- To tell
- To recommend
The organism of the future mother at the same time solves so many important and crucial tasks that there is no longer enough strength to maintain her own immunity. This, of course, is an exaggerated interpretation of what happens to a woman during pregnancy, but the meaning remains the same. Immunity decreases very much, and infections always use this chance. And apart from the common cold, the most common problem is the fungus of the genus Candida.
To combat it, a large number of drugs have been developed today, but most of them are prohibited for use by pregnant women during all or some trimesters. Sometimes appointed during pregnancy "fluconazole". However, the effectiveness and safety of such an appointment is the subject of dispute of physicians.
Impact on the body
Unlike topical preparations (vaginal tablets, suppositories), this drug acts on the entire body. This is its advantage and disadvantage. "Fluconazole" during pregnancy is prescribed to fight the fungus. The active substance penetrates into all biological fluids (saliva, sputum, lymph) and accumulates in them. The maximum concentration lasts for several hours, which allows to neutralize the cause of the infection and clear all mucous membranes from the fungus. This explains the high efficacy of the drug in the fight against thrush.
Is it possible to prescribe a drug to expectant mothers
This question can only be answered by the attending physician, focusing on the tests and the state of health of the woman. "Fluconazole" during pregnancy is prescribed in the event that a severe form of fungal diseases threaten the life and health of the woman and the fetus. The drug has a systemic effect, that is, it is able to penetrate into the bloodstream. This means that it will influence the development of the child.
That is, in certain cases, the doctor may find it appropriate to prescribe this drug. Let's dwell on this moment in more detail. What should be the clinical manifestations? Vaginal candidiasis is usually asymptomatic. But any weakening of immunity, whether it is ARVI or hormonal failure, and the disease manifests itself in all its glory.
"Fluconazole" during pregnancy is prescribed for the following symptoms:
- severe itching
- a large amount of discharge (whiter),
- pain while urinating,
- discomfort during intercourse,
- redness of the vaginal mucosa,
- the appearance of an unpleasant smell.
By the way, if the patient had a history of the disease, with the recurrence of symptoms, she usually does not go to the doctor, but immediately goes to the pharmacy for previously prescribed drugs. This is wrong, because a bacterial infection also likes to join candidiasis. And only a specialist can find out the nature of the disease on the basis of a survey.
Especially not to choose their own drugs during pregnancy. Only a doctor can weigh the pros and cons. In case of a complicated infection, an antibiotic may be prescribed. By itself, it is also contraindicated for women in the situation, but may be necessary to prevent complications.
During pregnancy planning
If you want to become a mother, then you need to undergo a thorough examination. Identified fungal infections should be treated on the background of local contraception, to prevent conception before the end of the course. At this time, Fluconazole is often prescribed. Tablets during pregnancy are usually replaced by candles, but there is not much difference between their effects. And at the planning stage, doctors usually prefer oral administration. But no matter what form of the drug will be used. He still carries a threat to the embryo.
After completing the course, you need to wait some more time. Doctors say that the withdrawal of the drug from the body takes from two weeks to a month. During this time, it is recommended not to take hormonal contraceptives, but to use condoms.
Fluconazole during pregnancy in the early stages is contraindicated, as well as any other drugs. At this time there is a laying of all organs and systems, and it is very difficult to calculate the probability of complications from a particular drug. Therefore, in the first trimester, expectant mothers are advised to maintain immunity with the help of folk remedies and restrain the growth of fungus by douching with chamomile or soda.
Second and third trimester
If at the beginning of pregnancy "Fluconazole" gynecologists do not designate, referring to the results of studies conducted on mice, in the second half of pregnancy, doctors refer to the prescription of drugs is much more loyal. All organs and systems of the child are already formed. Active growth continues, but the probability of mutation is already minimized.
In addition, at this time, the placenta is included in the work, which to a certain extent suppresses harmful effects, including those exerted by drugs. The third trimester is the most favorable for the selection of drugs for thrush. "Fluconazole" during pregnancy before childbirth can be appointed if the internal infection can seriously harm the baby. Such indications include the risk of developing pathologies, fading of pregnancy and difficult childbirth.
