Zhang L, De Salvo R, Ehret A, Young K, Trapp S. SAGE Open Med. Candida vaginitis is currently treated with a wide range of intravaginal preparations usually prescribed over several days. Clinical evidence of oropharyngeal candidiasis generally resolves within several days, but treatment should be continued for at least 2 weeks to decrease the likelihood of relapse. Other side effects reported with an incidence equal to or greater than 1% included diarrhea (3%), dyspepsia (1%), dizziness (1%), and taste perversion (1%). Fluconazole for Oral Suspension, USP is supplied as a (orange-flavored) white to almost white powder to provide 35 mL per bottle: Each mL contains 10 mg or 40 mg of fluconazole after reconstitution as directed. Thus, multiple-dose use of fluconazole at these doses is unlikely to have an effect on the efficacy of the combined oral contraceptive. Fluconazole treatment did not cause a decrease in the ethinyl estradiol AUC of any individual subject in this study compared to placebo dosing. I am 7 weeks pregnant, and my doctor took a swab and the lab confirmed I have thrush. If short-acting benzodiazepines, which are metabolized by the cytochrome P450 system, are concomitantly administered with fluconazole, consideration should be given to decreasing the benzodiazepine dosage, and the patients should be appropriately monitored. Fluconazole is commonly used to treat yeast infections of the mouth or throat (thrush). I'm having a reaction after taking fluconazole, is this normal? Thiry-six per cent were receiving antiretroviral therapy (74% of regimens contained nevirapine, and 55% of patients had been receiving treatment for less than three months). Fluconazole helps stop too much yeast from growing in the vagina so the yeast infection goes away. The following dose equivalency scheme should generally provide equivalent exposure in pediatric and adult patients: Experience with DIFLUCAN in neonates is limited to pharmacokinetic studies in premature newborns. The Cmax increased 13% 17% (range: -13 to 40%). Does fluconazole flush out yeast/discharge? Of 17 subjects with culture-confirmed candidemia, 11 of 14 (79%) with baseline symptoms (3 were asymptomatic) had a clinical cure; 13/15 (87%) of evaluable patients had a mycologic cure at the end of treatment but two of these patients relapsed at 10 and 18 days, respectively, following cessation of therapy. Theophylline: The pharmacokinetics of theophylline were determined from a single intravenous dose of aminophylline (6 mg/kg) before and after the oral administration of fluconazole 200 mg daily for 14 days in 16 normal male volunteers. Hydrochlorothiazide: Concomitant oral administration of 100 mg fluconazole and 50 mg hydrochlorothiazide for 10 days in 13 normal volunteers resulted in a significant increase in fluconazole AUC and Cmax compared to fluconazole given alone. The spectrum of these hepatic reactions has ranged from mild transient elevations in transaminases to clinical hepatitis, cholestasis and fulminant hepatic failure, including fatalities. They can cause serious problems. eCollection 2022. A clinical response to treatment was measured according to the clearance of oropharyngeal lesions. Fluconazole should be discontinued if clinical signs and symptoms consistent with liver disease develop that may be attributable to fluconazole. being unable to get an erection at any time. A possible mechanism of action is fluconazoles inhibition of CYP3A4. i've intestinal candidiasis and my doctor told me to take fluconazole (50mg 7 days) and metronidazole (250 mg 13 days). Furthermore, in a randomized crossover study with 12 healthy volunteers, it was shown that fluconazole delayed the elimination of fentanyl significantly. With Gift Aid, your generous donation of 10 would be worth 12.50 at no extra cost to you. The half-life of theophylline increased from 6.6 1.7 hours to 7.9 1.5 hours (See PRECAUTIONS). Epub 2022 Oct 17. Therefore, caution should be exercised when using these combinations and the patients should be carefully monitored. Patients underwent four oral examinations, oral swabs and blood tests during the treatment period and a follow-up exam 42 days after beginning the treatment course. In each phase the subjects were given oral fluconazole 400 mg and intravenous saline; oral placebo and intravenous fluconazole 400 mg; and oral placebo and IV saline. Adherence was monitored by pill counts at each clinic visit. There is no information regarding the efficacy of fluconazole for primary treatment of cryptococcal meningitis in children. Please enable it to take advantage of the complete set of features! There were no fetal effects at 5 mg/kg or 10 mg/kg; increases in fetal anatomical variants (supernumerary ribs, renal pelvis dilation) and