Fluconazole — NZ Medication Guide
📋 Reviewed by a Registered Pharmacist NZ — This information is for general educational purposes only and does not replace professional medical advice. Always consult your doctor or pharmacist before starting, stopping, or changing any medication.
What is Fluconazole?
Fluconazole is a triazole antifungal used for treatment and prevention of fungal infections including oral and vaginal thrush. This medication is funded by Pharmac for systemic fungal infections; 150 mg single-dose available over-the-counter for vaginal thrush.
What is Fluconazole Used For?
Fluconazole is used for vaginal candidiasis (vaginal thrush — single oral dose), oropharyngeal candidiasis (oral thrush), oesophageal candidiasis, cryptococcal meningitis (in immunocompromised patients), and prevention of fungal infections in immunocompromised patients.
How Does Fluconazole Work?
Fluconazole inhibits the fungal enzyme lanosterol 14-alpha-demethylase (a CYP51 enzyme), blocking the synthesis of ergosterol — a critical component of the fungal cell membrane. This disrupts membrane integrity and kills or inhibits fungal growth. Fluconazole is highly specific for fungal CYP51 with minimal effects on human CYP enzymes (though significant CYP3A4 and CYP2C9 inhibition occurs).
How to Take Fluconazole
For vaginal thrush: single oral dose of 150 mg. For oral thrush: 50–100 mg/day for 7–14 days. For cryptococcal meningitis (hospital): 400–800 mg/day. Can be taken with or without food.
Common Side Effects of Fluconazole
- Nausea
- Headache
- Rash
- Abdominal pain
- Diarrhoea
Serious Side Effects — Seek Medical Attention
Contact your doctor or call 111 immediately if you experience any of the following:
- Serious drug interactions — QT prolongation and torsades de pointes when combined with QT-prolonging medicines
- Hepatotoxicity (rare — with prolonged high-dose use)
- Severe skin reactions (Stevens-Johnson syndrome — rare)
- Anaphylaxis (rare)
Drug Interactions
Fluconazole may interact with other medicines. Always inform your doctor and pharmacist of all medications you are taking. Key interactions include:
- Warfarin (fluconazole significantly increases warfarin levels — serious bleeding risk)
- Tacrolimus, ciclosporin (increased immunosuppressant levels)
- Statins (increased statin levels — myopathy risk — particularly simvastatin)
- Midazolam and other benzodiazepines (increased sedation)
- QT-prolonging medicines (haloperidol, quinidine — increased cardiac risk)
- Oral antidiabetics (increased hypoglycaemia)
New Zealand Prescribing Information
Fluconazole (50 mg, 150 mg, 200 mg capsules; 200 mg/100 mL infusion) is funded by Pharmac for systemic fungal infections. A single 150 mg capsule for vaginal thrush is available over-the-counter at NZ pharmacies without a prescription (Canesten Oral®, Diflucan® One). Because of its significant drug interactions — particularly with warfarin — always inform your pharmacist of all medicines before taking fluconazole.
Frequently Asked Questions
Can I take the single-dose thrush tablet with my other medicines?
Fluconazole has many significant interactions — particularly with warfarin (serious bleeding risk), some statins, and several other medicines. Always inform your pharmacist of all medicines you take before purchasing or taking fluconazole, even the single over-the-counter dose.
Will one fluconazole tablet cure vaginal thrush?
For uncomplicated vaginal candidiasis, a single 150 mg oral dose is effective in approximately 90% of cases. If symptoms do not resolve within 7 days or recur frequently, consult your doctor for further assessment and treatment.
⚠️ Disclaimer: This page is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified health provider. In New Zealand, medication availability and funding may vary — check with Pharmac or your pharmacist for current information.
Reviewed by a Registered Pharmacist NZ
References & Further Information
The following New Zealand and international resources were used to inform this page: