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Fluconazole

  • Prescription medicine
  • Given by a clinician
  • Identity checked
  • Sources last checked 2026-09-04

This page shows what was measured, who it was measured in, and what that does not settle.

What Fluconazole does in the body

The half-finished sterols that pile up cannot do the job, so the membrane becomes leaky and disordered and the fungus stops growing.

Fungal cells build their outer membrane out of a fat called ergosterol, which they have to manufacture themselves. Fluconazole jams one specific enzyme on that production line. Human cells build cholesterol using a related enzyme, which is why the dose matters and why the drug interacts with so many others.

Why people take it. Used for thrush, other yeast infections and some serious fungal infections.

What happened in people

In African adults with HIV-related fungal meningitis, fluconazole plus another tablet matched two weeks of medicine given into a vein on early deaths.

Reviewed first-read answer

Where this came from

A person wrote this and a reviewer approved it against this exact record. It carries no effect size.

A reviewer approved this against this record. The reviewed-claim record carrying the exact population and effect size does not exist yet.

No source is stored against this line.

The limit that matters most

One tablet can treat simple vaginal thrush, while serious fungal disease needs longer, combined treatment.

Where it acts
Fungal endoplasmic reticulum, where ergosterol is synthesised
Kind of result
The kind of result is not recorded
Supervision
RNAWiki has not recorded a supervision or regulatory status for this substance.

What the registries record it as

  • The substance registry classes this as chemical.

    FDA substance registry · 8VZV102JFY · read 2026-08-29

  • Its recorded molecular formula is C13H12F2N6O, weighing 306.3.

    US prescribing information · afde17e7-b95b-4cd5-97eb-e361724014bd · read 2026-08-30

Where each sentence above came from

A person wrote this explanation into the record, with the studies named in the path below.

A reviewer approved this sentence against this exact record and its sources.

The limit a reviewer approved as the one that matters most here.

The four opening statements run to 106 words.

Words this page uses

Four words worth knowing first

Chosen from what this page shows, with each one explained before the word it depends on.

Comparator

A comparator is whatever the treatment was measured against.

A picture of it, and where the picture fails

It is like the other runner in a race.

Where that stops being true. A race has one winner. A study can show both arms improved.

What people get wrong. Results are read without asking what the other group got. Beating nothing is not beating a treatment.

The control condition against which the experimental intervention is assessed.

Randomisation

Randomisation means chance decides who gets which treatment.

A picture of it, and where the picture fails

It is like a coin toss deciding the groups.

Where that stops being true. A coin toss is fair once. Fairness here comes from doing it for everyone.

What people get wrong. It is thought to make groups identical. It makes them similar on average, including on things nobody measured.

Allocation of participants to arms by a chance process, so that unmeasured factors are balanced in expectation.

Absolute difference

An absolute difference is how many more people in a hundred were affected.

A picture of it, and where the picture fails

It is like counting heads in two rooms of a hundred.

Where that stops being true. Heads are easy to count. Study results carry a margin of error too.

What people get wrong. It is confused with a percentage change, which can look far larger.

The arithmetic difference in event rates between arms.

Confidence interval

A confidence interval is the range the true answer is likely to sit in.

A picture of it, and where the picture fails

It is like a weather forecast giving a range rather than one number.

Where that stops being true. A forecast range covers tomorrow. This one covers what the study could resolve.

What people get wrong. The middle number is read as the answer. A range crossing zero means no change is still possible.

An interval estimate that would contain the true parameter in a stated proportion of repeated studies.

What happened in peopleRead from sources, not yet reviewed

What happened in people

Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.

All-cause mortality at 2 weeks in HIV-associated cryptococcal meningitis

The study showed what it set out to show

Who was studied
ACTA (ISRCTN45035509)
How many people
721
Study design
Phase 3 randomised, open-label, non-inferiority with factorial partner-drug randomisation
Compared against
Not recorded for this study
Kind of result
Living longer, or avoiding a major event
What was found
Non-inferiority met (upper one-sided 97.5% bound 4.2 percentage points against a 10-point margin); P = 0.002 for flucytosine over fluconazole as the partner drug
Repeated elsewhere
Replicated

What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.

The limits of this study, and where it came from

Main limit. The partner-drug comparison showed 45.0% ten-week mortality with fluconazole against 31.1% with flucytosine, a difference not visible in the headline non-inferiority result.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Oral tablet, oral suspension and intravenous infusion

Interval reported. Not recorded in this summary

Written into the record, not signed off as a reviewed claim.

Death from any cause at 10 weeks

The study showed what it set out to show

Who was studied
AMBITION-cm (ISRCTN72509687)
How many people
844
Study design
Phase 3 randomised controlled non-inferiority
Compared against
Not recorded for this study
Kind of result
Living longer, or avoiding a major event
What was found
P < 0.001 for non-inferiority (difference -3.9 percentage points)
Repeated elsewhere
Unreplicated

What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.

The limits of this study, and where it came from

Main limit. No limitation is recorded for this study.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Oral tablet, oral suspension and intravenous infusion

Interval reported. Not recorded in this summary

Written into the record, not signed off as a reviewed claim.

Birth defects overall and 15 specific defects previously linked to azole antifungals

The study did not show it

Who was studied
Danish national birth-defect registry cohort
How many people
975588
Study design
Registry-based cohort study
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
Overall adjusted prevalence odds ratio 1.06 (95% CI 0.92 to 1.21); tetralogy of Fallot 3.16 (95% CI 1.49 to 6.71)
Repeated elsewhere
Partially Replicated

What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.

