Diflucan (Fluconazole) Use While Pregnant

In our latest question and answer, the pharmacist discusses whether or not  Diflucan (fluconazole) is safe to take while pregnant.

Jul 26, 2018

NH201 asked

I was given a Fluconazole 150mg tablet to take last night, however this morning I’ve found out I’m pregnant. Possibly 2 weeks. I’m now worried about the effect it will have on my baby?

Answer

Fluconazole is classified by the FDA as Pregnancy Category C which has the following meaning:

"Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks."

Fluconazole’s package insert, tells us:

"Available human data do not suggest an increased risk of congenital anomalies following a single maternal dose of 150 mg.”

Some studies have found an increase in abnormalities when higher doses of Fluconazole (over 400mg) have been taken continuously or intermittently over the course of a pregnancy.

While the use of Fluconazole is not recommended during pregnancy since there are drugs available that are considered safer to use during pregnancy, it can be considered reassuring that available human data does not suggest an increase in congenital abnormalities.

Further doses of Fluconazole should NOT be taken now that you are aware that you are pregnant unless recommended by your doctor. Also, once you meet with your OBGYN, this dose of Fluconazole should be mentioned so you can have a further conversation with your doctor.

Since Fluconazole 150mg is often prescribed for vaginal yeast infections, a discussion is below on possible treatment of vaginal yeast infections for women who are pregnant.

Recommended Treatment for Vaginal Yeast Infections in Pregnant Women

Vaginal yeast infections are common in pregnant women. The increase in hormones, especially estrogen, is thought to contribute to this increase of occurrence of vaginal yeast infections. Treatment for any type of infection during pregnancy, even a vaginal yeast infection, needs to be done under the supervision of the patient’s doctor or other health care provider. Women should not self-treat a vaginal yeast infection during pregnancy.

In pregnancy, the preferred treatment for vaginal yeast infections is often to treat with vaginal antifungals like Clotrimazole or Miconazole. During pregnancy, 7 day products are recommended over the 1 or 3 day preparations. Sometimes it may be necessary to treat a vaginal yeast infection during pregnancy for a full 7-14 days.

These drugs are usually very well tolerated drugs. Some common side effects reported from the use of antifungals like Clotrimazole or Miconazole include:

  • Abdominal cramps
  • Vulvovaginal burning
  • Vulvovaginal irritation
  • Vulvovaginal itching

Patients should make sure to always finish the course of therapy even if the symptoms have improved or disappeared. If symptoms are not improving or are worsening after 3-5 days, the doctor should be contacted.

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