Abstract

IS FLUCONAZOLE SAFE DURING PREGNANCY

Dr. Haritha Themagepalli*, G. N. Jagadeesh Kumar and Gousula Sri Satya

ABSTRACT

Introduction: Fluconazole is an azole antifungal agent used for the treatment of various indications like Coccidioidomycosis, cryptococcal meningitis, peritonitis and a wide range of candidial infections namely oropharyngeal candidiasis, esophageal candidiasis and vaginal candidiasis. Despite its limited safety profile during pregnancy, pregnant women are prescribed with this drug. Aim: This study aims to review all possible events like stillbirths, spontaneous abortions, congenital malformations and changes in Ano-Genital Distance in male offspring (AGD) among fluconazole exposed pregnant women. Methods: Literature from December 1992 to 2018 was reviewed regarding fluconazole induced teratogenic events during and after pregnancy including case reports, cross-sectional studies, prospective cohort, non-interventional observational cohort, preliminary study registries raised historical cohorts and many of its kind. Results: There seems to be a positive evidence for the occurrence of congenital abnormalities in infants, born to pregnant women who took high dose oral fluconazole (400- 800mg daily), but safer with 150mg oral fluconazole; spontaneous abortion in pregnant women who took a cumulative 150-300mg of oral fluconazole dose and a decrease in Ano-Genital Distance which may result in less masculinity among male off-springs. Conclusion: Although further studies are needed to establish a possible relationship between the occurrence of spontaneous abortions and reduced AGD with fluconazole, clinicians must be cautious regarding the use of fluconazole during pregnancy and to be used only when benefits outweigh the risk until safety profile is proved.

Keywords: Fluconazole, Pregnancy, Safety, Congenital abnormalities, Still Births.