Diflucan 200 mg hard capsules

Package leaflet: Information for the user

Introduction

Package leaflet: information for the user

Diflucan 50 mg hard capsules

Diflucan 100 mg hard capsules

Diflucan 150 mg hard capsules

Diflucan 200 mg hard capsules

fluconazole

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

• Keep this leaflet. You may need to read it again.
• If you have any questions, ask your doctor, pharmacist, or nurse.
• This medicine has been prescribed for you only. Do not give it to other people, even if they have the same symptoms as you, as it may harm them.
• If you experience any side effects, talk to your doctor, pharmacist, or nurse, even if they are side effects not listed in this leaflet. See section 4.

Contents of the leaflet:

1. What Diflucan is and what it is used for

2. What you need to know before taking Diflucan

3. How to take Diflucan

4. Possible side effects

5. How to store Diflucan

6. Contents of the pack and other information

1. What Diflucan is and what it is used for

Diflucan is one of the medicines belonging to a group called "antifungals". The active substance is fluconazole.

Diflucan is used to treat fungal infections, and may also be used to prevent the occurrence of a Candida infection. The most common cause of fungal infections is a yeast called Candida.

Adults

Your doctor may prescribe this medicine to treat the following types of fungal infections:

• Cryptococcal meningitis – a fungal infection of the brain.
• Coccidioidomycosis – a disease affecting the bronchopulmonary system.
• Infections caused by Candida located in the bloodstream, in body organs (e.g. heart, lungs), or in the urinary tract.
• Mucosal candidiasis – infection affecting the lining of the mouth, throat, or associated with dental prostheses.
• Genital candidiasis – infection of the vagina or penis.
• Skin infections – e.g. athlete's foot, ringworm, jock itch, nail infections.

Diflucan may also be prescribed to:

• prevent recurrence of cryptococcal meningitis.
• prevent recurrence of mucosal Candida infections.
• reduce repeated episodes of vaginal Candida infections.
• prevent Candida infections (if your immune system is weakened and not functioning properly).

Children and adolescents (0 to 17 years)

Your doctor may prescribe this medicine to treat the following types of fungal infections:

• Mucosal candidiasis – infection affecting the lining of the mouth or throat.
• Infections caused by Candida located in the bloodstream, in body organs (e.g. heart, lungs), or in the urinary tract.
• Cryptococcal meningitis – a fungal infection of the brain.

Diflucan may also be prescribed to:

• prevent Candida infections (if your immune system is weakened and not functioning properly).
• prevent recurrence of cryptococcal meningitis.

2. What you need to know before taking Diflucan

Do not take Diflucan

• if you are allergic (hypersensitive) to fluconazole, to other antifungal medicines you have taken, or to any of the other ingredients of this medicine (listed in section 6). Symptoms may include itching, skin redness, or difficulty breathing.
• if you are taking astemizole or terfenadine (antihistamine medicines used to treat allergies).
• if you are taking cisapride (used to treat stomach discomfort).
• if you are taking pimozide (used to treat mental illnesses).
• if you are taking quinidine (used to treat heart arrhythmias).
• if you are taking erythromycin (an antibiotic used to treat infections).

Warnings and precautions

Talk to your doctor or pharmacist before starting Diflucan

• if you have liver or kidney problems.
• if you have a heart condition, including heart rhythm problems.
• if you have abnormal levels of potassium, calcium, or magnesium in your blood.
• if you develop severe skin reactions (itching, skin redness, or difficulty breathing).
• if you experience signs of “adrenal insufficiency,” in which the adrenal glands do not produce enough of certain hormones such as cortisol (chronic or prolonged fatigue, muscle weakness, loss of appetite, weight loss, abdominal pain).
• if you have ever had a severe skin rash, skin peeling, blisters, and/or mouth sores after taking Diflucan.

Severe skin reactions, including drug reaction with eosinophilia and systemic symptoms (DRESS), have been reported with Diflucan treatment. Stop taking Diflucan and seek immediate medical attention if you notice any symptoms related to these severe skin reactions described in section 4.

Speak with your doctor or pharmacist if your fungal infection does not improve, as alternative antifungal treatment may be needed.

