Drug Uses

Diflucan is indicated for the treatment of:
-Vaginal candidiasis (vaginal yeast infections due to Candida).
-Oropharyngeal and esophageal candidiasis.
-Cryptococcal meningitis.
Diflucan is also indicated to decrease the incidence of candidiasis in patients undergoing bone marrow transplantation who receive cytotoxic chemotherapy and/or radiation therapy.

How Taken

Diflucan comes as a tablet and liquid to take by mouth. It is usually taken once a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Diflucan exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Shake the liquid well before each use to mix the medication evenly. Continue to take Diflucan even if you feel well. Do not stop taking Diflucan without talking to your doctor.

Warnings/Precautions

Do not take Diflucan if you are taking cisapride (Propulsid). Combined with cisapride (Propulsid), Diflucan could cause serious, even fatal, heart problems. Before taking Diflucan, tell your doctor if you have any other medical conditions, especially kidney disease, or if you take other medicines. You may not be able to take Diflucan, or you may require a dosage adjustment or special monitoring during your treatment. Diflucan is in the FDA pregnancy category C. This means that it is not known whether it will be harmful to an unborn baby. Do not take Diflucan without first talking to your doctor if you are pregnant or could become pregnant during treatment. Diflucan passes into breast milk and may be harmful to a nursing baby. For this reason, Diflucan should not be taken by nursing mothers. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

Missed Dose

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Possible Side Effects

If you experience any of the following serious side effects, stop taking Diflucan and seek emergency medical attention or contact your doctor immediately: an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); liver damage (pale stools, yellowing of the skin or eyes, abdominal pain, unusual fatigue, or dark urine); or a rash. Other, less serious side effects may be more likely to occur. If you experience any of the following side effects, continue taking Diflucan and talk to your doctor: nausea, vomiting, or abdominal pain; diarrhea; headache; dizziness; fatigue; or itching. Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Storage

Store tablets below 86°F (30°C). Protect from freezing. Diflucan injections in Viaflex Plus plastic containers are available in both sodium chloride and dextrose diluents. Store between 77°F (25°C) and 41°F (5°C). Brief exposure up to 104°F (40°C) does not adversely affect the product. Protect from freezing.

Overdose

Seek emergency medical attention if an overdose is suspected. Symptoms of a Diflucan overdose include confusion, hallucinations, paranoia, decreased movement, decreased breathing, tearing eyes, drooling, urinary incontinence, seizures, and death.

More Information

Avoid alcohol or use it in moderation while taking Diflucan. Alcohol and Diflucan can both affect the liver. Use caution when driving or performing other hazardous activities. Diflucan may cause dizziness. If you experience dizziness, avoid these activities.

Disclaimer

This drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of your medication. This is only general information, and should not be relied on for any purpose. It should not be construed as containing specific instructions for any particular patient. We disclaim all responsibility for the accuracy and reliability of this information, and/or any consequences arising from the use of this information, including damage or adverse consequences to persons or property, however such damages or consequences arise. No warranty, either expressed or implied, is made in regards to this information.

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We also recommend regular "drug checks" with your doctors. You may be able to switch to lower–cost generics, or to one of our Rx-drugs-online.com. Even if you have coverage, you may be able to save hundreds of dollars by switching to less expensive generics or by buying from Rx-drugs-online.com. Drug stores even in a single town or city can charge prices for the same drugs that vary by 50% or more. Shopping wisely for Diflucan can also save you money. This may mean buying drugs online or through mail order, checking prices at local pharmacies and discount stores, and getting a 90–day supply of any medicines you take on a regular basis.

Q: Do you deliver Diflucan to my state?
A: Due to regulations we cannot ship medicines to all states, please check the order form for the current list of states that we can ship to.


