Everything You Need To Know About Fluconazole

Fluconazole is an antifungal medication used to treat a variety of fungal infections. It belongs to a class of drugs known as azole antifungals and works by inhibiting the growth of fungi. [1]

Fluconazole is commonly prescribed to treat infections caused by Candida species, including vaginal yeast infections, oral thrush (a yeast infection of the mouth and throat), esophageal candidiasis (a yeast infection of the esophagus), and invasive candidiasis (systemic fungal infection). [2]

Additionally, fluconazole may be used to prevent fungal infections in people with weakened immune systems, such as those undergoing chemotherapy, organ transplant recipients, or patients with HIV/AIDS.

Fluconazole is available in various forms, including oral tablets, oral suspension, and intravenous (IV) injection. The dosage and duration of treatment depend on the type and severity of the infection being treated, as well as other individual factors such as overall health and medical history.

As with any medication, fluconazole may cause side effects in some people. This medication is also associated with a few contraindications, precautions, and drug interactions.

This article discusses the common side effects, contraindications, precautions, and drug interactions of fluconazole to help you make informed decisions. We will also discuss natural alternatives including herbal remedies for managing fungal infections and the most effective strategies to prevent these conditions.

What are the common side effects associated with fluconazole?

While most patients do tolerate fluconazole well, some may experience mild to severe side effects.

Here are some common side effects associated with fluconazole: [3] [4]

  • Nausea and vomiting
  • Headache
  • Diarrhea
  • Abdominal pain
  • Dizziness
  • Rash
  • Liver problems
  • Changes in taste
  • Hair loss
  • Allergic reactions

If you experience any signs of an allergic reaction or severe adverse effects, seek medical attention immediately. You can also try alternative treatments to manage the infection, especially if the symptoms are recurring in nature and when the underlying condition needs to be tackled for improving recovery and reducing the risk of a relapse.

What are the contraindications for fluconazole?

Contraindications refer to situations where the use of fluconazole is not recommended due to potential risks. Fluconazole is generally considered safe and effective for most patients, but there are certain contraindications and precautions to consider before using this medication.

Here are some contraindications for fluconazole:

  • Hypersensitivity: Patients who have a known hypersensitivity or allergy to fluconazole or other azole antifungal medications should not use fluconazole. [5]
  • Hypokalemia: Fluconazole should be used with caution in patients with hypokalemia (low potassium levels), as it may exacerbate this condition.
  • Hepatic impairment: Fluconazole is metabolized in the liver, so caution is advised in patients with pre-existing hepatic impairment or liver disease. Dosage adjustments may be necessary in these cases. [6]
  • Pregnancy and lactation: While fluconazole is generally considered safe for use during pregnancy and lactation, high doses have been associated with a rare but serious birth defect known as congenital cardiac defects. Therefore, caution is advised, especially during the first trimester of pregnancy. [7]
  • Pediatric use: Fluconazole is generally safe for use in children, but dosing adjustments may be necessary based on the child’s age, weight, and medical condition. It should be used with caution in infants and neonates.
  • Elderly: Although fluconazole is generally well-tolerated in elderly patients, caution should be exercised, especially in those with impaired renal function or other comorbidities.

If there are concerns about potential contraindications or interactions, alternative treatment options may be considered.

Precautions to be taken while using fluconazole

  • Before starting fluconazole, inform your healthcare provider about any pre-existing medical conditions you have, including allergies, liver or kidney problems, heart conditions, and pregnancy or breastfeeding status.
  • Take fluconazole exactly as prescribed by your healthcare provider. Do not exceed the recommended dose or duration of treatment unless instructed to do so by your doctor.
  • Complete the full course of fluconazole treatment, even if your symptoms improve before the medication is finished. Stopping treatment prematurely may result in incomplete eradication of the infection and increase the risk of recurrence. It may also result in the development of resistance to the medication, making it less effective.
  • Avoid consuming alcohol while taking fluconazole, as it may increase the risk of side effects such as liver toxicity and dizziness.
  • High doses of fluconazole may pose a risk of birth defects, particularly in the first trimester. Hence, if you are pregnant, planning to become pregnant, or breastfeeding, discuss the potential risks with your healthcare provider.
  • Fluconazole may increase sensitivity to sunlight, leading to sunburn or skin rash. Take precautions to protect your skin from sun exposure, such as wearing sunscreen, and protective clothing, and avoiding prolonged exposure to sunlight or tanning beds. [8]

Fluconazole and drug interactions

Fluconazole can interact with several medications, potentially leading to adverse effects or reducing the effectiveness of either medication.