The limits of this study, and where it came from

Main limit. The tetralogy of Fallot signal rests on 7 exposed cases, so the estimate is imprecise and was found among fifteen defects examined.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Oral tablet, oral suspension and intravenous infusion

Interval reported. 95% CI 0

Written into the record, not signed off as a reviewed claim.

Spontaneous abortion and stillbirth after oral fluconazole in pregnancy

The study showed what it set out to show

Who was studied
Danish spontaneous abortion and stillbirth cohort
How many people
1405663
Study design
Registry-based propensity-matched cohort study
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
Hazard ratio 1.48 (95% CI 1.23 to 1.77) versus unexposed and 1.62 (95% CI 1.26 to 2.07) versus topical azole exposure
Repeated elsewhere
Partially Replicated

What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.

The limits of this study, and where it came from

Main limit. No limitation is recorded for this study.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Oral tablet, oral suspension and intravenous infusion

Interval reported. 95% CI 1

Written into the record, not signed off as a reviewed claim.

What we know
RNAWiki holds 4 written-up human studies for this substance, each with the question it asked.
How we know it
Each card names the study, the number of people and what the study set out to measure.
What this does not prove
These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters
A study that failed is as informative as one that worked, and both are here.
What we still do not know
No reviewed claim exists, so no exact population, effect size or interval is published yet.

What it changes in the bodyRead from sources, not yet reviewed

The path through the body

From what a person takes to what changes. A solid line is a step measured in people. A dashed line is a step nobody has measured that way.

  1. Start

    Fluconazole

    What a person takes: Oral tablet, oral suspension and intravenous infusion.

    The measurement behind this step

    A single 150 mg tablet for uncomplicated vaginal candidiasis; daily dosing for oropharyngeal, oesophageal and invasive disease; 1,200 mg daily as part of combination induction for cryptococcal meningitis. Because oral bioavailability exceeds 90% and is unaffected by food or gastric acid, the intravenous and oral routes are interchangeable at the same dose.

  2. Getting in

    Absorbed almost completely and reaching the brain

    Fluconazole is water-soluble enough to be swallowed and still reach the fluid around the brain, which is why it can treat fungal meningitis.

    Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.

    The measurement behind this step

    Oral bioavailability exceeds 90% and is unaffected by food or gastric acidity, unlike itraconazole. Protein binding is low, around 11%, and cerebrospinal fluid concentrations approach plasma concentrations. Elimination is largely renal as unchanged drug, so dosing follows creatinine clearance.

  3. Reaching the cell

    Enters the fungal cell and reaches the endoplasmic reticulum

    The drug crosses into the fungus and travels to where membrane fats are made.

    Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.

    The measurement behind this step

    Uptake is by facilitated diffusion. Efflux through the Candida CDR1, CDR2 and MDR1 transporters is one of the main resistance mechanisms and is upregulated by repeated exposure, which is the pharmacological reason repeated single doses select for resistance.

  4. What it acts on

    A triazole nitrogen coordinates the enzyme haem iron

    One of the drug nitrogen atoms grips the iron atom at the heart of the enzyme, blocking the spot where the reaction happens.

    Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.

    The measurement behind this step

    The N-4 nitrogen of one triazole ring coordinates the haem iron of lanosterol 14-alpha-demethylase (Erg11p, CYP51), while the difluorophenyl group occupies the substrate channel. ERG11 point mutations and gene overexpression are the second major resistance route.

  5. The change it makes

    Ergosterol synthesis stalls and toxic sterols accumulate

    The production line stops, and the half-finished parts pile up and cause their own damage.

    Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.

    The measurement behind this step

    Depletion of ergosterol and accumulation of 14-alpha-methylated sterols, principally 14-alpha-methyl-3,6-diol, disorders the membrane and inhibits growth. The effect is fungistatic against Candida species, not fungicidal, which is why relapse follows if the immune system cannot finish the job.

  6. What that does for a person

    Fungal growth stops, and human CYP enzymes are inhibited too

    The infection is controlled. At higher doses the drug also slows some of the enzymes your liver uses to clear other medicines.

    Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.

    The measurement behind this step

    Fluconazole inhibits human CYP2C9, CYP2C19 and, at higher doses, CYP3A4, raising concentrations of warfarin, phenytoin, sulfonylureas and many other drugs. It also prolongs the QT interval. The selectivity for fungal CYP51 over human CYP enzymes is real but is a matter of degree rather than of kind.

No suggested links are held for this record, so nothing is hidden from this path.

What we know
The record describes 5 steps from taking it to an effect in a person.
How we know it
Each step names the study behind it in the technical detail beside it.
What this does not prove
A change inside the body is a reason to look. It is not a result in a person.
Why it matters
A reader can see exactly where the chain stops being measured in people.
What we still do not know
No reviewed claim binds any of these steps to a named population.

What is missing or unclearRead from sources, not yet reviewed

Were people like you studied?

RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.

Who was studied

People similar to this profile were included.

  • Women with vulvovaginal candidiasis, people with oral or oesophageal thrush, patients with candidaemia, and adults with cryptococcal meningitis as part of a combination and consolidation regimen.

Who is missing from the studies

  • Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.

What the label states about particular groups

  • On pediatric, the label states: “The safety profile of fluconazole has been studied in 577 pediatric patients from 1 day to 17 years of age who received doses ranging from 1 to 15 mg/kg/day for 1 to 1,616 days.”

