- Fluconazole - used with caution
- Side effects
In general, fluconazole was well tolerated - both at intravenous and oral administration. In some cases, while taking the drug were marked changes in the kidneys and liver - mostly in patients with serious underlying diseases such as AIDS and cancer. The clinical significance of these changes and their relationship with the administration of fluconazole is unclear.
In clinical trials, side effects were observed in 26% of patients treated during the course of treatment a single dose of fluconazole. Among patients treated with similar properties drugs, side effects have been observed in 16% of cases. The most common side effects in patients who received a single dose of fluconazole (150 mg) for the treatment of vaginal infections, were headache, nausea and abdominal pain. Most adverse events were mild or moderate.
Those or other side effects appeared in 16% of patients treated with a single dose of fluconazole. Side effects were more common in HIV-positive patients than in persons not infected with HIV (21% and 13%, respectively). At the same time, the nature of adverse effects in both patient groups was virtually identical.
From the nervous system
In rare cases, patients taking fluconazole, started cramping, although a direct link between the drug and this side effect was not possible. Nevertheless, it should be borne in mind that the cramps are possible upon receiving at least 100 mg of fluconazole. Other side effects of the nervous system - dizziness, headaches (observed in about 13% of cases), paraesthesia, insomnia, somnolence, tremor.
Side effects from the gastrointestinal tract
Among the side effects from the gastrointestinal tract in patients receiving fluconazole observed nausea (approximately 7% of patients), abdominal pain
Abdominal pain: Types and Symptoms
(6%), diarrhea (3%), vomiting (1.7%), dyspepsia (1%), taste disturbances (1%), loss of appetite, and general abdominal discomfort.
Side effects from the liver
Side effects from this category include such disorders as hepatitis
Hepatitis - the scourge of our time
, Cholestasis and hepatic insufficiency, which can sometimes lead to the death of the patient. Also, there have been cases of liver necrosis. Disorders of the liver with a fatal outcome have been observed very rarely, and were awarded, in large part, in patients with AIDS or cancer. Typically, these patients take several medicines simultaneously, and you can not say with certainty whether the development of serious complications is connected with taking fluconazole. A case where a patient with AIDS, about three weeks after you start taking fluconazole developed acute hepatic necrosis.
Increased transaminase levels was also noted in patients with serious illnesses to be taken during the course of treatment in addition to fluconazole and other drugs - mostly, hepatotoxicity.
In patients without severe underlying diseases observed temporary malfunction of the liver. In all of these cases, liver function returned to normal soon after the patients stopped taking fluconazole.
Dermatologic side effects
The most common dermatologic side effects are skin rash fluconazole (occurs in approximately 1.8% of patients taking this medication) and hair loss, which stops after the end of treatment. In some cases, also develops exanthematous pustulosis and begins a more intensive sweating.
Hair loss is most common in people who take fluconazole for two months or more.
In patients with severe disease, while taking the drug may develop serious violations affecting the skin; In very rare cases, as a rule, combined with the effects of other factors, they lead to the death of the patient.
In clinical trials in pyatidesyatidvuhletney subjects receiving a single dose of fluconazole (400 mg) was awarded a fixed dosage erythema. Within 12 hours after taking the drug in her body, there are three oval, painful spots, each with a diameter of 3-4 cm. The diagnosis was confirmed when the patient was given another 25 mg of the drug. Fixed erythema dosage - just one example of how can be shown hypersensitivity to the drug.
In rare cases, significantly more patients with hypersensitivity can develop side effects such as anaphylactic shock and angioedema. Furthermore, exfoliative dermatitis may develop and significant lowering of blood pressure.
Side effects from the cardiovascular system
In most cases, the side effects of this category while taking fluconazole occur in patients who have additional risk factors, such as structural heart disease and electrolyte disturbance. Many of them also take drugs that may contribute to the problems associated with the work of the cardiovascular system. The most common side effects with the cardiovascular system are the heart palpitations and prolongation of the interval QT.
Hematologic side effects
There are cases when while taking fluconazole patients developed anemia, eosinophilia, leukopenia, neutropenia
Neutropenia - immunity under attack
and thrombocytopenia. Typically, these patients had severe fungal infections or other serious illnesses.
Spontaneous development of anemia is most common in patients over the age of 65 years, but in normal elderly anemia occurs much more frequently than people younger than 65 years. It is unclear whether there is a direct link between the development of anemia and taking fluconazole.
Side effects in the kidneys
In pyatidesyativosmiletney women participating in clinical trials, which had a history of hypertension and cervical cancer
Cervical cancer: possible cure
, While taking fluconazole developed membrane nephropathy. The patient was observed generalized edema, nausea, and indigestion; These symptoms persisted for three weeks. In addition she received fluconazole amlodipine, hydrochlorothiazide, and metoclopramide levosulpirid. After the patient stopped taking fluconazole remission.
Cases of acute renal failure have been reported among the most commonly treated with fluconazole in patients older than 65 years. However, this is a violation of generally more common in older people, so we can not say with certainty that it is associated with taking fluconazole.
Metabolic side effects
Among the metabolic side effects of fluconazole were marked hypercholesterolemia, hypertriglyceridemia, and hypokalemia.
Side effects from the musculoskeletal system
Some patients taking fluconazole, complained of back pain and joint pain and stiffness in the joints of the fingers. Several less while taking fluconazole observed muscle pain. Association between the drug and the appearance of such side effects have not yet been established.
Other side effects
In addition to these side effects, fluconazole can cause fever, weakness, malaise, asthenia.
Seek immediate medical help if you have any following signs of allergic reaction to fluconazole: extensive skin rash, shortness of breath, swelling of the face, tongue, lips, throat swelling. As soon as possible to consult with your doctor if fluconazole caused symptoms such as loss of appetite, jaundice (yellowish skin and whites of the eyes), the symptoms are similar to flu symptoms, and seizures.