Here are some common drug interactions associated with fluconazole:

  • Blood thinners (Warfarin): Fluconazole can increase the effects of blood thinners, leading to an increased risk of bleeding. Monitoring of clotting times may be necessary, and dosage adjustments of warfarin may be required. [9]
  • Anticonvulsants (Phenytoin, Carbamazepine): Fluconazole can increase the blood levels of certain anticonvulsants, potentially leading to toxicity. [10]
  • Antidiabetic medications (Glyburide, Glipizide): Fluconazole can potentiate the effects of antidiabetic medications, leading to hypoglycemia (low blood sugar). Monitoring of blood glucose levels may be required.
  • Calcium channel blockers (Amlodipine, Diltiazem): Fluconazole can increase the blood levels of calcium channel blockers, leading to enhanced effects and toxicity. [11]
  • Certain antidepressants (SSRIs, SNRIs): Fluconazole can increase the blood levels of certain antidepressants, potentiating their effects.
  • Cyclosporine: Fluconazole can increase the blood levels of cyclosporine, leading to immunosuppressive effects.
  • Tacrolimus: Fluconazole can increase the blood levels of tacrolimus, leading to enhanced immunosuppressive effects and potential toxicity. Monitoring of tacrolimus levels may be necessary.
  • Statins (Lovastatin, Simvastatin): Fluconazole can increase the blood levels of certain statins. Monitoring of liver function may be necessary. [12]
  • Other antifungal medications: Concurrent use of fluconazole with other antifungal medications may increase the risk of adverse effects or reduce the effectiveness of treatment.

If you are using any of these drugs, you might need to choose alternative medication to avoid serious drug interactions.

Natural and safer alternatives to fluconazole

There are several natural and safer alternatives to fluconazole for managing fungal infections. These alternatives may be particularly suitable for patients who are looking to avoid potential side effects associated with fluconazole or those who can’t use this drug due to the contraindication factors.

Clove and Garlic

These herbs have been found to be highly effective in reducing bacterial and fungal overload in the body by improving immune system response and lowering inflammation. [13]

Garlic has natural antifungal properties due to its active compound allicin. Consuming raw garlic or using garlic supplements may help inhibit the growth of Candida and other fungi. [14]

Grapefruit Seed Extract

Studies have revealed that this herb can produce a natural antibacterial and antifungal effect and also act as a powerful antioxidant. It has also shown promising results in the management of H. Pylori infection. [15]

Pau d’arco

Pau d’arco can act as a natural anti-inflammatory agent and a detoxifier. It can strengthen your digestive functions while improving your body’s efficiency in fighting candida yeast infection by producing a natural antifungal effect. [16]

Moreover, the antifungal efficacy of this herb has been proven by numerous studies. These studies have established that the use of this herb could be highly effective in the management of systemic and local fungal infections.


Berberine has been shown to stop the growth of a broad range of harmful species of fungi and bacteria.

Berberine is revered as one of the most potent natural antimicrobial agents. It is a natural antifungal and antibacterial agent having a broad-spectrum application. It can not just weaken candida but also work effectively against some of the most harmful bacteria known to cause serious symptoms such as E coli, entamoeba histolytica, tric1homonas vaginalis, staph aureus giardia, leishmania donovani.

