Key Facts
- Drug Class
- Triazole antifungal agent
- Prescription
- Required
- NAFDAC Status
- NAFDAC Registered
- Forms
- Capsule, Tablet, Injection, Oral suspension
- Price Range
- ₦200 - ₦5,000
- WHO Essential
- Yes
What is Fluconazole?
Fluconazole is the most widely prescribed antifungal drug in Nigeria and across sub-Saharan Africa. It belongs to the triazole class of antifungals and works by inhibiting a fungal enzyme called lanosterol 14-alpha-demethylase, which is essential for the production of ergosterol — a key component of the fungal cell membrane. Without ergosterol, the fungal cell membrane becomes unstable and leaky, ultimately killing the fungus. Importantly, fluconazole is highly selective for the fungal enzyme and has minimal effect on the equivalent human enzyme, which is why it is generally well tolerated at standard doses.
In Nigeria, fluconazole is best known for treating vaginal candidiasis (yeast infections), which is extremely common. The warm, humid climate across much of Nigeria, combined with the widespread use of antibiotics (which disrupt the normal vaginal flora), means that vaginal yeast infections are one of the most frequent reasons women visit pharmacies. For uncomplicated vaginal candidiasis, a single 150mg capsule of fluconazole often resolves the infection — making it one of the most convenient treatments available. However, fluconazole's importance extends far beyond vaginal yeast infections. It is a lifesaving drug for HIV patients with cryptococcal meningitis, the most common cause of meningitis in people living with HIV in Africa and a leading killer of AIDS patients in Nigeria.
Fluconazole is available in Nigeria under several brand names including Diflucan (the original Pfizer brand), Flucoral (Hovid), Funzela (Aspen), and generic versions from local manufacturers including Emzor. Prices range from about ₦200 for generic versions to ₦5,000 for the original Diflucan brand. The 150mg capsule is the most commonly dispensed strength for vaginal and superficial candidiasis, while the 200mg strength is used for more serious systemic infections. All genuine fluconazole products in Nigeria must carry a valid NAFDAC registration number. The drug is generally well tolerated, but awareness of potential liver effects and drug interactions is important, particularly for patients on other medications.
What is Fluconazole used for?
In Nigeria, Fluconazole is commonly used for:
- Vaginal candidiasis (vaginal yeast infection) — the most common reason fluconazole is purchased in Nigeria; a single 150mg dose is often curative
- Oropharyngeal candidiasis (oral thrush) — extremely common in HIV patients and in patients who have used antibiotics or inhaled corticosteroids
- Oesophageal candidiasis — a serious fungal infection of the food pipe, typically seen in advanced HIV/AIDS
- Cryptococcal meningitis — fluconazole is used for both treatment (usually after initial amphotericin B) and long-term maintenance therapy to prevent relapse in HIV patients
- Systemic candidiasis (candidaemia) — serious bloodstream fungal infection in hospitalised patients
- Dermatophyte infections — tinea corporis (ringworm), tinea pedis (athlete's foot), tinea cruris (jock itch) when topical treatment is insufficient
- Prophylaxis against fungal infections in immunocompromised patients, including those undergoing chemotherapy or organ transplantation
- Candidal balanitis (fungal infection of the male foreskin/glans)
Dosage
IMPORTANT
Always follow your doctor's or pharmacist's instructions. The information below is for general reference only.
Adults
For vaginal candidiasis: a single dose of 150mg. For recurrent vaginal candidiasis (4 or more episodes per year): 150mg every 72 hours for 3 doses (days 1, 4, and 7), then 150mg once weekly for 6 months. For oropharyngeal thrush: 200mg on the first day, then 100mg to 200mg once daily for 7 to 14 days. For oesophageal candidiasis: 200mg to 400mg once daily for 14 to 21 days. For cryptococcal meningitis maintenance: 200mg once daily following initial treatment with amphotericin B. Take fluconazole at the same time each day, with or without food.
Children
For oropharyngeal candidiasis: 3 to 6mg per kilogram on the first day, then 3mg per kilogram once daily for at least 7 to 14 days. For systemic candidiasis: 6 to 12mg per kilogram per day. Maximum daily dose in children should not exceed 400mg. Fluconazole is available as an oral suspension for children. For neonates: fluconazole clearance is slower, and doses should be given every 72 hours in the first 2 weeks of life, then every 48 hours until 4 weeks of age. Paediatric dosing should be determined by a doctor.
Elderly
No specific dose adjustment is needed for elderly patients with normal kidney function. However, since kidney function declines with age, dose reduction may be necessary in elderly patients with reduced renal function. The dose should be adjusted based on creatinine clearance.
Fluconazole can be taken with or without food as absorption is not significantly affected. For a single dose for vaginal candidiasis, no special precautions are needed. For longer courses, ensure adequate hydration. If you are prescribed fluconazole for cryptococcal meningitis maintenance, do NOT stop the medication without your doctor's approval — stopping too early can result in a life-threatening relapse. Report any signs of liver problems (yellowing of the skin or eyes, dark urine, persistent nausea) to your doctor promptly.