delays in ossification were observed at 25 mg/kg and 50 mg/kg and higher doses. The pattern and incidence of adverse events and laboratory abnormalities recorded during pediatric clinical trials are comparable to those seen in adults. Mycoses. Last updated on Mar 23, 2023. What is the best treatment for oral thrush in healthy infants? The daily dose of fluconazole for the treatment of infections other than vaginal candidiasis should be based on the infecting organism and the patients response to therapy. In an intravenous perinatal study in rats at 5 mg/kg, 20 mg/kg, and 40 mg/kg, dystocia and prolongation of parturition were observed in a few dams at 20 mg/kg (approximately 5 to 15 times the recommended human dose) and 40 mg/kg, but not at 5 mg/kg. Am J Hospice Pall Care. The therapeutic cure rate, defined as a complete resolution of signs and symptoms of vaginal candidiasis (clinical cure), along with a negative KOH examination and negative culture for Candida (microbiologic eradication), was 55% in both the fluconazole group and the vaginal products group. For a list of all side effects, ask your doctor or pharmacist. In post-marketing experience, as with other azole antifungals, bleeding events (bruising, epistaxis, gastrointestinal bleeding, hematuria, and melena) have been reported in association with increases in prothrombin time in patients receiving fluconazole concurrently with warfarin. The recommended DIFLUCAN daily dosage for the prevention of candidiasis in patients undergoing bone marrow transplantation is 400 mg, once daily. For candidiasis, a single-dose fluconazole 150 mg via mouth was found to be very effective as the symptoms decreased significantly (P < 0.001) in most patients, and local antifungal treatments . To avoid a possible serious reaction, do NOT take fluconazole if you are taking erythromycin, astemizole, pimozide, quinidine, and cisapride (Propulsid) since it can cause changes in heartbeat in some people if taken with fluconazole. Another survey with HIV long-term survivors. The site is secure. being able to get an erection, but not having it last long enough for sex. Reduce the dose of tofacitinib when given concomitantly with fluconazole (i.e., from 5 mg twice daily to 5 mg once daily as instructed in the XELJANZ [tofacitinib] label). Increased pimozide plasma concentrations can lead to QT prolongation and rare occurrences of torsade de pointes. The https:// ensures that you are connecting to the There is no need to adjust single dose therapy for vaginal candidiasis because of impaired renal function. 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. range: 18 to 31%) and 13% (95% C.I. Bethesda, MD 20894, Web Policies Dosage of amitriptyline/nortriptyline should be adjusted, if necessary. Resistance in Candida glabrata usually includes upregulation of CDR genes resulting in resistance to multiple azoles. Combined systemic (fluconazole) and topical (metronidazole + clotrimazole) therapy for a new approach to the treatment and prophylaxis of recurrent candidiasis. Fluconazole - How long does it take to work? The recommended duration of treatment for initial therapy of cryptococcal meningitis is 10 to 12 weeks after the cerebrospinal fluid becomes culture negative. 5 allows us to reach millions of people globally with accurate and reliable resources about HIV prevention and treatment. These changes are attributed to a mean SD reduction in renal clearance of 30% 12% (range: -10 to -50%). If tolvaptan and fluconazole are concomitantly administered, the tolvaptan dose should be reduced as instructed in the tolvaptan prescribing information and the patient should be frequently monitored for any adverse reactions associated with tolvaptan. Our information is intended to support, rather than replace, consultation with a healthcare professional. Objectives: A clinical multicenter study comparing efficacy and tolerability of topical combination therapy with clotrimazole (Canesten, two formats) with oral single dose fluconazole (Diflucan) in vulvovaginal mycoses. Midazolam: The effect of fluconazole on the pharmacokinetics and pharmacodynamics of midazolam was examined in a randomized, cross-over study in 12 volunteers. These are suggested dose adjustments based on pharmacokinetics following administration of multiple doses. To reconstitute, add 24 mL of distilled water or Purified Water (USP) to fluconazole bottle and shake vigorously to suspend powder. Phenytoin: Phenytoin AUC was determined after 4 days of phenytoin dosing (200 mg daily, orally for 3 days followed by 250 mg intravenously for one dose) both with and without the administration of fluconazole (oral fluconazole 200 mg daily for 16 days) in 10 normal male volunteers. A common yeast infection of moist areas of the body, caused by the fungi of the candida family such asCandida albicans. When driving vehicles or operating machines, it should be taken into account that occasionally dizziness or seizures may occur. (See CONTRAINDICATIONS). Clipboard, Search History, and several other advanced features are temporarily unavailable. