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Common side effects include vomiting, diarrhea, rash, and increased liver enzymes. [5] Serious side effects may include liver problems, QT prolongation, and seizures. [5] During pregnancy it may increase the risk of miscarriage while large doses may cause birth defects. [6] [5] Fluconazole is in the azole antifungal family of medication. [5]
For patients who cannot tolerate oral medication, IV fluconazole can be used alternatively. [3] Other oral triazoles, such as itraconazole and voriconazole can be other options. [3] Amphotericin B can be used in nonresponsive cases, but should not be used routinely due to its serious side effects. [3]
Systemic therapy with oral antifungals including itraconazole, fluconazole, ketoconazole is effective, but adverse side effects have been documented for fluconazole and ketoconazole, with the latter not recommended for use, while itraconazole, with its good safety profile, is the most commonly prescribed. [3]
The side effects of oral treatment are significant and people without an infection should not take these drugs. [36] Azoles are the group of antifungals which act on the cell membrane of fungi. They inhibit the enzyme 14-alpha-sterol demethylase, a microsomal CYP, which is required for the biosynthesis of ergosterol for the cytoplasmic membrane.
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Itraconazole is a relatively well-tolerated drug (although not as well tolerated as fluconazole or voriconazole) and the range of adverse effects it produces is similar to the other azole antifungals: [22] elevated alanine aminotransferase levels are found in 4% of people taking itraconazole
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