Taking Diflucan with other medicines

Inform your doctor or pharmacist if you are currently using, have recently used, or might need to use any other medicines.

Inform your doctor immediately if you are taking astemizole, terfenadina (an antihistamine for allergies), cisapride (used for stomach discomfort), pimozide (used to treat mental illnesses), quinidine (used to treat heart arrhythmias), or erythromycin (an antibiotic for infections), as these medicines must not be taken with Diflucan (see section: “Do not take Diflucan”).

Some medicines may interact with Diflucan.

Ensure your doctor knows if you are taking any of the following medicines, as dose adjustment or monitoring may be necessary to ensure these medicines remain effective:

• Rifampicin or rifabutin (antibiotics for infections).

• Abrocitinib (used to treat atopic dermatitis, also known as atopic eczema).

• Alfentanil, fentanyl (used as anesthetics).

• Amitriptyline, nortriptyline (used as antidepressants).

• Amphotericin B, voriconazole (antifungals).

• Medicines that make the blood less viscous to prevent blood clots (warfarin or similar medicines).

• Benzodiazepines (midazolam, triazolam, or similar medicines) used to help sleep or for anxiety.

• Carbamazepine, phenytoin (used to treat seizures).

• Nifedipine, isradipine, amlodipine, verapamil, felodipine, and losartan (for hypertension – high blood pressure).

• Olaparib (used to treat ovarian cancer).

• Cyclosporine, everolimus, sirolimus, or tacrolimus (to prevent transplant rejection).

• Cyclophosphamide, vinca alkaloids (vincristine, vinblastine, or similar medicines) used to treat cancer.

• Halofantrine (used to treat malaria).

• Statins (atorvastatin, simvastatin, fluvastatin, or similar medicines) used to lower high cholesterol levels.

• Methadone (used for pain).

• Celecoxib, flurbiprofen, naproxen, ibuprofen, lornoxicam, meloxicam, diclofenac (Non-Steroidal Anti-Inflammatory Drugs -NSAIDs-).

• Oral contraceptives.

• Prednisone (a steroid).

• Zidovudine, also known as AZT; saquinavir (used in HIV-infected patients).

• Medicines for diabetes, such as chlorpropamide, glyburide, glipizide, or tolbutamide.

• Theophylline (used to control asthma).

• Tofacitinib (used to treat rheumatoid arthritis).

• Tolvaptan (used to treat hyponatremia [low sodium levels in blood] or to delay worsening of kidney function).

• Vitamin A (nutritional supplement).

• Ivacaftor (alone or combined with medicines used to treat cystic fibrosis).

• Amiodarone (used to treat irregular heartbeats “arrhythmias”).

• Hydrochlorothiazide (diuretic).

• Ibrutinib (used to treat blood cancer).

• Lurasidone (used to treat schizophrenia).

Taking Diflucan with food and drink

You may take this medicine with or without food.

Pregnancy, breastfeeding, and fertility

If you are pregnant, breastfeeding, think you may be pregnant, or are planning to become pregnant, consult your doctor or pharmacist before taking any medicine.

If you are planning to become pregnant, it is recommended that you wait one week after a single dose of fluconazole before trying to conceive.

For longer treatment cycles with fluconazole, consult your doctor about the need to use appropriate contraceptive methods during treatment, which should be continued for one week after the last dose.

Do not take Diflucan if you are pregnant, think you may be pregnant, or intend to become pregnant, unless your doctor has specifically instructed you to do so. If you become pregnant while taking this medicine or within one week after the most recent dose, consult your doctor.

Fluconazole taken during the first or second trimester of pregnancy may increase the risk of spontaneous abortion. Fluconazole use during the first trimester may increase the risk of congenital malformations affecting the baby’s heart, bones, and/or muscles.

Cases of babies born with congenital malformations affecting the skull, ears, and thigh and elbow bones have been reported in women treated for three months or more with high doses (400–800 mg daily) of fluconazole for coccidioidomycosis. The relationship between fluconazole and these cases is not clear.

Breastfeeding may be continued after a single 150 mg dose of Diflucan. You should not continue breastfeeding if you are taking repeated doses of Diflucan.

Driving and using machines

When driving or operating machinery, bear in mind that dizziness or seizures may occasionally occur.