If the mucous membranes are affected by the fungus, the risk of rupture in labor is much higher. Often, obstetricians say that if time is treated, they can be avoided.
Diagnosis of candidiasis in pregnant women
To accurately diagnose and prescribe treatment, it is necessary to conduct an examination on the chair. Usually at this stage, the gynecologist can already determine the presence of the fungus, but to exclude concomitant infections, crops should be performed. Similarly, bacterial vaginosis, as well as some other infections.
To perform the survey, you must take a swab. On the basis of a laboratory examination, it will be possible to make a conclusion about the presence of the fungus itself or signs of inflammation. Is it possible to drink Fluconazole during pregnancy, doctors continue to argue. And to a common opinion is unlikely to come. If you trust your gynecologist, then follow his appointments. If not, then it is better to contact another specialist to clarify the diagnosis.
How to avoid taking the drug
Despite the obvious advantages, there are significant drawbacks. Therefore, it should not be taken as a panacea for fluconazole candles during pregnancy. It is rather an emergency tool if everyone else cannot help. In order not to make such a choice, it is recommended:
- Even before pregnancy, be examined, and if necessary, then therapy.
- Regularly checked by a gynecologist and follow all recommendations.
- Use condoms.
- When prescribing any drugs, study their side effects, especially candidiasis and antibiotics.
- Follow the rules of personal hygiene.
Like any drug, the drug has pros and cons, side effects. Therefore, his appointment should be done only by a doctor.
Dosage regimen and dosage
Depends on the diagnosis. Most often, doctors recommend taking a single pill with a dosage of 150 mg. If the mucous membranes of the mouth are affected, a longer course of treatment is required, lasting 1-2 weeks. In this case, the daily dosage is reduced to 50 mg. Candles are also appointed by the course, for 3-5 days. For pregnant women, the doctor selects the course and dosage individually, based on her health and clinical studies.
Alternative drugs price
Instructions for use "Fluconazole" contains an impressive list of contraindications, but it overlaps a significant advantage. Take the capsule is required only once. During pregnancy, the drug is prescribed in the form of candles and ointments. The cost of one course is up to 180 rubles, that is, the price is quite affordable.
Alternatively, you can use Miconazole, Clotrimazole, Itraconazole, Ketoconazole. Each of them has its own characteristics, so the choice should be made by an experienced doctor. Their cost ranges from 100 to 200 rubles. "Clotrimazole" costs about 40 rubles, this is the lowest price. Instructions for use "Fluconazole" emphasizes its high efficiency compared with analogues, but at the same time, the presence of more contraindications, as well as side effects. These include:
- toxic effect on the liver.
Therefore, it is necessary to first examine the history and the results of the analyzes. The drug is not prescribed for arrhythmias, severe liver disease and hypersensitivity to active substances. In the list of contraindications is pregnancy. This is alarming future moms. Often they refuse to take the drug, even if he was appointed by a specialist.
In this regard, the clear advantages of a number of similar drugs are determined. For example, clotrimazole is not recommended to be used only in the first weeks of pregnancy, and then with the help of it you can maintain the health of mucous membranes right up to the birth. Mom's health is most important for the future baby, so it is best to consult with several doctors, but not to make mistakes when choosing a drug and not to harm the fetus.
Release form, indications for use
You can buy fluconazole in different dosage forms, it can be capsules, tablets, solution for parenteral administration.
Capsules during pregnancy is impractical, except in life-threatening cases. Contraindications include chronic alcoholism, renal, liver failure, hypersensitivity to fluconazole, other components of the drug. Do not take capsules in violation of electrolyte balance.
Tablets are taken exclusively on the doctor's prescription, only if the benefits exceed the potential harm to the health of the child and the mother. Among the contraindications in the instructions indicated the parallel use of alcoholic beverages, kidney and liver failure, an allergic reaction to the drug.
When planning a pregnancy
Planning a pregnancy is a serious matter, requiring an integrated and responsible approach. During this period, it is necessary to try to get rid of the focus of the inflammatory process, various infections, especially chronic ones. If a woman suffers from thrush, she must also be cured, otherwise yeast-like fungi will increase the pathogenic effect.