    US prescribing information · afde17e7-b95b-4cd5-97eb-e361724014bd · read 2026-08-30

  • On older people, the label states: “Controlled clinical trials of fluconazole did not include sufficient numbers of patients aged 65 and older to evaluate whether they respond differently from younger patients in each indication.”

    US prescribing information · afde17e7-b95b-4cd5-97eb-e361724014bd · read 2026-08-30

  • On people who are pregnant, the label states: “Potential for Fetal Harm: Use in pregnancy should be avoided except in patients with severe or potentially life-threatening fungal infections in whom fluconazole may be used if the anticipated benefit outweighs the possible risk to the fetus.”

    US prescribing information · afde17e7-b95b-4cd5-97eb-e361724014bd · read 2026-08-30

  • On people who are breastfeeding, the label states: “Fluconazole was present in low levels in breast milk following administration of a single 150 mg dose, based on data from a study in 10 breastfeeding women who temporarily or permanently discontinued breastfeeding 5 days to 19 months postpartum.”

    US prescribing information · afde17e7-b95b-4cd5-97eb-e361724014bd · read 2026-08-30

Where the result stopped carrying

  • Fluconazole as the partner drug for amphotericin B: 45.0% ten-week mortality against 31.1% for flucytosine in the same randomised trial
  • Fluconazole monotherapy for cryptococcal meningitis was already known to be inadequate and was not given an arm in ACTA
  • This is a scope explorer, not a diagnosis engine.
  • It shows who was studied so you can see whether people similar to you were included.

RNAWiki cannot tell whether a study fits you. It can show who was in it.

What it would be like to takeRead from sources, not yet reviewed

Why it might seem to do nothing

A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.

It was studied in different people

The people in the studies were not much like the reader.

On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.

The evidence may simply be wrong

Small early studies often do not hold up.

On this record: RNAWiki has not yet published a reviewed conclusion for this use.

Other reasons RNAWiki checked and found nothing for (11)
It was studied for a different goal
The studies measured something else entirely. Nothing in this record points to this reason.
A different form was studied
The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct
Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too
In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel
A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it
Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet
The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied
Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time
Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
The product may not be what it says
Contents of a sold product are not always what the label states. Nothing in this record points to this reason.
No recorded reason
RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.

None of these is a reason to take more. Taking more is not a step this page ever suggests.

What it would be like to takeRead from sources, not yet reviewed

What taking it involves

The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.

How it is supplied

Given by a clinician

Quoted from a source

Where this came from

Copied from a source RNAWiki stored, with the source named.

Read from the recorded approval status.

No source is stored against this line.

Form and route

Oral tablet, oral suspension and intravenous infusion

Source-linked record

Where this came from

A person wrote this into the record with the study named beside it. No reviewer has signed it off.

The form and route recorded on this substance.

No source is stored against this line.

Who oversees it

RNAWiki has not recorded a supervision or regulatory status for this substance.

Quoted from a source

Where this came from

Copied from a source RNAWiki stored, with the source named.

No register row and no identity class settled the question.

No source is stored against this line.

What is in the pack

A single 150 mg tablet for uncomplicated vaginal candidiasis; daily dosing for oropharyngeal, oesophageal and invasive disease; 1,200 mg daily as part of combination induction for cryptococcal meningitis. Because oral bioavailability exceeds 90% and is unaffected by food or gastric acid, the intravenous and oral routes are interchangeable at the same dose.

Source-linked record

Where this came from

A person wrote this into the record with the study named beside it. No reviewer has signed it off.

Recorded notes on how this is sold and what that means for what is in the pack.

No source is stored against this line.

Where it is registered

Regulatory records are listed in the technical disclosure at the foot of this page.

Counted from records

Where this came from

A count of rows RNAWiki holds. It describes our records, not your body.

Register entries are stored per jurisdiction and shown with their dates.

No source is stored against this line.

Why people stop

Not recorded.

Nothing recorded

Where this came from

RNAWiki holds nothing here and says so rather than guessing.

No record of why people stopped taking it is stored for this substance.

No source is stored against this line.

What it would be like to takeRead from sources, not yet reviewed

What can go wrong

Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.

Worth asking a clinician aboutWritten into the record from the studies named on this page

The dominant practical issue is drug interaction: fluconazole inhibits CYP2C9 and CYP2C19 and, at higher doses, CYP3A4, raising levels of warfarin, phenytoin, sulfonylureas and many others. QT prolongation is documented. Hepatotoxicity and rare severe cutaneous reactions occur. In pregnancy, Danish registry analyses associated oral exposure with tetralogy of Fallot and with spontaneous abortion, and intravaginal azoles are preferred where a local option will do.

Nobody counted how many people took this and were fine, so this cannot be turned into a rate.

Where this came from

Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.

Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.

What is missing or unclearRead from sources, not yet reviewed

Does the exact form matter?

Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.

The form that was studied

Oral tablet, oral suspension and intravenous infusion

Source-linked record

Where this came from

A person wrote this into the record with the study named beside it. No reviewer has signed it off.

The form used in the studies cited on this page.

No source is stored against this line.

What is sold

Because oral bioavailability exceeds 90% and is unaffected by food or gastric acid, the intravenous and oral routes are interchangeable at the same dose.

Source-linked record

Where this came from

A person wrote this into the record with the study named beside it. No reviewer has signed it off.

Recorded notes on which forms are sold and how they compare.

No source is stored against this line.