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). An inadequate period of treatment may lead to recurrence of active infection. Clinically or potentially significant drug interactions between fluconazole and the following agents/classes have been observed and are described in greater detail below: Alfentanil: A study observed a reduction in clearance and distribution volume as well as prolongation of t of alfentanil following concomitant treatment with fluconazole. My pulmonologist prescribed nystatin. Conclusion: Sharifi-Rad J, Quispe C, Rahavian A, Pereira Carneiro JN, Rocha JE, Alves Borges Leal AL, Bezerra Morais Braga MF, Melo Coutinho HD, Ansari Djafari A, Alarcn-Zapata P, Martorell M, Antika G, Tumer TB, Cruz-Martins N, Helon P, Paprocka P, Koch W, Docea AO, Calina D. Front Pharmacol. Call your doctor or 911 if you think you may have a medical emergency. Do not use fluconazole for a condition for which it was not prescribed. However, the effectiveness of fluconazole in treating clinical infections due to these fungi has not been established in adequate and well-controlled clinical trials. (See CLINICAL PHARMACOLOGY: Drug Interaction Studies. However, if the fungal infection is extending down into the esophagus and causing pain with swallowing a much more aggressive dose and management are needed. Clinical adverse events were reported more frequently in HIV infected patients (21%) than in non-HIV infected patients (13%); however, the patterns in HIV infected and non-HIV infected patients were similar. You can ask your pharmacist or doctor for information about fluconazole that is written for health professionals. The psychomotor effects of midazolam were significantly increased after oral administration of midazolam but not significantly affected following intravenous midazolam. Get answers from Dermatologists and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. The investigators conclude by noting that single-dose therapy is less costly than a 14-day course of treatment, and has the additional advantage that it can be given as a directly-observed treatment by medical personnel. What is the dose of fluconazole for tinea? Hepato-biliary: In combined clinical trials and marketing experience, there have been rare cases of serious hepatic reactions during treatment with fluconazole (See WARNINGS). Ask your doctor or pharmacist if you do not understand any of this information or if you want to know more about fluconazole. (See CONTRAINDICATIONS. and transmitted securely. Medicines are sometimes prescribed for conditions that are mentioned in patient information leaflets. (See CLINICAL PHARMACOLOGY: Drug Interaction Studies.). Epidemiological studies suggest a potential risk of spontaneous abortion and congenital abnormalities in infants whose mothers were treated with 150 mg of fluconazole as a single or repeated dose in the first trimester, but these epidemiological studies have limitations and these findings have not been confirmed in controlled clinical trials. Twenty-four patients experienced a relapse of symptoms after completing treatment.There was no significant difference in relapse rates between days 14 and 42 according to the study treatment. Co-administration of other drugs known to prolong the QT interval and which are metabolized via the enzyme CYP3A4 such as cisapride, astemizole, erythromycin, pimozide, and quinidine are contraindicated in patients receiving fluconazole (See CLINICAL PHARMACOLOGY: Drug Interaction Studies and PRECAUTIONS). Similar proportions of older patients (2.4%) and younger patients (1.5%) discontinued fluconazole therapy because of side effects. Your doctor might prescribe a one-time, single oral dose of fluconazole (Diflucan). Clipboard, Search History, and several other advanced features are temporarily unavailable. SINCE ORAL ABSORPTION IS RAPID AND ALMOST COMPLETE, THE DAILY DOSE OF DIFLUCAN (FLUCONAZOLE) IS THE SAME FOR ORAL (TABLETS AND SUSPENSION) AND INTRAVENOUS ADMINISTRATION. . Prepare a suspension at time of dispensing as follows: tap bottle until all the powder flows freely. This interaction may result in the risk of a significant increase in adverse reactions associated with tolvaptan, particularly significant diuresis, dehydration and acute renal failure. The recommended dosage of fluconazole for suppression of relapse of cryptococcal meningitis in patients with AIDS is 200 mg once daily. Upregulation of the MDR gene leads to