It should be remembered that after applying the pills or capsules are evacuated from the body no earlier than 14 days later. In other words, you can become pregnant only after the expiration of this period after the last administration of the drug.
If the conception has already happened, and an infection is present in the body, you need to consult a doctor. He will prescribe drugs against the fungus, which will be less dangerous to the fetus.
In addition, it is important:
- carefully follow the rules of personal hygiene
- review the diet
- try not to contact a sick person.
The first weeks will need to take multivitamin preparations, mineral complexes to restore immune protection. The recommendation helps to prevent fungal disease and prevent the adherence of pathogenic flora.
If the couple is trying to get pregnant, she should find out from the doctor all the nuances of drug therapy.
In case of mycoses of the skin, including fungal diseases of the groin, feet, candidiasis of the skin, the optimal dosage is 150 mg of the substance once a week or 50 mg every day for 7 days. The exact dose is determined by the clinical, mycological effect.
The average duration of therapy in the absence of bacterial flora is from 2 to 4 weeks, with mycoses of the skin of the feet, it may be necessary to increase the duration of the course of use of the medication.
Pityriasis versicolor involves to drink 300 mg of the drug once a week, a course of 2 weeks. Sometimes patients need to take treatment for three weeks. If the dosage is insufficient to achieve positive disease dynamics, it is better to switch to an alternative therapy regimen, take 50 mg once a day for a month.
In case of fungal infections of the nail plates, it is recommended to drink 150 mg each once a week. Treatment continues until such time as a healthy nail grows. On average, tablets continue to drink from three months to one year.
Major contraindications, adverse reactions
Instructions for use of the drug indicates that oral administration of Fluconazole is not recommended for excessive sensitivity to the active ingredients, other components of the composition.
Parallel administration with Terfenadine is prohibited, especially against the background of the systematic use of Fluconazole at a dosage of 400 mg per day or more. Also, do not take the drug with Astemizole, Tsisaprid, other drugs that change the QT interval, when breastfeeding.
Some patients complain about the occurrence of undesirable effects in the treatment process. The most striking adverse reactions are nausea, vomiting, upset stool, increased gas formation.
It can also be:
- allergic rashes,
- fast fatiguability.
Fluconazole is a drug with proven adverse effects on the fetus, but the potential benefit justifies its use. Each patient doctor writes an individual regimen, self-treatment is prohibited. It happens that for safety it is still better to use analogues with other active ingredients and an equivalent effect on the body.
Today there is no information about cases of overdose, with a significant excess of the recommended dosages, the patient may begin serious psychotic disorders: obsessions, hallucinations. Treatment of overdose is eliminated by washing the stomach, in case of a severe course of the pathological condition, hemodialysis cannot be done.
The drug Fluconazole is taken with caution, while using with statins (tablets against high bad blood cholesterol), nonsteroidal anti-inflammatory drugs.
Combination with hypertensive drugs, antidepressants, Rifampicin, tablets for the treatment of malignant tumors is undesirable. Fluconazole provokes an increase in adverse reactions when taking antiviral drugs, antiepileptic drugs.
Increased adverse effects from taking benzodiazepines, inhibiting evacuation of Theofillin from the bloodstream, and an increased risk of signs of intoxication are not excluded. A woman has an increased elimination period for antihyperglycemic drugs.
Treatment is carried out before the onset of clinical and hematological remission, the unauthorized termination of therapy leads to the following consequences:
- recurrence of fungal disease
- resistance to active substances
- strengthening the symptoms of pathology.
When therapy is required to keep under control blood counts, to investigate the function of the liver and kidneys. In case of a violation by the internal organs, treatment is immediately stopped.
Rarely against the background of Fluconazole toxic changes in the liver, including fatal, are observed. More often pathology was diagnosed in patients with serious comorbidities.
With hepatotoxic effects caused by drug therapy, there is no obvious dependence on the amount of substance taken. Also does not affect the duration of the use of tablets and the age of the woman. Symptomatology is reversible, completely disappears when treatment is stopped.
