Fluconazole is a triazole antifungal medication widely used in the treatment of various fungal infections. It works by inhibiting the synthesis of ergosterol, an essential component of fungal cell membranes, thereby disrupting cell membrane formation and leading to cell death. This mechanism of action makes fluconazole effective against a broad spectrum of fungal pathogens, including Candida species and Cryptococcus neoformans.

Fluconazole is commonly prescribed for conditions such as oropharyngeal and esophageal candidiasis, cryptococcal meningitis, and as a prophylactic treatment in immunocompromised patients. Its pharmacokinetic profile is characterized by excellent oral bioavailability, allowing for both oral and intravenous administration, which provides flexibility in treatment regimens. The drug is primarily excreted unchanged in the urine, making it a suitable option for patients with hepatic impairment.

One of the key advantages of fluconazole is its ability to penetrate the central nervous system, making it particularly useful in treating fungal infections of the brain and spinal cord. However, prescribers should be aware of potential drug interactions, as fluconazole can inhibit cytochrome P450 enzymes, leading to increased plasma concentrations of other medications metabolized by this pathway. Monitoring for adverse effects such as hepatotoxicity and QT prolongation is also recommended, especially in patients with pre-existing liver conditions or those taking other medications that affect cardiac rhythm.