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Some azole drugs may disrupt estrogen production in pregnancy, affecting pregnancy outcome. [26] Oral fluconazole is not associated with a significantly increased risk of birth defects overall, although it does increase the odds ratio of tetralogy of Fallot, but the absolute risk is still low. [27] Women using fluconazole during pregnancy have ...
Short-course topical formulations (i.e., single dose and regimens of 1–3 days) effectively treat uncomplicated candidal vulvovaginitis. The topically applied azole drugs are more effective than nystatin. Treatment with azoles results in relief of symptoms and negative cultures in 80–90% of patients who complete therapy. [4]
In pregnancy, use on the skin or in the vagina is believed to be safe. [2] There is no evidence of harm when used by mouth during pregnancy but this has been less well studied. [2] When used by mouth, greater care should be taken in those with liver problems. [2] It is in the azole class of medications and works by disrupting the fungal cell ...
Oral ketoconazole has various contraindications, such as concomitant use with certain other drugs due to known drug interactions. [6] Other contraindications of oral ketoconazole include liver disease , adrenal insufficiency , and known hypersensitivity to oral ketoconazole.
The search for antifungal agents with acceptable toxicity profiles led first to the discovery of ketoconazole, the first azole-based oral treatment of systemic fungal infections, in the early 1980s. Later, triazoles fluconazole and itraconazole , with a broader spectrum of antifungal activity and improved safety profile were developed.
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For example, the azole antifungals such as ketoconazole or itraconazole can be both substrates and inhibitors of the P-glycoprotein, which (among other functions) excretes toxins and drugs into the intestines. [34] Azole antifungals are also both substrates and inhibitors of the cytochrome P450 family CYP3A4, [34] causing increased ...