When a woman finds out she is pregnant, one of the first steps she should take is to speak with her doctor to discuss both current and past medications she has taken. Fluconazole is an antifungal drug that should not be taken while pregnant because it can increase the risk of birth defects or miscarriage. It is important to discuss any medications taken before learning of the pregnancy with a doctor, especially if the medication could have an impact on the baby. In this blog post, I will discuss my experience of taking fluconazole before I knew I was pregnant, and how I navigated this situation with my doctor. I will discuss the risks associated with taking this medication during pregnancy, as well as a few preventative measures I took to ensure my baby’s health.
In reality, there’s been more than just one “old study” linking fluconazole to miscarriage.
Just to be crystal clear, I don’t pretend to be a doctor and I’m not one. Having said that, I am very knowledgeable about the fluconazole research (i e. Diflucan) use during pregnancy, and it’s not good.
The research my doctor cited? Its actually a 2015 report in the journal Canadian Family Physician, the official publication of The College of Family Physicians of Canada. It found an increased risk of miscarriage and birth defects in babies born to women who took high doses of fluconazole (400 to 1200 milligrams per day) during pregnancy. (FYI: The standard recommended dosage of Diflucan or fluconazole is 150 milligrams per the U.S. National Library of Medicine.)
Theres been more recent research, too. For a 2016 JAMA study, researchers analyzed data from 1.4 million pregnant women and found that those who took fluconazole in any dose had a “statistically significant increased risk” of miscarriage compared to those who didn’t take the drug. The study didn’t find a direct link between fluconazole and stillbirth (the loss of a fetus after the 20th week of pregnancy), but the researchers urged “cautious prescribing” of the drug in pregnancy as a whole.
And most recently, a February 2019 study in the Canadian Medical Association Journal looked at 441,949 pregnancies and found that fluconazole in both typical and high doses increased a woman’s risk for miscarriage. (Women who took a dose of 150 milligrams were twice as likely to have a miscarriage than those who took no fluconazole; those who took doses higher than 150 milligrams had a three-times greater risk.) It also found that having doses higher than 150 milligrams during the first trimester may increase a woman’s risk of having a baby with a heart defect.
Fluconazole is labeled as a category C medication by the Food and Drug Administration (FDA), which means animal studies have shown the drug to have definitive “adverse effects on the fetus,” but no conclusive studies in humans, per the U.S. Department of Health and Human Services.
Although the FDA claims that there is a risk of birth defects with “chronic, high doses” of the medication and that “this risk does not appear to be associated with a single, low dose of fluconazole to treat vaginal yeast infection,” it still seems to me that it should at least raise an eyebrow—especially given all the other research on the miscarriage link that is available.
I just found out that one of my patients is 8 weeks pregnant. She recently took a 150-mg dose of fluconazole to treat vaginal candidiasis, but she is concerned about how it will affect her unborn child and pregnancy. Can I reassure her?.
Question One of my patients recently learned that she is eight weeks pregnant. She took a 150 mg dose of fluconazole two weeks ago to treat vaginal candidiasis, but she is concerned about the effects it may have on her unborn child and her pregnancy. Puis-je la rassurer?.
When compared to nonusers, Jick found no increased risk of congenital malformations in the offspring of 234 women who took fluconazole as a single oral dose in the first trimester (1,2). 7% vs 1. 6%; OR 1. 1, 95% CI 0. 4 to 3. 3). 11.
There have been 5 cases of infants who were exposed to daily, oral, high-dose fluconazole (400 to 800 mg) in the first trimester and were born with numerous craniofacial and skeletal malformations. 3-6 It has been proposed that fluconazole may be the cause of these defects by inhibiting cytochrome P450 or other enzymes. 5.
In comparison to infants who were not exposed to fluconazole during their first trimester, a registry-based study that looked at 1079 women found no increased risk of major malformations in their offspring (4). 1% vs 3. 6%; OR 1. 0, 95% CI 0. 8 to 1. 4). Additionally, there was no rise in the incidence of craniofacial (OR 1 3, 95% CI 0. 6 to 2. 6) or cardiovascular (OR 1. 3, 95% CI 0. 7 to 2. 1) malformations. In total, 797 women (74%) received 150 mg of fluconazole, 235 (22%) received 300 mg, and the remainder (n = 47) received 450 or 600 mg In exposed pregnancies, the study found no increased risk of low birth weight, stillbirth, or prematurity. 12.
This is my first pregnancy; we’ve been trying for so long that it didn’t even occur to me to factor this in earlier this week. I’m trying not to cry at the thought of having done incredible damage already. Just wondering if anyone else has taken in the first trimester, what their doctors say, etc. Advertisement | page continues below
I have a raging yeast infection that didn’t go away earlier this week, and I’m four weeks pregnant (I’m shocked that a pregnancy test could detect it already). I had a few extra Diflucan pills after getting a prescription, so I went crazy and took three of them this week (my doctor had only prescribed me two, so I guess I just went overboard).
Not only has the YI not subsided, but now that I took Diflucan during the first trimester, I’m panicking!
FAQ
Can fluconazole affect early pregnancy?
What if you take fluconazole before knowing you’re pregnant?
Can a two weeks pregnant woman take fluconazole?
Has anyone taken fluconazole while pregnant?