What is recorded as being sold

  • 184 products list this as an active ingredient in the United States drug directory. 184 of them contain it and nothing else.

    FDA National Drug Code directory · 72189-342 · read 2026-08-29

  • They are sold as injection, injection, solution, powder, powder, for suspension and tablet, taken intravenous and oral.

    FDA National Drug Code directory · 72189-342 · read 2026-08-29

  • The regulator's established pharmacologic class for it is azole antifungal [epc], azoles [cs] and cytochrome p450 2c19 inhibitors [moa].

    FDA National Drug Code directory · 72189-342 · read 2026-08-29

  • 102 published labels name it as an active ingredient. 102 of them describe this substance alone, which is where its own label text on this page comes from.

    US prescribing information · c2c7242d-d172-4733-e053-2995a90acb2e · read 2026-08-29

  • Those labels are classed as human prescription drug.

    US prescribing information · c2c7242d-d172-4733-e053-2995a90acb2e · read 2026-08-29

  • Fluconazole is uncoated tablets at 150 mg (unit dose package of 1), recorded as prescription product; fda label in effect 2025-11-17 in the United States.

    US prescribing information · 01df20c4-7b94-044e-e063-6394a90a406a · read 2026-08-27

  • Recorded price in US: 0.19932–0.43349 USD per one unit as the pricing file counts it — a tablet, capsule, patch or single item, across 57 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..

    Recorded source · 2026-08-26 · read 2026-08-28

  • Recorded price in US: 0.28232–0.52297 USD per one millilitre, across 7 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..

    Recorded source · 2026-08-26 · read 2026-08-28

Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.

What it would be like to takeRead from sources, not yet reviewed

What you could measure

This one is decided with a clinician, so this section holds questions to ask rather than a plan to run.

RNAWiki could not confidently classify this substance, so no self-experiment plan is offered.

Questions worth asking

  • Which of the trials of Fluconazole studied people like me?
  • What was measured, and for how long?
  • Was the result a laboratory value or a health outcome?
  • What would we watch for, and when would we stop?

Tracking can show whether something changed for you. It cannot show what caused it.

RNAWiki records evidence. It does not say whether this substance is right for you.

What is missing or unclearRead from sources, not yet reviewed

Claims that go past the evidence

Things said about this substance that sound reasonable, and the exact step that is missing between the evidence and the claim.

Goes past the evidence

That the safety and convenience of a single 150 mg dose for vaginal candidiasis describes fluconazole in general, when the cryptococcal regimen is 1,200 mg daily for two weeks in combination

Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.

The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.

What would change this

A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.

RNAWiki has not yet published a reviewed conclusion for this use.

Goes past the evidence

That non-inferiority of an oral regimen means fluconazole is as good as flucytosine — the same trial randomised that question separately and answered it in the other direction

Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.

The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.

What would change this

A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.

RNAWiki has not yet published a reviewed conclusion for this use.

What is missing or unclearRead from sources, not yet reviewed

What nobody knows yet

Open questions, each with why it is open and what would close it.

Missing populations

Which groups were under-represented in the studies has not been recorded.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

Missing long-term data

No completed tested study window is recorded.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

No reviewed conclusion

RNAWiki has not yet published a reviewed conclusion for this use.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

Missing interaction studies

No interaction was found in the registers checked. Not finding one is not the same as showing there is none.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

Formulation uncertainty

Several salts, forms or products of Fluconazole are recorded. Results from one form may not transfer to another.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

Mechanism not reviewed

No reviewed mechanism story exists for this substance.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

What happened in peopleRead from sources, not yet reviewed

Check any of this yourself

Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.

Every line above can be traced to the study named beside it. Follow the link and read it.

