Gynofloran (Fluconazole)

Gynofloran is prescribed for several fungal infections where fluconazole is an appropriate therapy.

• Vulvovaginal candidiasis (yeast infection of the vagina and vulva).
• Oropharyngeal and esophageal candidiasis in immunocompromised patients.
• Systemic candidiasis affecting bloodstream or internal organs.
• Adjunctive treatment of cryptococcal meningitis in combination with other antifungals.

Side effects of Gynofloran vary in frequency; most are mild and reversible, while rare reactions may require medical attention.

Common

• Nausea, abdominal discomfort or dyspepsia.
• Headache or dizziness.
• Diarrhea or loose stools.
• Skin rash or mild itching.

Serious

• Severe allergic reactions such as anaphylaxis.
• Liver enzyme elevations indicating possible hepatotoxicity.
• QT interval prolongation leading to cardiac arrhythmias.
• Stevens‑Johnson syndrome or toxic epidermal necrolysis.

Before prescribing Gynofloran, clinicians should evaluate patient history and laboratory results to minimize risks.

• Assess liver function; avoid use in patients with severe hepatic impairment.
• Review renal function; dose adjustment may be needed in moderate to severe kidney disease.
• Caution in patients with known QT prolongation or electrolyte disturbances.
• Avoid during pregnancy unless benefits outweigh risks, as safety data are limited.
• Monitor for drug interactions, especially with medications metabolized by CYP2C9 and CYP3A4.
• Use carefully in patients with a history of allergic reactions to azole antifungals.

Fluconazole can affect the metabolism of many drugs; some combinations should be avoided, while others require dose adjustments.

Avoid

• Concurrent use with cisapride, pimozide, or terfenadine due to risk of serious cardiac events.
• Co‑administration with certain statins (e.g., simvastatin, lovastatin) that may cause rhabdomyolysis.
• Combining with oral anticoagulants such as warfarin without close INR monitoring.

Use with caution

• Antidiabetic agents (e.g., sulfonylureas, insulin) may need dose reduction to prevent hypoglycemia.
• Benzodiazepines (e.g., midazolam, triazolam) may have increased sedation.
• Certain immunosuppressants (e.g., cyclosporine, tacrolimus) may require therapeutic drug monitoring.
• Oral contraceptives may have reduced efficacy; consider backup contraception.