Even as Evista (raloxifene) reduced the risk of invasive breast cancer by 44%, compared with placebo, it had a significantly increased relative risk of thromboembolic events -- including fatal strokes -- according to a study of more than 10,000 postmenopausal women.
Evista was associated with a 49% increase in the relative risk of fatal stroke (P=0.05), Elizabeth Barrett-Connor, M.D., of the University of California San Diego and colleagues for the RUTH (Raloxifene Use for The Heart) trial reported in the July 13 issue of the New England Journal of Medicine.
Evista was also associated with a significant increase in risks of venous thromoboembolic events (P=0.02), but as expected Evista was associated with a significant decrease in risk of clinical vertebral fractures (P=0.007).
The 44% decrease in invasive breast cancer risk (P=0.003) among women taking Evista was driven by a highly significant reduction in estrogen-positive breast cancer (P<0.001). Evista did not reduce the risk of estrogen-negative breast cancers (P=0.40).
Women taking Evista also had significantly more hot flushes, leg cramps, and peripheral edema (P<0.001 for all compared with placebo), they wrote.
The RUTH investigators randomly assigned 10,101 postmenopausal women (mean age 67.5) with established coronary heart disease or multiple risk factors for heart disease to either 60 mg of Evista daily or placebo. The women were followed for a median of 5.6 years. The primary endpoints were coronary events and invasive breast cancer.
In this group of women at high risk for coronary events, "the difference in absolute rates of events that were decreased (i.e., breast cancer and clinical vertebral fractures) was similar to the difference in the absolute rates of events that were increased (i.e., venous thromboembolic events and fatal strokes)," the authors wrote.
And that may be the sticking point for many clinicians counseling women, said Steven Nissen, M.D., acting director of cardiology at the Cleveland Clinic.
"When a drug increases cardiovascular risk, we have to take that seriously," he said adding that Dr. Barrett-Connor and colleagues did an excellent job of "laying out the risks and benefits very clearly, with no spin."
Dr. Nissen, who was an early critic of Vioxx (rofecoxib) because of its increased risk of thromboembolic events, said that results of the RUTH trial are likely to spur debate if Lilly, the maker of Evista, seeks FDA approval for Evista for breast cancer prevention.
Currently the drug is approved for treatment and prevention of osteoporosis in postmenopausal women.
Earlier this year, results of the STAR (Study of Tamoxifen and Raloxifene) trial indicated that Evista is as effective as tamoxifen for preventing breast cancer in postmenopausal women. Tamoxifen is the only FDA approved drug for prevention of breast cancer.
Lilly said in June that it plans to ask the FDA to approve Evista for cancer prevention.
Evista and tamoxifen are both selective estrogen receptor modulators, or SERMs. SERMs were originally developed as alternatives to estrogen to treat symptoms of menopause as well as osteoporosis. But unlike estrogen, SERMs do not reduce vasomotor symptoms, although they have demonstrated efficacy in osteoporosis.
When the RUTH trial began recruiting women in 1998 it was widely believed that estrogen reduced the risk of coronary events, which led Dr. Barrett-Connor and colleagues to hypothesize that Evista would also be cardio-protective. But in 2002, investigators for the Women's Health Initiative reported that estrogen increased the risk of stroke and thromboembolic events, as well as increasing the risk of breast cancer.
The RUTH results "now allow us to say that all modulators of the estrogen receptors potentially increase the risk of cardiovascular events," said Dr. Nissen.
John T. Cole, M.D., medical director of hematology and oncology services at the Ochsner Health System in New Orleans, said that the RUTH findings coming on the heels of the STAR trial confirm that Evista has a role in chemoprevention in a select population -- but defining that population may be difficult.
Even so-called high risk women only have very small absolute risk for developing breast cancer, he said. "If you look at in terms of telling a woman that she has about a 98.4% chance of [not developing breast cancer], it is difficult to imagine her wanting chemoprevention," he said.
Nonetheless, Dr. Cole said that in both the RUTH trial and the STAR trial "as risk increased, so did the potential benefit of chemoprevention."
In an NEJM editorial, Marcia L. Stefanick, Ph.D., of the Stanford Prevention Research Center in Stanford, Calif., said the RUTH study "highlights the need to consider the risk of breast cancer as well as other risks and coexisting conditions in determining whether and when [Evista] or another SERM is warranted for an individual woman."
"For women represented by the RUTH cohort of women with or at increased risk for CHD, the moderate benefits of raloxifene for breast cancer prophylaxis do not seem to justify the risks" she wrote.
"For now," Dr. Stefanick continued, "there is no magic bullet that can reduce the risks of major health problems related to estrogens and aging without introducing other potentially serious health concerns."

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