ACTA: an all-oral fluconazole and flucytosine regimen was non-inferior to two weeks of amphotericin B
In plain words
In 721 African adults with HIV-associated cryptococcal meningitis, two weeks of oral fluconazole plus flucytosine matched two weeks of intravenous amphotericin B on death at two weeks.
What was measured
All-cause mortality at 2 weeks, with 10-week mortality as a secondary outcome
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Randomised trial in HIV-infected adults with cryptococcal meningitis. Two-week mortality was 18.2% (41 of 225) in the oral regimen group, 21.9% (49 of 224) with one week of amphotericin B and 21.4% (49 of 229) with two weeks; ten-week mortality was 35.1%, 36.2% and 39.7%. The upper limit of the one-sided 97.5% confidence interval for the oral regimen versus two-week amphotericin B was 4.2 percentage points, inside the prespecified 10-point non-inferiority margin. Severe anaemia was more frequent with two weeks of amphotericin B than with the oral regimen.
Source
Molloy SF et al., N Engl J Med 2018;378:1004-1017 (ISRCTN45035509)
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
In the same trial, fluconazole was clearly the inferior partner drug for amphotericin B
In plain words
Patients given amphotericin B with flucytosine died substantially less often than those given amphotericin B with fluconazole.
What was measured
All-cause mortality at 10 weeks by partner-drug randomisation
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
Within ACTA, each patient assigned amphotericin B was separately randomised to fluconazole or flucytosine as the partner drug. Ten-week mortality was 71 deaths (31.1%) with flucytosine and 101 deaths (45.0%) with fluconazole, hazard ratio for death 0.62 (95% CI 0.45 to 0.84; P=0.002). One week of amphotericin B plus flucytosine had the lowest ten-week mortality of any arm at 24.2% (95% CI 16.2 to 32.1). Fluconazole monotherapy, which the trial was explicitly designed to improve upon, was not an arm because it was already known to be inadequate.
Source
Molloy SF et al., N Engl J Med 2018;378:1004-1017
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
First-trimester exposure and tetralogy of Fallot in Danish registry data
In plain words
A national registry study of nearly a million pregnancies found no overall increase in birth defects, and one specific heart malformation that was more common.
What was measured
Adjusted prevalence odds ratio for specific birth defects
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Registry cohort of liveborn infants in Denmark. Birth defects occurred in 210 of 7,352 fluconazole-exposed pregnancies (2.86%) and 25,159 of 968,236 unexposed (2.60%), adjusted prevalence odds ratio 1.06 (95% CI 0.92 to 1.21). Fourteen of fifteen specific defects previously linked to azoles showed no significant increase. Tetralogy of Fallot did: 7 cases (0.10%) versus 287 (0.03%), adjusted prevalence odds ratio 3.16 (95% CI 1.49 to 6.71). Most exposures were at the common 150 mg or 300 mg doses. Seven events is a small numerator and the confidence interval is correspondingly wide.
Source
Molgaard-Nielsen D et al., N Engl J Med 2013;369:830-839
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
caution
Review state
Written into the record, not signed off as a reviewed claim
Spontaneous abortion: a 48% relative increase against unexposed pregnancies
In plain words
A second Danish registry analysis found more miscarriages among women who took oral fluconazole in pregnancy, including when compared with women who used topical antifungals instead.
What was measured
Hazard ratio for spontaneous abortion and stillbirth
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
From a cohort of 1,405,663 pregnancies, 3,315 women exposed to oral fluconazole between 7 and 22 weeks were compared with 13,246 propensity-matched unexposed women: 147 versus 563 spontaneous abortions, hazard ratio 1.48 (95% CI 1.23 to 1.77). Against topical azole exposure as the comparator, 130 of 2,823 versus 118 of 2,823, hazard ratio 1.62 (95% CI 1.26 to 2.07). Stillbirth was not significantly increased (hazard ratio 1.32, 95% CI 0.82 to 2.14). The topical-azole comparison is what makes confounding by indication a weaker explanation than it would otherwise be.
Source
Molgaard-Nielsen D et al., JAMA 2016;315:58-67
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
caution
Review state
Written into the record, not signed off as a reviewed claim
AMBITION then moved the standard again, to a single dose of liposomal amphotericin
In plain words
Four years after the oral regimen was shown to be non-inferior, a single high dose of a different drug plus two weeks of fluconazole and flucytosine did better still.
What was measured
All-cause mortality at 10 weeks
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Phase 3 non-inferiority trial in five African countries, 844 randomised and 814 in the intention-to-treat population. A single 10 mg/kg dose of liposomal amphotericin B plus 14 days of flucytosine and fluconazole gave 10-week mortality of 24.8% (95% CI 20.7 to 29.3) against 28.7% (95% CI 24.4 to 33.4) for the then-recommended WHO regimen, difference -3.9 percentage points, upper one-sided 95% bound 1.2 points, P<0.001 for non-inferiority. Grade 3 or 4 adverse events occurred in 50.0% versus 62.3%. Fluconazole is a component of the new standard rather than a competitor to it.
Source
Jarvis JN et al., N Engl J Med 2022;386:1109-1120 (ISRCTN72509687)
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
Single-dose convenience is an efficacy claim about one infection, not about all of them
In plain words
One 150 mg tablet clears most simple vaginal yeast infections. Nothing about that generalises to serious fungal disease, which needs weeks of combination therapy.
What was measured
That the convenience and safety of a single 150 mg dose describes fluconazole as a drug rather than one indication
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The dose used in the Danish registry studies for the commonest indication was 150 mg (56% of exposed pregnancies) or 300 mg (31%). The dose used in ACTA and AMBITION for cryptococcal meningitis was 1,200 mg per day for two weeks, as part of a combination, with ten-week mortality still around a quarter of patients. The same molecule spans an eightfold daily dose range and two entirely different evidence bases, and a claim proved at one end says nothing about the other.
Source
Molgaard-Nielsen D et al., N Engl J Med 2013; Molloy SF et al., N Engl J Med 2018; Jarvis JN et al., N Engl J Med 2022
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
caution
Review state
Written into the record, not signed off as a reviewed claim

How many documents were read

  • 102 documents were read for this substance.

    RNAWiki source record

  • 102 of them state the same halfLife, and they agree.

    RNAWiki source record

  • 102 of them state the same bioavailability, and they agree.

    RNAWiki source record

  • 70 of them state the same volumeOfDistribution, and they agree.

    RNAWiki source record

Where else this substance is registered

FDA substance identifier (UNII)
8VZV102JFY
CAS registry number
86386-73-4
PubChem compound
3365
RxNorm concept
4450

Checks this page had to pass

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  • Not passed

    Trial roles classified for highlighted evidence

    No registered study is classified as testing this substance.

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    enforced by the copy-contract test over the rendered page

  • Not passed

    Safety mode resolved

    No register row and no identity class settled the question.

  • Passed

    Canonical metadata present

    slug and display name present

What is missing or unclearRead from sources, not yet reviewed

How this medicine reached us

Kept near the foot of the page. A historical event moves up only when it changes something about this substance today.

What the approval register records

  • 46 approved applications cover products containing this substance. The earliest was NDA019949, approved 19900129 to PFIZER.