fluconazole resistance, whereas, upregulation of CDR genes may lead to resistance to multiple azoles. RISK FACTORS. Genovese C, Cianci A, Corsello S, Ettore G, Mattana P, Tempera G. Minerva Ginecol. Unauthorized use of these marks is strictly prohibited. An official website of the United States government. Depending on clinical circumstances, consideration should be given to increasing the dose of fluconazole when it is administered with rifampin. Video chat with a U.S. board-certified doctor 24/7 in a minute. Hematopoietic and Lymphatic: Leukopenia, including neutropenia and agranulocytosis, thrombocytopenia. This enzyme functions to convert lanosterol to ergosterol. The features seen in these infants include brachycephaly, abnormal facies, abnormal calvarial development, cleft palate, femoral bowing, thin ribs and long bones, arthrogryposis, and congenital heart disease. Some medicines can affect how well fluconazole works. The following formula may be used to estimate creatinine clearance in children: (Where K=0.55 for children older than 1 year and 0.45 for infants.). Bloodstream or systemic infection: Your dose will depend on how your infection responds to fluconazole (Diflucan). These patients also received 5 placebo tablets on the first day of therapy. Fungal isolates exhibiting reduced susceptibility to other azoles may also show reduced susceptibility to fluconazole. Urinary tract infections and peritonitis: For the treatment of Candida urinary tract infections and peritonitis, daily doses of 50 to 200 mg have been used in open, noncomparative studies of small numbers of patients. Fluconazole is cleared primarily by renal excretion as unchanged drug. Coadministration of fluconazole and pimozide is contraindicated. In our 35th year were asking people to donate 35 thats just 1 for every year weve been providing life-changing information. There was a significant increase in zidovudine AUC following the administration of fluconazole. Oral health problems among palliative and terminally ill patients: an integrated systematic review. (See CLINICAL PHARMACOLOGY.) The discontinuation of fluconazole presumably caused an enhanced CYP3A4 activity which led to increased metabolism of prednisone. Tolbutamide: In 13 normal male volunteers, there was significant increase in tolbutamide (500 mg single dose) AUC and Cmax following the administration of fluconazole. If you would like more information, talk with your doctor. Cisapride 20 mg four times daily was started after 7 days of fluconazole or placebo dosing. Resulting increased plasma concentrations of astemizole can lead to QT prolongation and rare occurrences of torsade de pointes. Use of quinidine has been associated with QT prolongation and rare occurrences of torsade de pointes. The safety profile of fluconazole in children has been studied in 577 children ages 1 day to 17 years who received doses ranging from 1 to 15 mg/kg/day for 1 to 1,616 days (See ADVERSE REACTIONS). This formulation has been shown to be equivalent to ketoconazole for treatment of oropharyngeal candidiasis, and is available at cost-only price from manufacturer Tibotec through a range of non-profit distributors including the International Dispensary Association (IDA), Missionpharma and UNICEF. Sex Transm Dis. Oral fluconazole increased the midazolam AUC and Cmax by 272% and 129%, respectively. I have reoccurring thrush, why could this be?Doc keeps prescribing me fluconazole 150mg each time,could the yeast build up resistance?As not working. h/mL, and the mean terminal half-life was 46.2 hours. Content on HealthTap (including answers) should not be used for medical advice, diagnosis, or treatment, and interactions on HealthTap do not create a doctor-patient relationship. There was no significant difference in adverse events between the two treatment groups. It may be useful to monitor renal function (See CLINICAL PHARMACOLOGY and DOSAGE AND ADMINISTRATION). Dosage adjustment of alfentanil may be necessary. We comply with the HONcode standard for trustworthy health information. Although not specifically studied, fluconazole has the potential to increase the systemic exposure of other non-steroidal anti-inflammatory drugs (NSAIDs) that are metabolized by CYP2C9 (e.g., naproxen, lornoxicam, meloxicam, diclofenac). Goje O, Sobel R, Nyirjesy P, Goldstein SR, Spitzer M, Faught B, Larson S, King T, Azie NE, Angulo D, Sobel JD. 2020 Mar 18;20(1):79. doi: 10.1186/s12903-020-01075-w. Indian J Palliat Care. This Patient Information has been approved by the U.S. Food and Drug Administration. There is at least one literature report that suggests that 150 mg as a single dose may work in a very specific group of patients, but the dose youre describing is not the norm. In patients with impaired renal function who will receive multiple doses of fluconazole, an initial loading dose of 50 mg to 400 mg should be given. 