Fluconazole I.V. Injection

• Type: Antifungal medication

• Drug Class: Triazole antifungal

• Form: Sterile solution for intravenous (IV) infusion

How It Works

• Fluconazole works by inhibiting the fungal enzyme lanosterol 14-α-demethylase, an essential step in ergosterol synthesis.

• Ergosterol is a critical component of fungal cell membranes. Blocking its production causes membrane disruption, leading to fungal cell death or inhibition of growth.

Common Uses

Fluconazole IV is used when oral therapy is not possible or for severe systemic fungal infections:

• Candidemia (Candida bloodstream infections)

• Disseminated candidiasis (spread to organs)

• Cryptococcal meningitis (including HIV-related cases)

• Oropharyngeal and esophageal candidiasis (severe or refractory cases)

• Fungal prophylaxis in immunocompromised patients (bone marrow transplant, chemotherapy)

Advantages

• Good penetration into cerebrospinal fluid (CSF) → effective for fungal meningitis

• Less hepatotoxic than some older antifungals (like ketoconazole)

• Can be switched to oral fluconazole once patient improves

• Convenient once-daily dosing

Possible Side Effects

Common:

• Nausea, vomiting

• Headache

• Rash

Less Common but Serious:

• Elevated liver enzymes or hepatitis

• QT prolongation (risk of arrhythmias)

• Severe allergic reactions (rare)

• Drug interactions (it inhibits certain liver enzymes, affecting metabolism of other drugs)

Precautions

• Monitor liver function tests during prolonged therapy

• Dose adjustment required in renal impairment (fluconazole is mainly excreted by kidneys)

• Avoid using with certain drugs that may cause dangerous interactions (like some antiarrhythmics, warfarin, phenytoin)

• Use with caution in pregnancy (benefit vs risk must be assessed)