Antifungals fight infections caused by different kinds of fungus. Diflucan is used for the treatment of cryptococcosis, all forms of candidiasis (generalized candidiasis, candidemia, mucosal candidiasis, bronchopulmonary candidiasis, candidiasis of skin, genital and vaginal candidiasis), fungal infections of the skin (scaly skin disease, onychomycosis), deep fungal infections, for the prevention and treatment of fungal diseases in cancer patients and AIDS patients.

WHY DO PEOPLE WITH HIV TAKE IT?

Fluconazole is used when fungal infections can't be treated with skin lotions or creams. It works against several different types of fungus, including the yeast infection called candidiasis or thrush.

Many germs live in our bodies or are common in our surroundings. A healthy immune system can fight them off or keep them under control. However, HIV infection can weaken the immune system. Infections that take advantage of weakened immune defenses are called "opportunistic infections". People with advanced HIV disease can get opportunistic infections. The yeast infection candidiasis, or thrush, is fairly common. It can be more serious in people with HIV. Another opportunistic infection is cryptococcal meningitis. Fluconazole has been approved to treat both of these infections.

Some doctors also use fluconazole to treat other opportunistic infections caused by fungus.

WHAT ABOUT DRUG RESISTANCE?

Whenever you take medication, be sure to take all of the prescribed doses. Many people stop if they feel better. This is not a good idea. If the drug doesn't kill all of the germs, they might change (mutate) so that they can survive even when you are taking medications. When this happens, the drug will stop working. This is called "developing resistance" to the drug.

For example, if you are taking fluconazole to fight thrush and you miss too many doses, the thrush in your body could develop resistance to fluconazole. Then you would have to take a different drug or combination of drugs to fight thrush. Many doctors prefer to treat thrush with creams, or lozenges that dissolve in the mouth. Thrush is much less likely to develop resistance when the treatment is applied directly to the infection instead of through the whole body.

WHAT ARE THE POSSIBLE ADVERSE REACTION OF DIFLUCAN?

Tolerability of fluconazole is usually very good. The most common adverse reactions arise from the part of gastrointestinal tract, and include:

• loss of appetite, nausea, constipation or diarrhea, bloating, abdominal pain, tooth pain, rarely - liver dysfunction (scleral icterus, jaundice, hyperbilirubinemia, increased activity of ALT, AST and alkaline phosphatase)

Other possible reactions to Diflucan are as follows:

• From the nervous system: headache, dizziness, excessive fatigue, rarely - seizures
• From the part of hematopoiesis: rarely - leukopenia, thrombocytopenia (bleeding, petechiae), neutropenia, agranulocytosis
• Allergic reactions: skin rash, rare - exudative erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell syndrome), anaphylactoid reactions.

In extremely rare cases Diflucan may cause renal failure, alopecia, hypercholesterolemia, hypertriglyceridemia, hypokalemia.

HOW DOES DIFLUCAN INTERACT WITH OTHER MEDICINES?

Fluconazole is processed mostly by the kidneys. It does not interact very much with drugs that use the liver, including most ARVs used to fight HIV. However, fluconazole interacts with indinavir (Crixivan), ritonavir (Norvir), and zidovudine (Retrovir, AZT). It also interacts with several other types of drugs. These include some blood thinners, seizure medications, water pills (diuretics), pills to lower blood sugar, and other antibiotics.