Pregnancy:

• 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)

Breastfeeding:

• 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.