Fluconazole

Provider Level

RN/Paramedic

Class

Antifungal (Azole)

Mechanism of Action

Interferes with fungal cytochrome P450 activity, decreasing ergosterol synthesis and inhibiting cell membrane formation.

Indications

Treatment of systemic and localized fungal infections including candidiasis and cryptococcal meningitis. Primarily encountered in interfacility transport.

Contraindications

Hypersensitivity to fluconazole or other azoles. Concurrent use of drugs known to prolong the QT interval that are metabolized by CYP3A4.

Routes

PO, IV

Onset / Duration

Onset: Rapid (PO) or Immediate (IV). Duration: Long half-life (approximately 30 hours).

Adverse Effects

Nausea, vomiting, diarrhea, abdominal pain, headache, rash, QT prolongation, hepatotoxicity.

Precautions & Interactions

Monitor for QT prolongation. Use with caution in patients with renal or hepatic impairment. Highly prone to drug-drug interactions due to CYP inhibition.

Special Considerations

Authorized for RN/Paramedic use typically during interfacility critical care transport. Not indicated for acute prehospital emergencies. Requires cardiac monitoring if administering IV due to arrhythmia risk.