    Drugs@FDA application register · NDA019949 · read 2026-08-29

  • Marketing status on the register: discontinued and prescription.

    Drugs@FDA application register · NDA019949 · read 2026-08-29

  • The earliest marketing start date recorded for a listed product is 19900129.

    FDA National Drug Code directory · 72189-342 · read 2026-08-29

What is missing or unclearRead from sources, not yet reviewed

What to learn next

Ordered by what would most change how you read this page, starting with what is easiest to misunderstand.

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What is not here

7 questions this page could not answer

These sections were prepared and left out because there was nothing to put in them. They are listed rather than hidden, so the gaps in this record are visible.

  • What was measured, goal by goal — found nothing in the sources checked.
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  • Felt, measured, or meaningful — found nothing in the sources checked.
  • How long anything takes — found nothing in the sources checked.
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Everything above is built from what is below. This layer keeps the technical vocabulary, record identifiers and every stored row, so a reader who wants to check the page can.

The older medicine-wide conclusion held in this record

Written for a clinical reader, and about the medicine as a whole rather than about one indication, population and set of trials. RNAWiki does not treat it as a programme conclusion and no reviewer has signed it off in that form. It is here word for word because it is what the record holds.

A triazole that stalls fungal membrane synthesis at one enzyme, effective and convenient in candidiasis, measurably inferior to flucytosine as the partner drug in cryptococcal meningitis (45.0% versus 31.1% ten-week mortality), and associated in Danish registry data with tetralogy of Fallot and with spontaneous abortion in pregnancy.

Recorded evidence blocks (10)

On the Fluconazole label: indicated for what?


"Fluconazole Tablets are indicated for the treatment of: Vaginal candidiasis (vaginal yeast infections due to Candida ). Oropharyngeal and esophageal candidiasis.": indications and usage on Fluconazole's label. DailyMed label · 91adb548-9875-47e9-8054-578ed8c7572e · 2026-06-10

188 registered trials of Fluconazole — at which phases?


Registered studies posting no result
147 of 188

188 registered studies of Fluconazole: 53 phase1, 48 phase3, 32 na, 31 phase2, 21 phase4, 10 na or unstated, 2 early phase1. CLINICALTRIALS_SNAPSHOT · 2026-09-01

817 with a PubMed record

Show the evidence
  • phase1
    53
  • phase3
    48
  • na
    32
  • phase2
    31
  • phase4
    21
  • na or unstated
    10
8 more recorded rows
  • early phase1
    2
  • completed
    145
  • unknown
    17
  • recruiting
    11
  • terminated
    8
  • withdrawn
    3
  • active not recruiting
    2
  • not yet recruiting
    2

recorded 2026-09-01 · last checked 2026-09-04

11 of Fluconazole's trials stopped: safety, accrual/recruitment, funding/business, other?


safety (2), accrual/recruitment (2), funding/business (1) and other (6): Fluconazole's stop wording, clustered. CLINICALTRIALS_SNAPSHOT · 2026-09-01

"Limited clinical staff"; 11 of 188 registered studies

Show the evidence

Trial

  • NCT00166166
    terminated; "Limited clinical staff"
  • NCT00304772
    withdrawn; "Subjects were not recruited as intended."
  • NCT00675714
    terminated; "At the request of the study site, this study has been closed and access to study-related data is unavailable. We are unable to submit the results-data."
  • NCT01562132
    terminated; "Stopped in accordance with pre-specified stopping rules for poor recruitment."
  • NCT01950507
    terminated; "Slow/Insufficient accrual"
  • NCT01953744
    terminated; "Low cure rate in the study (fluconazole) group"
5 further recorded trials
  • NCT02532192
    withdrawn; "Withdrawal of study support."
  • NCT02663674
    terminated; "Study terminated due to lack of feasibility of study design."
  • NCT03002012
    terminated; "SAEs with n=1 serotonin syndrome, n=2 SAEs after sertraline interruption."
  • NCT04464577
    withdrawn; "Business objectives have changed."
  • NCT05178862
    terminated; "Strategic decision not related to safety or efficacy concerns for Ibrexafungerp."

recorded 2026-09-01 · last checked 2026-09-04

Human studies of Fluconazole used Fluconazole 200mg tab — over how long?


Human studies of Fluconazole used "Fluconazole 200mg tab". ClinicalTrials.gov · 2026-09-01

8 recorded entries; human; capsule; also "Fluconazole capsule 50mg", "Fluconazole 150mg capsule", "Fluconazole (BAYT006267) 150 mg capsules"

Show the evidence

human

  • NCT03002012
    Fluconazole 200mg tab
  • NCT03821480
    capsule; Fluconazole capsule 50mg
  • NCT03840616
    capsule; Fluconazole 150mg capsule
  • NCT03929861
    Fluconazole (BAYT006267) 150 mg capsules
  • NCT03929861
    Fluconazole 150 mg capsules (DiflucanTM)
  • NCT04122560
    Fluconazole 2 MG/ML
2 more recorded rows
  • human NCT04734405
    Fluconazole 150 mg
  • human NCT05602597
    Fluconazole 400 mg

recorded 2026-09-01 · last checked 2026-09-04

Fluconazole's half-life is 2 hours — which schedules were studied?


2 hours, the half-life Fluconazole's label states: "Peak plasma concentrations (C max ) in fasted normal volunteers occur between 1 and 2 hours with a terminal plasma elimination half-life of approximately 30 hours (range: 20 to 50 hours) after oral administration." DailyMed label · 91adb548-9875-47e9-8054-578ed8c7572e · 2026-06-10

tmax 2 hours; bioavailability 90 %.