Diflucan contains lactose (milk sugar) and sodium (salt)

This medicine contains a small amount of lactose (milk sugar). If your doctor has informed you that you have an intolerance to certain sugars, consult him before taking this medicine.

Diflucan capsules also contain less than 1 mmol of sodium (23 mg) per capsule; this is essentially “sodium-free.”

3. How to take Diflucan

Follow exactly the administration instructions for this medicine as indicated by your doctor. If in doubt, consult your doctor or pharmacist again.

The capsules should be swallowed whole with a glass of water. It is best to take your medicine at the same time of day each time.

The following are the recommended doses of this medicine for different types of infections:

Adults

Adolescents aged 12 to 17 years

Follow the dose prescribed by your doctor (the adult or pediatric dosage).

Children up to 11 years

The maximum daily dose for children is 400 mg per day.

The dose will be based on the child's weight in kilograms.

Use in children from 0 to 4 weeks of age

Use in children aged 3 to 4 weeks:

• The same dose as described in the table, but administered once every 2 days. The maximum dose is 12 mg per kg of body weight every 48 hours.

Use in children under 2 weeks of age:

• The same dose as described in the table, but administered once every 3 days. The maximum dose is 12 mg per kg of body weight every 72 hours.

Elderly patients

The usual adult dose, unless you have kidney problems.

Patients with kidney problems

Your doctor may adjust your dose, depending on how well your kidneys are functioning.

If you take more Diflucan than you should

Taking too many capsules at once may make you feel unwell. Contact your doctor immediately or go to the nearest hospital. You may also call the Toxicology Information Service at telephone number 91 562 04 20, stating the medication and the amount ingested. Symptoms of a possible overdose may include hearing, seeing, feeling, and thinking things that are not real (hallucinations and paranoid behavior). It may be appropriate to initiate symptomatic treatment (with supportive measures and gastric lavage if necessary).

If you forget to take Diflucan

Do not take a double dose to make up for forgotten doses. If you forget to take a dose, take it as soon as you remember. If it is almost time for your next dose, do not take the missed dose.

If you have any questions about the use of this medicine, ask your doctor or pharmacist.

4. Possible adverse effects

Like all medicines, this medicine can cause adverse effects, although not everyone will experience them.

Stop taking Diflucan and seek medical attention immediately if you notice any of the following symptoms:

• widespread rash, high body temperature, and enlarged lymph nodes (DRESS syndrome or drug hypersensitivity syndrome).

Some people may develop allergic reactions, although severe allergic reactions are rare. If any adverse effect occurs, speak to your doctor or pharmacist. This includes any possible adverse effects not mentioned in this leaflet. If you experience any of the following symptoms, inform your doctor immediately:

• sudden wheezing, difficulty breathing, or chest tightness.
• swelling of the eyelids, face, or lips.
• itching all over the body, skin redness, or itchy red spots.
• skin rash.
• severe skin reactions, such as blistering rash (this may affect the mouth and tongue).

Diflucan may affect your liver. Signs indicating liver problems include:

• fatigue.
• loss of appetite.
• vomiting.
• yellowing of the skin or whites of the eyes (jaundice).

If you experience any of these symptoms, stop taking Diflucan and contact your doctor immediately.

Other adverse effects:

Additionally, if you consider any of the adverse effects you experience to be severe, or if you notice any adverse effects not listed in this leaflet, inform your doctor or pharmacist.

Frequent adverse effects (may affect up to 1 in 10 patients) are:

• headache.
• stomach discomfort, diarrhoea, nausea, vomiting.
• elevated blood test results indicating liver function.
• rash.

Uncommon adverse effects (may affect up to 1 in 100 patients) are:

• reduction in red blood cells, which may cause pale skin, weakness, or difficulty breathing.
• decreased appetite.
• inability to sleep, numbness sensation.
• seizures, dizziness, spinning sensation, tingling, prickling, or numbness, changes in taste sensation.
• constipation, indigestion, flatulence, dry mouth.
• muscle pain.
• liver damage and yellowing of the skin and eyes (jaundice).
• hives, blisters (wheals), itching, increased sweating.
• fatigue, general feeling of being unwell, fever.