1992 Jan-Feb;12(1):24-7. doi: 10.1111/j.1754-4505.1992.tb00402.x. Azithromycin: An open-label, randomized, three-way crossover study in 18 healthy subjects assessed the effect of a single 800 mg oral dose of fluconazole on the pharmacokinetics of a single 1200 mg oral dose of azithromycin as well as the effects of azithromycin on the pharmacokinetics of fluconazole. If the combination cannot be avoided, reduce the dose of olaparib as instructed in the LYNPARZA (Olaparib) Prescribing Information. Hydrochlorothiazide: In a pharmacokinetic interaction study, coadministration of multiple-dose hydrochlorothiazide to healthy volunteers receiving fluconazole increased plasma concentrations of fluconazole by 40%. There was a mean SD increase in tolbutamide AUC of 26% 9% (range: 12 to 39%). Ward 86, the first dedicated HIV inpatient clinic in the United States, marked its 40th anniversary with a celebration at Zuckerberg San Francisco General Hospital on January 25. These elevations occurred in patients with severe underlying disease, predominantly AIDS or malignancies, most of whom were receiving multiple concomitant medications, including many known to be hepatotoxic. 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. Azithromycin: An open-label, randomized, three-way crossover study in 18 healthy subjects assessed the effect of a single 1200 mg oral dose of azithromycin on the pharmacokinetics of a single 800 mg oral dose of fluconazole as well as the effects of fluconazole on the pharmacokinetics of azithromycin. Concomitant administration of voriconazole and fluconazole at any dose is not recommended. This combination may be used with a dosage adjustment of sirolimus depending on the effect/concentration measurements. This leaflet contains important information about fluconazole. Clinical and mycological response rates were higher in the children treated with fluconazole. You may want to clarify with your doctor if you can. Oral thrush is a common fungal infection of the mouth experienced by palliative medicine and hospice patients who have advanced cancer. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Gastrointestinal: Cholestasis, dry mouth, hepatocellular damage, dyspepsia, vomiting. Unauthorized use of these marks is strictly prohibited. The mean SD theophylline AUC increased 21% 16% (range: -5 to 48%). Treatment should be continued until clinical parameters or laboratory tests indicate that active fungal infection has subsided. Body as a Whole: Asthenia, fatigue, fever, malaise. Careful monitoring of cyclosporine concentrations and serum creatinine is recommended in patients receiving fluconazole and cyclosporine. The Tanzanian study of fluconazole, conducted at Muhimbili National Hospital in Dar es Salaam in 2006 and 2007, recruited 220 HIV-positive patients with a clinical and microbiological diagnosis of oropharyngeal candidiasis. Tiyese Jeranji explores what role Digital Adherence Technologies can play in helping people stay on treatment. These rates were comparable to control products. Alternatives to fluconazole include nystatin, ketoconazole and miconazole. government site. Single high dose fluconazole equivalent to 14 day treatment for oropharyngeal candidiasis, This article is more than 15 years old. Before Fluconazole did not affect the fertility of male or female rats treated orally with daily doses of 5 mg/kg, 10 mg/kg, or 20 mg/kg or with parenteral doses of 5 mg/kg, 25 mg/kg, or 75 mg/kg, although the onset of parturition was slightly delayed at 20 mg/kg PO. The https:// ensures that you are connecting to the I then took megadoses of probiotics, avoid sugar and ate lots of yog. The most common side effects of fluconazole are: Allergic reactions to fluconazole are rare, but they can be very serious if not treated right away by a doctor. There is no information regarding cross-hypersensitivity between fluconazole and other azole antifungal agents. At least 90% of the following fungi exhibit an in vitro MIC less than or equal to the susceptible breakpoint for fluconazole (https://www.fda.gov/STIC) against isolates of similar genus or organism group. Poland J. It may harm them. official website and that any information you provide is encrypted Individuals often experience distressing symptoms that affect their oral intake with most regimens adding to pill burden. Conclusion: Single-dose fluconazole 150 mg is an effective treatment of oral thrush for individuals with advanced cancer. [See USP Controlled Room Temperature.] No information regarding fluconazole pharmacokinetics in full-term newborns is available. On the sixth day of dosing, fluconazole increased the