    • May be associated with congenital malformations with first trimester use (resembling Antley Bixler syndrome)
    • May be associated with an increased risk of miscarriage
  • Low dose (150 - 300 mg/day, short course): (including those used for vaginal yeast infections)

    • Likely not associated with congenital malformations
    • May be associated with an increased risk of miscarriage
  • Does not appear to be associated with stillbirth at any dose

Recommended not to use oral fluconazole to treat vaginal yeast infections in pregnancy. First line therapy in pregnancy is 7 days topical antifungal agents (ie. clotrimazole, miconazole)


  • Fluconazole transfers into breastmilk.
  • The relative infant dose (RID) is reported as 16-22%.
  • Based on limited data, no adverse effects have been reported in breastfeeding infants.
  • Fluconazole is used at therapeutic doses to treat invasive Candida infections in neonates.
  • Candida infections both mucocutaneous and invasive - i.e. Candidemia
  • Cryptococcus and Coccidioides infections
  • Antifungal prophylaxis in immunocompromised
  • Consider QTc monitoring in patients at increased risk.
  • Liver function tests, check baseline and one week after starting treatment.
  • Multiple drug interactions possible, consult pharmacy.
  • QTc prolongation
  • Hepatic enzyme abnormalities, hepatitis
  • Rash
  • Alopecia
  • GI upset
  • Multiple drug interactions possible. Inhibits CYP2C19 (strong), CYP2C9 (moderate), CYP3A4 (moderate).
  • Inhibits metabolism of phenytoin (increase phenytoin plasma levels) and careful monitoring of phenytoin serum concentrations is required.
  • Inhibits metabolism of zidovudine (ZDV). Monitor patients closely for adverse effects of ZDV.
  • Inhibits metabolism of cisapride (contraindicated in patients receiving cisapride).

Antimicrobial class: Triazole antifungal, decreases ergosterol synthesis