Rare adverse effects (may affect up to 1 in 1,000 patients) are:

• lower than normal levels of white blood cells that help defend against infections and blood cells that help stop bleeding.
• reddish or purplish skin discoloration, which may be due to low platelet count, other changes in blood cells.
• changes in blood tests (high levels of cholesterol, fats).
• low blood potassium levels.
• tremors.
• abnormal electrocardiogram (ECG), changes in heart rate or rhythm.
• liver function failure.
• allergic reactions (sometimes severe), including extensive blistering and peeling skin rash, severe allergic reactions, swelling of the lips or face.
• hair loss.

Frequency not known, but possible (cannot be estimated from available data):

• hypersensitivity reaction with skin rash, fever, swollen glands, increase in a type of white blood cells (eosinophilia), and inflammation of internal organs (liver, lungs, heart, kidneys, and large intestine) (drug reaction or eosinophilia and systemic symptoms [DRESS]).

Reporting of adverse effects:

If you experience any type of adverse effect, consult your doctor, pharmacist, or nurse, even if they are possible adverse effects not listed in this leaflet. You can also report them directly via the Spanish Pharmacovigilance System for Human Medicines: www.notificaRAM.es. By reporting adverse effects, you can help provide more information on the safety of this medicine.

5. Conservation of Diflucan

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date stated on the packaging after EXP. The expiry date is the last day of the month indicated.

Store below 30°C.

Medicines must not be disposed of via wastewater or household waste. Dispose of empty containers and unused medicines at the SIGRE collection point at your pharmacy. If you are in doubt, ask your pharmacist how to dispose of containers and medicines you no longer need. This will help protect the environment.

6. Contents of the pack and other information

Composition of Diflucan

• The active substance is fluconazole.
• Each hard capsule contains 50 mg, 100 mg, 150 mg or 200 mg of fluconazole.
• The other components (excipients) are:

Capsule contents: lactose monohydrate, corn starch, colloidal anhydrous silica, magnesium stearate and sodium lauryl sulphate (see section 2, Diflucan contains lactose (milk sugar) and sodium (salt)).

Composition of the gelatin capsules:

Diflucan 50 mg hard capsules: gelatin (E441), titanium dioxide (E171) and patent blue V (E131).

Diflucan 100 mg hard capsules: gelatin (E441), titanium dioxide (E171), erythrosine (E127) and patent blue V (E131).

Diflucan 150 mg hard capsules: gelatin (E441), titanium dioxide (E171) and patent blue V (E131).

Diflucan 200 mg hard capsules: gelatin (E441), titanium dioxide (E171), erythrosine (E127) and indigo carmine (E132).

Printing ink: shellac, black iron oxide (E172), N-butyl alcohol, dehydrated alcohol, purified water, propylene glycol (E1520), industrial methylated spirits, isopropyl alcohol, concentrated ammonium solution, potassium hydroxide (E525).

Appearance of Diflucan and contents of the pack

• Diflucan 50 mg capsules have a white body and turquoise blue cap. They are printed with “FLU-50” and “Pfizer” in black ink.
• Diflucan 100 mg capsules have a white body and blue cap. They are printed with “FLU-100” and “Pfizer” in black ink.
• Diflucan 150 mg capsules have a turquoise blue body and cap. They are printed with “FLU 150” and “Pfizer” in black ink.
• Diflucan 200 mg capsules have a white body and violet cap. They are printed with “FLU-200” and “Pfizer” in black ink.

They are available in packs of 1, 2, 3, 4, 6, 7, 10, 12, 14, 20, 28, 30, 42, 50, 60, 100 or 500 hard capsules. Not all pack sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder:

Vinci Farma S.A. Avda de Europa, 20B. Parque Empresarial La Moraleja. 28108, Alcobendas. Madrid.

Local Representative:

Pfizer, S.L. Avda de Europa, 20B. Parque Empresarial La Moraleja. 28108, Alcobendas. Madrid. Spain.

Manufacturer:

Fareva Amboise. Zone Industrielle. 29 Route des Industries. 37530, Pocé-sur-Cisse. France.

Date of the most recent revision of this leaflet: February 2024

Detailed and up-to-date information on this medicine is available on the website of the Spanish Agency of Medicines and Medical Devices (AEMPS): http://www.aemps.gob.es/