Fluconazole

What is this medication for?

• CNS/ocular fungal infections (cryptococcal meningitis), fungal UTI, blastomycosis, Malassezia dermatitis

How is it given?

Give exactly as your veterinarian prescribed — never change the dose or stop on your own unless your veterinarian has told you to.

What if I miss a dose?

• Give it as soon as you remember — unless it is almost time for the next dose (then skip the missed one; never double up).
• Call your clinic if you miss more than one dose in a row.

Side effects — what should I watch for?

Effects listed as common in this handout

• Inappetence, vomiting, diarrhea (Occasional)

Worth a phone call to your veterinarian

• Hepatotoxicity (Possible, generally less than ketoconazole)
• Toxic to budgerigars

⚠️ Contact your veterinarian or an emergency clinic IMMEDIATELY if you notice

• Trouble breathing, collapse, seizures, severe vomiting or diarrhea, facial swelling, or pale gums

Before starting (or refilling), tell your veterinarian if your pet:

• has or has had: Azole hypersensitivity
• has or has had: Renal impairment (dose/interval adjustment needed); hepatic impairment

• is pregnant, nursing, or used for breeding
• is taking any other medications, supplements, or flea/tick products, including:
  • Cyclosporine
  • Midazolam, other benzodiazepines
  • Warfarin
  • Theophylline
  • Amphotericin B

Storage and handling

Tablets <30°C; injection 5–30°C, avoid freezing, no additives to into a vein bag.

Good to know

• Best azole choice for CNS, ocular, and fungal urinary tract infections due to superior CSF/urine penetration and minimal protein binding.
• Fewer endocrine side effects than ketoconazole (doesn't significantly suppress cortisol/testosterone) — a reasonable alternative in dogs with hepatic disease where itraconazole/ketoconazole are riskier.
• Treatment courses are often prolonged (months) — cost can become a major limiting factor, especially in cats at higher doses.