What is Fluconazole
Fluconazole - is a synthetic triazole-based antibiotic that is effective against many types of fungi parasitizing on the skin, mucous membranes and in the internal organs of man. By suppressing the synthesis of components of their cell wall, the drug causes the death of pathogenic microorganisms.
Unlike other commonly used antimycotic drugs, such as Zalain or Clotrimazole, Flucostat is perfectly absorbed into the blood when it is applied to the skin. And when taken orally, the concentration of the active substance in the cells of the mucous or skin is almost equal to the content in the blood and internal organs. In addition, it is able to penetrate even through the protective blood-brain barrier, affecting the causative agent of the disease in brain tissue.
Even with long-term use Fluconazole does not cause unpleasant symptoms of dysbiosis.
What diseases effective Fluconazole
Diflucan, like all other drugs - synonymous with Fluconazole - prevents and cures many fungal infections, localized not only in the skin or mucous membranes, but also in any organ. That is, both local and systemic mycoses are subject to it.These are lichen, thrush, cryptococcosis, mycosis of the feet and other parts of the body, fungal nail infections (onychomycosis), deep and generalized mycoses, including those infected by HIV-infected people and immunocompromised patients (for tumors, after taking antibiotics or immunosuppressors).
Is fluconazole allowed during pregnancy and lactation?
In the study of teratogenic (that is, damaging the organs of the fetus) Fluconazole exposure was able to reveal that in very high concentrations in the blood it can cause the development of bone pathology in a child. Therefore, the drug is prohibited for self-use during pregnancy.
But in medical practice there are situations when severe candidiasis can threaten the health, and even the life of a woman. In this case, the determination of the sensitivity of the causative agent of the disease shows its resistance to other antimicotic agents. In this case, the benefit of the drug exceeds its possible harm, and it is prescribed to a pregnant woman, but strictly following the dosing regimen.
Since fluconazole is quickly and evenly distributed throughout the body, it easily passes into breast milk. Therefore, at the time of treatment, the mother is prohibited to feed her baby with milk
What form of fluconazole is used during pregnancy
Due to the rapid absorption into the blood by any method of drug administration and the ease of its distribution throughout all organs and skin, there is no need to invent many local forms of release of this drug. Therefore, Fluconazole and its analogues are used in the form of tablets, capsules, syrup or powders of a suspension of drinking for oral administration, as well as in the form of an aqueous solution for intravenous administration.
After bacteriological examination, depending on the type of fungal infection and severity of the course, the doctor may prescribe as a single dose of the drug, and its regular use for many months.
What are the contraindications and side effects of fluconazole
With long-term use of the drug is high probability of impaired function of the liver and kidneys. Therefore, the expressed insufficiency of these organs is a contraindication for the use of fluconazole. In addition, it is prohibited in case of allergies, inhibition of any germ of blood formation.
Of the frequent side effects, we note the irritation of the mucous membranes of the gastrointestinal tract, manifested by nausea, abdominal pain, and swelling. Rarely can be a headache and even seizures.
Fluconazole is rapidly absorbed by oral administration, the bioavailability index exceeds 90%. Simultaneous use with food does not affect the degree of absorption of the drug. The maximum daily concentration is reached one and a half hours after administration or ingestion.
The distribution is equal to the amount of fluid in the body, the degree of binding to plasma proteins is about 12%. The active substances penetrate well into body fluids, the indicator of fluconazole in sputum and saliva is equal to the concentration of the drug in the blood plasma.
The level of the substance in the skin exceeds the rate of funds in biological fluids. About 11% of the active substance is metabolized, evacuated along with the urine unchanged.
The half-life is approximately 30 hours:
- the main part is excreted by the kidneys (80% of the dosage is found unchanged),
- clearance is proportional to creatinine clearance,
- circulating metabolites are not observed in the bloodstream.
The long half-life of the drug from blood plasma allows you to use the drug once a day, for some indications it is enough to take one dose per week.
Popular and effective analogues for the main substance are the means Mikomax, Diflazon, Flucostat, Mikosist. Due to the danger of use in pregnancy, gynecologists replace the drug with another active ingredient.
The question of the use of the drug is solved exclusively in the absence of positive dynamics. The safest drug options for treating pregnant women are natamycin based fungi.