midazolam AUC and Cmax by 259% and 74%, respectively. Study design: For vaginal yeast infections, it's recommended to take one 150 mg tablet for a single dose. I am a UK taxpayer and I understand that if I pay less Income and /or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in the relevant tax year, it is my responsibility to pay any difference. Fluconazole half-life decreased from 33.4 4.4 hours to 26.8 3.9 hours (See PRECAUTIONS). This combination should be avoided. These results are consistent with the hypothesis that higher values for the pharmacokinetic parameters observed in the elderly subjects compared to normal young male volunteers are due to the decreased kidney function that is expected in the elderly. The overall incidence of side effects possibly related to fluconazole was 26%. Patients on long-term treatment with fluconazole and prednisone should be carefully monitored for adrenal cortex insufficiency when fluconazole is discontinued. Keywords: Keywords: advanced cancer; fluconazole; hospice; oral candidiasis; oral thrush; palliative medicine. Erectile dysfunction (ED) is often a symptom . Mean is based on data from 12 subjects as one of 13 subjects experienced a 2-fold increase in his prothrombin time response. The findings, published in the journal Clinical Infectious Diseases, could make it easier and cheaper to treat one of the most common infections in people with advanced HIV disease in resource-limited settings, the Tanzanian and Dutch study investigators say. CLINICAL PHARMACOLOGY: Drug Interaction Studies. The half-life of zidovudine was likewise prolonged by approximately 128% following combination therapy with fluconazole. Systemic Candida infections: For systemic Candida infections including candidemia, disseminated candidiasis, and pneumonia, optimal therapeutic dosage and duration of therapy have not been established. 8600 Rockville Pike Conclusion: Fluconazole administered as a single 150 mg oral dose proved to be as safe and effective as 7 days of intravaginal clotrimazole therapy for Candida vaginitis. The second major mechanism of drug resistance involves active efflux of fluconazole out of the cell through the activation of two types of multidrug efflux transporters; the major facilitators (encoded by MDR genes) and those of the ATP-binding cassette superfamily (encoded by CDR genes). There were no relevant effects on hormone level in the 50 mg fluconazole study, while at 200 mg daily, the AUCs of ethinyl estradiol and levonorgestrel were increased 40% and 24%, respectively. No information regarding DIFLUCAN pharmacokinetics in full-term newborns is available. For the treatment of candidemia and disseminated Candida infections, daily doses of 6 to 12 mg/kg/day have been used in an open, noncomparative study of a small number of children. This is particularly problematic if an individual is starting nevirapine treatment, because nevirapine dosing must be scaled up carefully after 14 days to avoid early toxicity. It is not meant to take the place of your doctor's instructions. Patients receiving rifabutin and fluconazole concomitantly should be carefully monitored. Fluconazole for Oral Suspension, USP is indicated for the treatment of: Prophylaxis: Fluconazole is also indicated to decrease the incidence of candidiasis in patients undergoing bone marrow transplantation who receive cytotoxic chemotherapy and/or radiation therapy. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Fluconazole - How long does it take to work? N Engl J Med 1992; 326:83-9.). During comparative clinical studies conducted in the United States, 448 patients with vaginal candidiasis were treated with fluconazole, 150 mg single dose. Treatment should be administered for at least 2 weeks to decrease the likelihood of relapse. This leaflet summarizes the most important information about fluconazole. The disturbances in parturition were reflected by a slight increase in the number of still born pups and decrease of neonatal survival at these dose levels. Following administration of 200 mg of fluconazole, the mean percentage increase of AUC for levonorgestrel compared to placebo was 25% (range: -12 to 82%) and the mean percentage increase for ethinyl estradiol compared to placebo was 38% (range: -11 to 101%). Unable to load your collection due to an error, Unable to load your delegates due to an error. Tell your doctor or pharmacist if you experience skin rash, fever, swollen glands, increase in a type of white blood cell (eosinophilia), and inflammation of internal organs (liver, lungs, heart, kidneys, and large intestine) as they may be signs of a hypersensitivity reaction (Drug Reaction or rash with Eosinophilia and Systemic Symptoms (DRESS)). 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