Show the evidence
  • half life pharmacokinetics
    2 hours; Peak plasma concentrations (C max ) in fasted normal volunteers occur between 1 and 2 hours with a terminal plasma elimination half-life of approximately 30 hours (range: 20 to 50 hours) after oral administration.
  • tmax pharmacokinetics
    2 hours; Peak plasma concentrations (C max ) in fasted normal volunteers occur between 1 and 2 hours with a terminal plasma elimination half-life of approximately 30 hours (range: 20 to 50 hours) after oral administration.
  • bioavailability pharmacokinetics
    90 %; In normal volunteers, the bioavailability of orally administered fluconazole is over 90% compared with intravenous administration.
  • metabolism pharmacokinetics
    and Metabolism The pharmacokinetic properties (PK) of fluconazole are similar following administration by the intravenous or oral routes.

recorded 2026-06-10 · last checked 2026-09-04

Which 76 trials of Fluconazole posted no result?


Posted no result
76 of 76 completed trials
Registrations
NCT00000676, NCT00000788, NCT00000627, NCT00000744, NCT00004938 and NCT00000776, and 70 more
Completion dates
oldest 1993-11; newest 2024-07-01
Show the evidence

Trial

  • NCT00000676
    1993-11
  • NCT00000788
    1994-06
  • NCT00000627
    1994-11
  • NCT00000744
    1995-12
  • NCT00004938
    1996-08
  • NCT00000776
    1996-09
14 further recorded trials
  • NCT00000639
    1997-09
  • NCT00000826
    1999-05
  • NCT00001937
    2000-12
  • NCT00012467
    2001-07
  • NCT00001542
    2001-11
  • NCT00000951
    2002-05
  • NCT00003883
    2002-07
  • NCT01511757
    2002-07
  • NCT01511770
    2002-09
  • NCT00645242
    2003-03
  • NCT00666185
    2004-02
  • NCT00056368
    2004-10
  • NCT00001107
    2005-11
  • NCT00353561
    2006-04

At the median, Fluconazole's trials enrolled 68 people — anything larger?


Median enrolment
68
Largest enrolment
40110
Registered trials counted
169

What do 2550 spontaneous reports say about Fluconazole — and not say?


These are reports people sent to a regulator. They do not show the medicine caused the reaction. Nobody counted how many people took the medicine and reported nothing. The same event can be reported more than once, and many reports are incomplete. News coverage, lawsuits and new warnings change how often people report. A count is not a rate and not a risk.

Fluconazole appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 2550 reaction mentions were counted: drug interaction 868; drug hypersensitivity 419; electrocardiogram qt prolonged 199; abortion spontaneous 176. FAERS via Open Targets · CHEMBL106 · 2026-06-24

Show the evidence
  • drug interaction
    868
  • drug hypersensitivity
    419
  • electrocardiogram qt prolonged
    199
  • abortion spontaneous
    176
  • drug reaction with eosinophilia and systemic symptoms
    175
  • pancytopenia
    157
4 more recorded rows
  • stevens-johnson syndrome
    153
  • international normalised ratio increased
    141
  • rash maculo-papular
    132
  • torsade de pointes
    130

recorded 2026-06-24 · last checked 2026-09-04

Which 10 reactions does Fluconazole's label not list?


abortion spontaneous, drug hypersensitivity and drug interaction and 7 more reported for Fluconazole, absent from its label. FAERS via Open Targets · CHEMBL106 · 2026-06-24

3 label terms; 10 reported and unlisted; 91adb548-9875-47e9-8054-578ed8c7572e

Show the evidence
  • abortion spontaneous
    count not stated
  • drug hypersensitivity
    count not stated
  • drug interaction
    count not stated
  • drug reaction with eosinophilia and systemic symptoms
    count not stated
  • electrocardiogram qt prolonged
    count not stated
  • international normalised ratio increased
    count not stated
4 more recorded rows
  • pancytopenia
    count not stated
  • rash maculo-papular
    count not stated
  • stevens-johnson syndrome
    count not stated
  • torsade de pointes
    count not stated

recorded 2026-06-24 · last checked 2026-09-04

Fluconazole and CYP3A4 and CYP2C9: shared by which compounds?


CYP3A4 and CYP2C9 appear in Fluconazole's recorded interaction sentences, 8 in all. DailyMed label · 91adb548-9875-47e9-8054-578ed8c7572e · 2026-06-10

CYP2C19, CYP2C19, CYP2C9, CYP2C9, CYP2C9, CYP3A4; 8 shared nodes; drug_interactions