Fluconazole belongs to the class of antifungal drugs. It inhibits the synthesis of substances that are necessary for the formation and reproduction of fungi. The advantage of the drug over some means of similar action is the lack of androgenic activity. In other words, it does not provoke increased hair growth on the body and maintains a healthy scalp.
Fluconazole actively fights mycoses and candidiasis. One of the reasons for their appearance may be a decrease in immunity during pregnancy (after conception, the body itself suppresses its immune system so that the fetus does not reject).
Consequences of use in the early stages
The first trimester of pregnancy is considered the most dangerous for taking any medication. Fluconazole can cause miscarriage and serious brain damage to the fetus. According to the world research organizations, during this period the drug has a mutagenic effect (that is, it can cause mutations).
Possible pathologies include:
- underdevelopment of the fetus,
- skeletal formation defects,
- wolf's mouth.
Most often, fluconazole during pregnancy in the early stages is replaced by safer drugs.
Appointment in the second and third trimesters
During the second trimester, the fetus forms a skeleton and internal organs. Fluconazole is able to penetrate the placenta, so its use during this period can provoke congenital defects in the structure of bones or underdevelopment of body systems. In the last third of the term, the drug is prescribed only in the event of the occurrence of pathological strains of fungi that threaten the life of the mother or fetus.
In any period of pregnancy Fluconazole is used only on prescription. The consequences of self-medication in this case can be fatal.
Contraindications for the appointment of the drug
According to the instructions, contraindications are:
- hypersensitivity to the active substance and other components of the composition,
- simultaneous reception of Terfenadine (against the background of continuous use of Fluconazole at a dose of 400 mg / day or more),
- simultaneous administration of Zisapride, Astemizole and other drugs that prolong the QT interval (an indicator of heart failure),
- lactation period.
Among the side effects are:
- nausea and vomiting,
- diarrhea and flatulence,
- cramp, dizziness, headache and fatigue,
- allergy in the form of a rash.
According to the classification of the FDA (Food and Drug Administration of the USA) classification, fluconazole is classified as category D. This indicates a proven risk of adverse effects of the drug on the fetus, but the potential benefits associated with using the drug in pregnant women may justify its use.
Analogs and drugs with a similar effect
Analogues of fluconazole for the active substance are:
Because of the danger of use during pregnancy, gynecologists for the treatment of fungal infections are more likely to prescribe drugs with another active ingredient. The question of the use of Fluconazole is solved only in the absence of their effectiveness.
Natamycin-based drugs are currently considered the safest treatment for pregnant women.
Why use antimycotic
Fluconazole tablets are prescribed for various types of fungal infections:
- candidiasis of the genital organs in men and women
- oral candidiasis,
- skin manifestations of thrush,
- Candida sepsis.
The drug is used in adults and adolescents over 12 years old, children are prescribed other antifungal agents.
The regimen and dosage depend on the diagnosis. For example, you can get rid of thrush of the genital tract by taking a single pill 150mg. For candidiasis of the oral cavity, a course of treatment is required for 1-2 weeks. Tablets containing 50 or 100 mg of the active substance are prescribed once a day. For severe forms, treatment may be longer.
The advantage of using antimycotics for fungal infections is as follows:
- the drug gives a lasting effect, fungi rarely develop insensitivity to it, so the effectiveness of treatment is preserved,
- tablets can be drunk once a day,
- low cost.
More expensive foreign analogues with the same active ingredient cost more, but are comparable in efficiency.
Side effects and contraindications
Despite all its advantages, Fluconazole has a number of side effects, due to which it is necessary to take it only after consulting a doctor. These include:
- digestive disorders - abdominal pain, nausea, diarrhea,
- allergic reactions in the form of rash and headache,
- toxic effect on the liver, the effect on the electrical activity of the heart.
In this regard, determined by contraindications to the reception, which are quite a lot. The drug is not prescribed for arrhythmias, as well as together with other drugs that affect the electrical activity of the heart, with severe liver disease and hypersensitivity to active substances. Also contraindications include pregnancy and child age (up to 4 years).