Forcan (Fluconazole)
Also sold as: Forcan, Diflucan, Zocon, Syscan
Pregnancy
Cat D
Lactation
Caution
Schedule
H
Forms
Tablet 50/100/150/200/400mg +2
Indications
- Vulvovaginal candidiasis (single dose)
- Oral/esophageal candidiasis
- Cryptococcal meningitis
- Tinea (some)
- Systemic candidiasis
- Antifungal prophylaxis (HSCT, neutropenia)
Adult Dosing
VVC (single dose)
150 mg PO single dose
Oral candidiasis
200 mg loading, then 100 mg OD × 7-14 days
Esophageal candidiasis
200-400 mg PO/IV OD × 14-21 days
Cryptococcal meningitis (consolidation)
400-800 mg OD
Pediatric Dosing
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl > 50 | Standard |
| CrCl < 50 | Reduce to 50% |
Hepatic Adjustment
Caution in hepatic impairment
Pregnancy & Lactation
Pregnancy: Category D
150 mg single dose generally OK (Cat C); high-dose prolonged use AVOID (Cat D — skeletal anomalies)
Lactation: Caution
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Warfarin | Major INR increase | Major |
| Statins | Myopathy risk | Major |
| Sulfonylureas | Hypoglycemia | Major |
| Phenytoin, carbamazepine, cyclosporine, tacrolimus | Increased levels | Major |
| QT-prolonging drugs | Additive QT | Major |
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Side Effects
Common
- Nausea
- Headache
- Abdominal pain
- Skin rash
Serious / Discontinue If
- Hepatotoxicity
- QT prolongation
- SJS/TEN
- Anaphylaxis
- Adrenal insufficiency
Contraindications
- Concomitant cisapride, terfenadine, quinidine, pimozide, erythromycin (QT)
- Hypersensitivity
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Forcan 150 | Cipla | 1 tab ₹35 |
| Zocon 150 | FDC | 1 tab ₹38 |
| Syscan 150 | Sun Pharma | 1 tab ₹28 |
Monitoring Required
- LFT for prolonged use
- ECG (QT) in risk patients
Patient Counseling Points
- Single dose for typical VVC
- Take with or without food
- Inform other medications
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References
- BNF
- Lexicomp
- Indian National Formulary
- Specialty society guidelines