Because azoles are the most popular drugs for treating fungal infections, oral fluconazole is often used during pregnancy. This is due to the fact that during this period women are especially susceptible to vulvovaginal candidiasis.
Canadian scientists have conducted studies on the effects of high and low doses of fluconazole on the fetus during pregnancy. Researchers have established a link between the use of the drug and the occurrence of spontaneous abortions and serious congenital malformations.
Read on estet-portal.com, why it is not safe to give fluconazole during pregnancy.
Fluconazole during pregnancy: the mechanism of action of the drug
Fluconazole is a triazole antifungal agent that inhibits the fungal cytochrome P451 (CYP51) enzyme, which is required for ergosterol synthesis and fungal cell wall formation.
Oral fluconazole is given as a single dose of 150 mg for the treatment of vulvovaginal candidiasis, and at a higher dose for systemic fungal infections.
Pregnant women are much more susceptible to vulvovaginal candidiasis, which occurs in almost every tenth pregnant woman. Topical azoles are currently recommended as first line therapy during pregnancy, however – is it safe?
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Side effects of fluconazole during pregnancy
According to the results of the study, the use of oral fluconazole in early pregnancy was associated with an increased risk of spontaneous abortion. Exposure to fluconazole during the first trimester did not increase the risk of common serious congenital malformations, however, exposure to high doses of the drug (above 150 mg) during the first trimester was associated with an increased risk of abnormal closure of the cardiac septum.
No association has been found between exposure to fluconazole during pregnancy and the risk of stillbirth.
Animal studies have confirmed the teratogenicity of fluconazole at high doses.
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Fluconazole during pregnancy: why the drug can be dangerous
Data from the US National Birth Registry showed that exposure to low doses of fluconazole during the first trimester increased the risk of cleft lip or palate and transposition of the great arteries.
Treatment with high doses of fluconazole during pregnancy has been associated with craniofacial, skeletal and cardiac defects.
Thus, exposure to fluconazole during pregnancy has been shown by Canadian researchers to be associated with an increased risk of spontaneous abortion and a risk of anomalies in cardiac septal closure.
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