Show the evidence

Interaction statement

  • drug_interactions
    (See CONTRAINDICATIONS .) Fluconazole is a moderate CYP2C9 and CYP3A4 inhibitor.
  • drug_interactions
    Patients treated with fluconazole, who are also concomitantly treated with drugs with a narrow therapeutic window metabolized through CYP2C9 and CYP3A4, should be monitored for adverse reactions associated with the concomitantly administered drugs.
  • drug_interactions
    In addition to the observed/documented interactions mentioned below, there is a risk of increased plasma concentration of other compounds metabolized by CYP2C9, CYP2C19, and CYP3A4 co-administered with fluconazole.
  • drug_interactions
    Clinically or potentially significant drug interactions between fluconazole and the following agents/classes have been observed and are described in greater detail below: Abrocitinib: Drug interaction studies indicate that when co-administered with fluconazole (strong inhibitor of CYP2C19; moderate inhibitor of CYP2C9 and CYP3A4), the systemic exposure of abrocitinib and its active metabolites…
  • drug_interactions
    A possible mechanism of action is fluconazole's inhibition of CYP3A4.
  • drug_interactions
    Calcium channel blockers: Certain calcium channel antagonists (nifedipine, isradipine, amlodipine, verapamil, and felodipine) are metabolized by CYP3A4.
2 more recorded rows
  • Interaction statement drug_interactions
    HMG-CoA reductase inhibitors: The risk of myopathy and rhabdomyolysis increases when fluconazole is co-administered with HMG-CoA reductase inhibitors metabolized through CYP3A4, such as atorvastatin and simvastatin, or through CYP2C9, such as fluvastatin (decreased hepatic metabolism of the statin).
  • Interaction statement drug_interactions
    Ibrutinib: Moderate inhibitors of CYP3A4 such as fluconazole may increase plasma ibrutinib concentrations and increase risk of adverse reactions associated with ibrutinib.

CYP2C19

  • FINGOLIMOD LAURYL SULFATE, FOSAPREPITANT DIMEGLUMINE, TAFAMIDIS MEGLUMINE, Arimoclomol, Rasagiline, Golodirsen, Naldemedine, Etravirine
  • FINGOLIMOD LAURYL SULFATE, FOSAPREPITANT DIMEGLUMINE, TAFAMIDIS MEGLUMINE, Arimoclomol, Rasagiline, Golodirsen, Naldemedine, Etravirine

CYP2C9

  • FINGOLIMOD LAURYL SULFATE, FOSAPREPITANT DIMEGLUMINE, TAFAMIDIS MEGLUMINE, Arimoclomol, Rasagiline, Golodirsen, Tinidazole, Naldemedine
  • FINGOLIMOD LAURYL SULFATE, FOSAPREPITANT DIMEGLUMINE, TAFAMIDIS MEGLUMINE, Arimoclomol, Rasagiline, Golodirsen, Tinidazole, Naldemedine
  • FINGOLIMOD LAURYL SULFATE, FOSAPREPITANT DIMEGLUMINE, TAFAMIDIS MEGLUMINE, Arimoclomol, Rasagiline, Golodirsen, Tinidazole, Naldemedine

CYP3A4

  • FINGOLIMOD LAURYL SULFATE, ERYTHROMYCIN LACTOBIONATE, FOSAPREPITANT DIMEGLUMINE, TAFAMIDIS MEGLUMINE, Arimoclomol, Beclometasone, Rasagiline, Sofpironium
  • FINGOLIMOD LAURYL SULFATE, ERYTHROMYCIN LACTOBIONATE, FOSAPREPITANT DIMEGLUMINE, TAFAMIDIS MEGLUMINE, Arimoclomol, Beclometasone, Rasagiline, Sofpironium
  • FINGOLIMOD LAURYL SULFATE, ERYTHROMYCIN LACTOBIONATE, FOSAPREPITANT DIMEGLUMINE, TAFAMIDIS MEGLUMINE, Arimoclomol, Beclometasone, Rasagiline, Sofpironium

recorded 2026-06-10 · last checked 2026-09-04

Where it is registered
Identifiers, relations and other names

The exact record

ChEMBL id
CHEMBL106
PubChem CID
3365
CAS number
86386-73-4
RxCUI
4450
InChIKey
RFHAOTPXVQNOHP-UHFFFAOYSA-N
Also called
Alkanazole, Difluconazole, Fluconazol, Fluconazoli, Zoltec, fcz, flucanazole, 1H-1,2,4-TRIAZOLE-1-ETHANOL, 1-(2,4-DIFLUOROPHENYL)-1-(1H-1,2,4-TRIAZOL-1-YLMETHYL)-, 2,4-DIFLUORO-1',1'-BIS(1H-1,2,4-TRIAZOL-1-YLMETHYL)BENZYL ALCOHOL, FLUCONAZOLE [EP MONOGRAPH], FLUCONAZOLE [HSDB], FLUCONAZOLE [JAN]
Development code
BAYT-006267, BAYT006267, NSC-758661, UK-49,858, UK-49858
Salt form
Canesten oral, Fluconazole in Sodium Chloride 0.9% in Plastic Container, Fluconazole in Sodium Chloride 0.9%, Diflucan in Sodium Chloride 0.9%
Trade name
Diflucan, Diflucan one, Triflucan, Fluconazole in Dextrose 5% in Plastic Container, Diflucan in Dextrose 5% in Plastic Container
Sources (6)

Sources

ChEMBL 37 — CC BY-SA 3.0 Unported · ChEMBL ATC CC BY-SA · ClinicalTrials.gov — US Government work · Open Targets 26.06 — CC0 · mixed register set; per-register licences in docs/specs/corpus-20k-sources.md · openFDA / DailyMed — US Government work

How these records are assembled · Which registers were checked

Index-quality checks
  • identity passed: no open identity hold
  • required summary fields resolved: 4 required field(s) not terminal: Why people use it, Best-supported result, Biggest unanswered question, Human evidence
  • public claims reviewed: 0 reviewed claim(s); drafts are never rendered
  • source coverage passed: 6 source rows
  • no critical contamination: no quarantine open
  • canonical metadata passed: slug and display name present
  • no raw internal fields: enforced by the copy-contract test over the rendered page

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