Vaginal yeast infections are particularly common and uncomfortable. They often occur more commonly when people are taking antibiotics or hormonal contraceptives, are pregnant, or in individuals with certain underlying conditions such as diabetes. Most vaginal yeast infections happen when Candida, a type of fungus that naturally lives on the skin and inside the body, grows too much. While anyone can develop a yeast infection, certain factors can increase the risk such as having a weakened or altered immune system, taking medications such as antibiotics, steroids, or cancer treatments, or having certain underlying health conditions like diabetes, cancer, or HIV/AIDS.

The most common symptoms of a vaginal yeast infection include:

• severe itching, burning, soreness, and pain in and around the vagina
• symptoms that may feel worse during sex or when you urinate
• redness, swelling, and small cracks in the skin near the vagina
• a thick, white discharge that doesn’t have a strong smell

While these are typical signs of a yeast infection, they can also be caused by other health problems. That’s why it’s important to seek medical care to find out what’s really going on and what to do next.

Yes, a prescription is required to get fluconazole. It is not available over the counter.

Fluconazole is an antifungal medication that works by stopping fungus (yeast) from growing. It can be used to treat multiple fungal infections, including yeast infections. Your healthcare provider can determine if fluconazole is appropriate for you.

Fluconazole (Diflucan)

Contraindications:

• Hypersensitivity to fluconazole or to any of its components.
• People with hypersensitivity to other azole antifungal medications should use caution when taking fluconazole.
• Fluconazole should not be taken along with other drugs that are known to prolong the QT interval and are metabolized via the enzyme CYP3A4 such as erythromycin, pimozide, and quinidine.

Warnings and Precautions:

• Before you take any new medication, you should tell your healthcare provider about any medications you are currently taking, including any supplements or over-the-counter medications.
  Tell your healthcare provider if you take any of the following medications, as they may interact with fluconazole and cause adverse effects: abrocitinib, alfentanil, amiodarone, amitriptyline, nortriptyline, amphotericin B, azithromycin, calcium channel blockers, carbamazepine, celecoxib, coumarin-type anticoagulants (e.g., warfarin), cyclophosphamide, cyclosporine, fentanyl, HMG-CoA reductase inhibitors (“statins”), hydrochlorothiazide, ibrutinib, ivacaftor and fixed dose ivacaftor combinations (e.g., tezacaftor/ivacaftor and ivacaftor/tezacaftor/elexacaftor), lemborexant, losartan, lurasidone, methadone, non-steroidal anti-inflammatory drugs, olaparib, oral contraceptives, oral hypoglycemics, phenytoin, pimozide, prednisone, quinidine, rifabutin, rifampin, saquinavir, short-acting benzodiazepines, sirolimus, tacrolimus, theophylline, tofacitinib, tolvaptan, triazolam, vinca alkaloids, vitamin A, voriconazole, zidovudine.
• Serious Liver injury: Fluconazole should be administered with caution to patients with liver dysfunction. Fluconazole has been associated with rare cases of serious hepatic toxicity, including fatalities primarily in people with serious underlying medical conditions. People who develop abnormal liver function tests during fluconazole therapy should be monitored for the development of more severe liver injury. Fluconazole should be discontinued if clinical signs and symptoms consistent with liver disease develop that may be attributed to fluconazole use.
• Anaphylaxis: in rare cases, serious systemic allergic reaction has been reported.
• Dermatologic: Serious skin disorders during treatment with fluconazole have been reported. Fatal outcomes have been reported in people with serious underlying diseases. Individuals with deep seated fungal infections who develop rashes during treatment with fluconazole should be monitored closely and the drug discontinued if lesions progress. Fluconazole should be discontinued in individuals treated for superficial fungal infection who develop a rash that may be attributed to fluconazole.
• Adrenal insufficiency: Some people who have taken fluconazole developed adrenal insufficiency that was reversible.
• Potential for fetal harm: People who are pregnant, considering becoming pregnant, or breastfeeding should also talk to their healthcare provider before taking fluconazole.
• Fluconazole should be taken with caution by people with low potassium (hypokalemia), kidney dysfunction, potentially proarrhythmic (heart, arrhythmia) conditions, and women who are breastfeeding.
• May cause dizziness or seizures — do not operate heavy machinery or drive until you know how fluconazole affects you.
• The convenience and effectiveness of a single-dose oral fluconazole tablet for treating vaginal yeast infections should be balanced against the higher rate of drug-related adverse events observed with fluconazole (26%) compared to intravaginal treatments (16%) in U.S. comparative clinical trials.

Common Side Effects:

• Changes in kidney and blood function test results and liver abnormalities: For some people, particularly those with serious underlying diseases such as AIDS and cancer, these changes have happened during treatment with fluconazole and similar medications.
• One-dose therapy: The most common treatment-related adverse events reported in the individuals who received 150 mg single dose fluconazole for vaginal candidiasis were headache, nausea, and abdominal pain. Other side effects reported with an incidence equal to or greater than 1% included diarrhea, dyspepsia, dizziness, and taste perversion. Most of the reported side effects were mild to moderate in severity. Rarely, angioedema and anaphylactic reaction have been reported.
• This is not a complete list of possible side effects of fluconazole. If you experience any side effects, report them to your healthcare provider for appropriate management.

Food or Drug Interactions:

• Fluconazole is a moderate CYP2C9 and CYP3A4 inhibitor and a strong inhibitor of CYP2C19. Those who are also taking drugs with a narrow therapeutic window metabolized through CYP2C9 and CYP3A4, should be monitored for adverse reactions associated with those drugs. There is a risk of higher levels of other compounds metabolized by CYP2C9, CYP2C19, and CYP3A4 when given with fluconazole. Therefore, caution should be exercised when using these combinations with fluconazole and individuals should be carefully monitored.