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Oral Antifungals

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Oral Antifungals - Side Effects, Precautions, and Contraindications

What side effects can Oral Antifungals cause?

Common side effects of these medications include:

  • Do not stop taking your medication without checking with your healthcare professional.
  • Griseofulvin, Itraconazole and Ketoconazole should be taken with or after food.
  • Terbinafine and Fluconazole may be taken with or without food.
  • Nystatin suspension:
    • You may take this medication with or without food.
    • Shake the suspension well before measuring a dose.
    • Use a dose-measuring dropper to measure the specified dose of the suspension.
    • Swish the suspension around in your mouth. Keep the suspension in the mouth for as long as possible and swallow the medication.
  • Complete the course as prescribed by the doctor.

If any of these side effects do not go away or are serious, please see your doctor.

​Medication​Side-effect
​Griseofulvin 
  • ​Reduced effectiveness of oral contraceptives and higher risk of unwanted pregnancy
    • Use a different or additional non-hormonal means of birth control while you are taking griseofulvin and for one month after stopping griseofulvin.
  • Griseofulvin may affect sperm quality and production. It is recommended that you avoid planning for a child with your partner during treatment with griseofulvin and for 6 months following therapy.
  • Increased sensitivity to sunlight, and severe burning may result. 
    • Avoid prolonged exposure to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.
​Terbinafine​Taste disturbances or a loss of taste
​Itraconazole​Dizziness
​Ketoconazole​Dizziness

 

Rare, but serious side effects include:

  • High fever or chills
  • Unexplained bruising or bleeding
  • Heart failure
  • Chest pain
  • Abnormal or fast heartbeat
  • Burning, numbness, or abnormal tingling feeling
  • Feeling confused
  • Dark urine or light coloured stools
  • Nausea, vomiting
  • Loss of appetite
  • Stomach pain
  • Yellowing of eyes or skin
  • Unusual tiredness or weakness
  • Muscle pain or weakness

Symptoms of a drug allergy:

  • Swollen face/eyes/lips/tongue
  • Difficulty in breathing
  • Itchy skin rashes over your whole body

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

Before taking Oral Antifungals, what precautions must I follow?

Inform your healthcare professional if:

  • You are allergic to this medication or any of the other ingredients of this medication.
  • You are pregnant, planning to become pregnant, or breastfeeding.
  • Effective contraception is recommended for any woman who is taking itraconazole or ketoconazole who could potentially become pregnant during treatment and for 2 months following the end of treatment.
  • You are taking any other medications, including supplements, traditional medications and herbal remedies.
  • There are potential interactions between itraconazole or ketoconazole with other medications.
  • The blood concentration of digoxin, midazolam and cyclosporine may be increased when taken with itraconazole or ketoconazole.
  • There is a risk of muscle weakness if combined with cholesterol lowering drugs such as simvastatin or atorvastatin.
  • Medications such as phenytoin and rifampicin can decrease the blood level of itraconazole and ketoconazole, making them less effective.

What food or medicine must I avoid when I take Oral Antifungals?

  • ​Avoid alcoholic drinks while you are taking any of these medications. 
    • Alcohol, terbinafine, itraconazole and ketoconazole can affect the liver. 
      • It is important that you check with your doctor immediately if you persistently experience any discomforts of liver disease (e.g., nausea or vomiting, lack or loss of appetite, general feeling of tiredness or weakness, stomach pain, yellow eyes or skin, dark urine, or pale stools).
    • Alcoholic drinks may also cause stomach pain, nausea, vomiting, headache, or flushing or redness of the face when taken with ketoconazole.
    • The combination of alcohol and griseofulvin may cause flushing and a fast heart rate.

Oral Antifungals - Additional Information

  • Updated on Friday, April 30, 2021
  • Article contributed by PSS National Medication Information Workgroup PSS National Medication Information Workgroup

    The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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