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Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
Prepared to a prescriber's order for one patient. Not FDA-approved.
Fluconazole is a triazole antifungal, commonly compounded into oral suspensions, capsules and troches.
Fluconazole is a triazole antifungal. It blocks a fungal enzyme, 14-alpha-demethylase, that converts lanosterol into ergosterol, the building block of the fungal cell membrane; without ergosterol the membrane fails and Candida and related yeasts stop growing. It absorbs well with or without food. Manufactured products include Diflucan tablets and powder for oral suspension and generic fluconazole, FDA-approved for vaginal, oropharyngeal and esophageal candidiasis, cryptococcal meningitis, certain other Candida infections, and prevention of candidiasis in bone marrow transplant patients receiving chemotherapy or radiation. A prescriber might order fluconazole compounded when a patient needs a strength, flavor or sugar-free liquid that is not manufactured, a capsule or troche in a specific strength, or a preparation free of a dye or other allergen. Compounded preparations are not FDA-approved and require a prescription.
Fluconazole has no FDA boxed warning, but the label warns of rare serious liver injury including deaths, anaphylaxis, severe peeling skin reactions and QT prolongation, a heart rhythm problem seen mostly in seriously ill patients. It must not be taken with erythromycin, pimozide or quinidine, and because it inhibits CYP2C9, CYP2C19 and CYP3A4 for days after the last dose it interacts with warfarin (bleeding), phenytoin, sulfonylurea diabetes pills (low blood sugar), tacrolimus and cyclosporine (kidney harm) and statins (muscle damage). Do not use it if you are allergic to fluconazole or other azoles, and tell your prescriber about heart rhythm problems, low potassium or magnesium, or kidney disease. High doses in early pregnancy have been linked to birth defects, so the label advises avoiding it in pregnancy unless the infection is severe; LactMed considers it acceptable during breastfeeding. Common side effects are headache, nausea, stomach pain, diarrhea and taste changes. For yellow skin or eyes, dark urine, rash, palpitations or fainting, talk to your prescriber or pharmacist right away.
Fluconazole inhibits fungal cytochrome P450 14-alpha-demethylase, depleting ergosterol; it is fungistatic against Candida, with resistance arising from ERG11 mutations and efflux pump upregulation, notably in C. glabrata. Oral bioavailability exceeds 90% and is unaffected by food; plasma protein binding is low at 11 to 12%; terminal half-life is about 30 hours (range 20 to 50), supporting once-daily dosing; about 80% is excreted unchanged in urine, so renal function drives dose adjustment and hemodialysis removes roughly half over a session. CSF concentrations reach 50 to 90% of plasma. Labeled indications: Diflucan for vaginal, oropharyngeal and esophageal candidiasis, cryptococcal meningitis, candidiasis prophylaxis in bone marrow transplant recipients, and other Candida infections including urinary tract infection, peritonitis, candidemia, disseminated candidiasis and pneumonia. Beyond the label, StatPearls lists blastomycosis, histoplasmosis and coccidioidomycosis including bone, joint, meningeal and pulmonary disease in immunocompromised patients, and LactMed notes frequent use for lactation-associated breast candidiasis. Dosing is per prescriber. Monitor liver function, PT/INR with warfarin, cyclosporine and tacrolimus levels with creatinine, electrolytes, and baseline ECG in patients at risk for QT prolongation; the label also notes possible reversible adrenal insufficiency. Fluconazole is not a controlled substance.
Wash your hands. If the suppository is soft, chill it in its wrapper in the refrigerator or under cool water for a few minutes, then unwrap it. For rectal use, coat the tip with a water-soluble lubricant (not petroleum jelly), lie on your side with your upper knee bent, and insert it pointed end first past the muscle at the opening. For vaginal use, lie on your back with knees bent and insert it as far as it comfortably goes, by finger or applicator; bedtime use limits leakage, and a panty liner protects clothing. Stay lying down about 15 minutes. Wash your hands.
Suppositories are nonaqueous, so under USP <795> they can carry a beyond-use date of up to 180 days at controlled room temperature or in the refrigerator when no other stability data apply. Storage depends on the base: fatty bases can soften at room temperature and may be labeled for the refrigerator, while polyethylene glycol bases usually do not need refrigeration. Keep them cool so they do not melt, and refrigerate them if your label says to.
This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.
Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.
Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.
Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.
Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.
Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.
Licensed to dispense in RI, MA, CT, NJ, NH, FL, ME, and PA; New York is served on a limited basis while nonresident registration is pending. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.
Insert 1 unwrapped suppository