Notably, Berberine is also found to reverse multidrug resistance associated with Candida albicans, suggesting its safety and effectiveness even in patients who have developed resistance to the commonly used antifungal drugs. [17]

Coconut Oil

Coconut oil contains caprylic acid, a natural antifungal compound that can help combat Candida overgrowth. Consuming coconut oil or applying it topically to affected areas may help reduce fungal infections. Additionally, coconut oil may support overall immune function. [18]

Tea Tree Oil

Tea tree oil has powerful antifungal properties and is commonly used to treat fungal infections, including Candida. Diluted tea tree oil can be applied topically to affected areas, such as the skin or nails, to help alleviate fungal symptoms. [19]


Oregano contains compounds such as carvacrol and thymol, which have potent antifungal properties. Taking oregano supplements or using diluted oregano oil topically may help combat Candida infections and other fungal conditions. [20]


Neem can produce a powerful antifungal and antibacterial effect that is comparable to commonly used drugs. However, unlike antibiotics, this herb offers a higher safety as it does not cause antimicrobial resistance or any serious side effects. [21]

Neem has also shown immense potential in the management of infections like MRSA (Methicillin-resistant Staphylococcus aureus) biofilm and S. mansoni worms that are resistant to commonly used medications.

It can also act as natural antioxidants and anti-inflammatory agents thus supporting your recovery.

Black Walnut

Black walnuts have been shown to produce promising results in the management of fungal infections affecting the skin, oral cavity, and vagina while producing an antioxidant and anti-inflammatory effect. This can ease your recovery phase and help you avoid symptoms like itching, burning, and irritation. [22]

Probiotic-rich foods

Incorporating probiotic-rich foods such as yogurt, kefir, sauerkraut, and kimchi into your diet could help restore the balance of beneficial bacteria in the gut and inhibit the growth of Candida, even in immunocompromised people. These foods contain strains of beneficial bacteria that can support digestive health and immune function. [23]

A number of studies have provided evidence linking the use of these herbs to the effective management of candida infection. These herbs have also shown immense potential in improving immune systemic functions, enhancing gut microbiota, and improving heart health.

Prevention of Candida

Prevention of candida involves adopting various strategies to minimize the risk of fungal overgrowth.

Here are some key preventive measures:

Diet Modification

  • Adopt a balanced diet rich in whole foods, fruits, vegetables, lean proteins, and whole grains to support immune function and overall health.
  • Limit your consumption of sugary and processed foods, as excess sugar can promote yeast overgrowth.
  • Consider incorporating probiotic-rich foods such as yogurt, kefir, and fermented vegetables into your diet to support a healthy balance of gut bacteria.

Good Hygiene Practices

  • Maintain proper hygiene, especially in areas prone to moisture, such as the genital area, armpits, and skin folds.
  • Keep the skin clean and dry, especially after bathing or sweating, to prevent fungal growth.
  • Change damp or sweaty clothes promptly.
  • Practice good oral hygiene by brushing and flossing teeth regularly to prevent oral thrush.
  • Use clean and dry towels, especially for areas susceptible to fungal infections.

Avoiding Unnecessary Antibiotics

Antibiotics can disrupt the balance of beneficial bacteria in the body, increasing the risk of fungal overgrowth. Hence, use antibiotics only when necessary and as directed by a healthcare provider. [24]

Managing Underlying Health Conditions

Properly manage underlying health conditions such as diabetes, nutritional deficiencies, poor gut microbiome, leaky gut, HIV/AIDS, and autoimmune disorders, which can weaken the immune system and increase susceptibility to candidiasis.

Consider using supplements

You can consider using supplements that provide a rich source of probiotics, digestive enzymes, and natural antifungal herbs to get faster and better results. The use of supplements is specifically beneficial for people who suffer from severe or recurrent candida symptoms, have weak immunity or gut dysbiosis, or cannot safely use fluconazole or other antifungal drugs. [25]


Fluconazole is a commonly used antifungal drug for the management of candidiasis. However, using natural antifungals over fluconazole offers several potential benefits in most cases.

Natural antifungals such as herbs, spices, and essential oils often have fewer side effects and hence, can be particularly beneficial for patients who are sensitive to fluconazole. In addition, natural antifungals are less likely to interact with other medications compared to fluconazole. This can be advantageous for patients who are taking multiple medications and want to avoid potential interactions.

There is also some evidence to suggest that certain fungi may develop resistance to pharmaceutical antifungal drugs over time. By using natural antifungals, it may be possible to reduce the risk of fungal resistance and maintain their effectiveness.


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