Side Effects
Common side effects
- •Headache
- •Nausea and abdominal pain
- •Diarrhoea
- •Skin rash — usually mild, but stop the drug and see a doctor if it progresses
- •Elevated liver enzymes — usually detected through blood tests and typically reversible
Serious side effects — seek medical help immediately
- Liver toxicity (hepatotoxicity) — rare but potentially serious; manifests as jaundice (yellow skin/eyes), dark urine, severe fatigue, and right upper abdominal pain. More likely with prolonged high-dose therapy
- Severe skin reactions — Stevens-Johnson syndrome and toxic epidermal necrolysis are rare but life-threatening; more common in HIV patients and those with other serious medical conditions
- QT prolongation — can cause dangerous heart rhythm abnormalities, particularly when combined with other QT-prolonging drugs
- Severe allergic reaction (anaphylaxis) — rare; seek emergency care for facial swelling or difficulty breathing
- Adrenal insufficiency — rare, reported with very high doses or prolonged use
When to see a doctor
See a doctor promptly if you develop yellowing of the skin or eyes, dark urine, persistent nausea or vomiting, severe abdominal pain, or unusual fatigue while taking fluconazole — these may indicate liver damage. Stop fluconazole immediately and seek emergency care if you develop a skin rash that spreads or blisters, mouth sores, difficulty breathing, or swelling of the face or throat. If you are HIV-positive and taking fluconazole for cryptococcal meningitis, report any worsening headache, neck stiffness, or vision changes to your doctor immediately as these may indicate treatment failure or immune reconstitution inflammatory syndrome (IRIS).
Warnings & Precautions
Do not take Fluconazole if you have:
- Known allergy to fluconazole or other azole antifungals (ketoconazole, itraconazole, voriconazole)
- Concurrent use with terfenadine, astemizole, cisapride, pimozide, or quinidine at fluconazole doses of 400mg or more — risk of fatal cardiac arrhythmias
- Concurrent use with erythromycin and fluconazole due to cardiac risk
- Severe liver disease — fluconazole should be used with extreme caution and only when necessary
Drug interactions
- •Warfarin — fluconazole significantly increases the anticoagulant effect of warfarin by inhibiting its metabolism; INR must be closely monitored and warfarin dose reduced accordingly
- •Oral hypoglycaemics (glibenclamide, glipizide) — fluconazole can increase their blood sugar-lowering effect, causing hypoglycaemia; blood sugar should be monitored closely
- •Phenytoin — fluconazole increases phenytoin levels, risking toxicity
- •Rifampicin — significantly reduces fluconazole levels, potentially making it ineffective; may need to increase fluconazole dose. This is particularly important in Nigeria where TB-HIV co-infection is common
- •Ciclosporin and tacrolimus (immunosuppressants) — fluconazole increases their levels, requiring dose adjustments and monitoring
- •Statins (atorvastatin, simvastatin) — fluconazole can increase statin levels, increasing the risk of muscle damage (rhabdomyolysis)
- •Certain antiretrovirals (efavirenz, nevirapine) — complex interactions relevant for HIV patients in Nigeria; consult a doctor or pharmacist
Pregnancy & Breastfeeding
A single 150mg dose of fluconazole for vaginal candidiasis is generally considered low risk during pregnancy, though some guidelines recommend topical antifungals (such as clotrimazole) as first-line treatment during pregnancy. However, high doses of fluconazole (400mg or more daily) and prolonged courses are CONTRAINDICATED in pregnancy due to reports of birth defects including skeletal and craniofacial abnormalities. Pregnant women with serious fungal infections requiring high-dose fluconazole should discuss the risks and benefits with their doctor. Fluconazole is excreted in breast milk at concentrations similar to blood levels. A single 150mg dose is generally considered compatible with breastfeeding, but prolonged courses require medical guidance.
Brands of Fluconazole in Nigeria
4 brands available in Nigeria.
| Brand Name | Manufacturer | Strength | Form | NAFDAC Reg. No. |
|---|---|---|---|---|
| Diflucan | Pfizer | 150mg, 200mg | Capsule | 04-1426 |
| Flucoral | Hovid | 50mg, 150mg | Capsule | |
| Funzela | Aspen Pharmacare | 150mg, 200mg | Capsule | |
| Fluconazole | Emzor | 150mg | Capsule |
How to Verify Your Fluconazole is Genuine
- 1Check for a valid NAFDAC registration number on the packaging — all fluconazole products in Nigeria, whether imported or locally made, must display this
- 2Verify the NAFDAC number via the NAFDAC Green Book portal (greenbook.nafdac.gov.ng) or the NAFDAC mobile verification app
- 3Purchase from licensed pharmacies — fluconazole is a prescription antifungal and should ideally be dispensed by a pharmacist who can advise on correct use
- 4For Diflucan (Pfizer), check for the distinctive blue and white capsule appearance, clear embossing, and consistent packaging quality
- 5Inspect the capsules for uniform colour, size, and markings. Reject any that appear damaged, discoloured, or have an unusual odour
- 6Be cautious of unusually cheap products — if fluconazole 150mg costs significantly less than ₦200, verify the source and NAFDAC registration before use
Fluconazole Price in Nigeria
Fluconazole prices in Nigeria typically range from ₦200 to ₦5,000 per pack, depending on the brand, strength, and where you buy it.
₦200 – ₦5,000
per pack
Prices vary by location and vendor. Last updated: 2026-02-01
Where to Buy
Purchase Fluconazole only from licensed pharmacies and verified distributors. Avoid buying medicines from unverified sources, roadside vendors, or unregistered market stalls.
Frequently Asked Questions
Sources
- •NAFDAC Greenbook — National Agency for Food and Drug Administration and Control registered products database
- •WHO Model List of Essential Medicines (23rd List, 2023)
- •British National Formulary (BNF)
- •Nigerian Standard Treatment Guidelines