Can I take fluconazole while pregnant?

Research suggests that taking fluconazole during pregnancy may pose some risks. A single low dose of fluconazole may sometimes be prescribed during early pregnancy, but only if other treatments have not worked and the drug is needed to treat a severe fungal infection.

Fluconazole is an antifungal drug that doctors prescribe to treat or prevent various types of fungal and yeast infections, such as:

• vaginal yeast infections
• oral yeast infections (oral thrush)
• fungal skin infections
• fungal meningitis

Fluconazole, which is only available with a prescription from a doctor or licensed healthcare professional, comes in several different forms, including:

• oral tablet (the oral tablet also comes as a brand-name drug called Diflucan)
• oral suspension
• injection

For some people, the benefit of using fluconazole while pregnant may outweigh the possible risks. If you are pregnant, your doctor will help determine whether fluconazole is a suitable treatment for you. If it isn’t, they may prescribe other medications.

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Is fluconazole safe to use during pregnancy?

According to the prescribing information for fluconazole, people who are pregnant should not use this drug unless they have a severe or potentially life threatening fungal infection.

Research has shown that doses of 150 milligrams (mg) of fluconazole or more during pregnancy may cause birth defects in infants whose mothers received treatment with fluconazole during the first trimester (months 1 to 3) of pregnancy.

For doses below 150 mg, there has been research in animals that also shows adverse effects. However, there isn’t enough research to show how lower doses of fluconazole may affect a human fetus.

Fluconazole is most commonly prescribed as a one-time single-dose treatment for vaginal yeast infections with a dose of 150 mg. More studies need to be done to understand that doses below 150 mg may cause birth defects. A 2019 study shows that exposure to any amount of fluconazole during pregnancy may increase the risk of loss of pregnancy.

Because of this risk, doctors usually prescribe fluconazole during pregnancy only if the drug’s benefit outweighs the potential risk to the fetus.

If you’ve taken fluconazole before you knew you were pregnant, let your doctor know. They will let you know about any potential risks to the fetus.

How does the FDA rate drug risk levels when taken during pregnancy?

In 1979, the Food and Drug Administration (FDA) developed a rating system to determine the risk level of drugs when taken during pregnancy. These ratings were calculated based on data from both animal and human studies. The FDA classified drugs used in pregnancy into 5 categories, A, B, C, D, and X. Category A was considered the safest, and category X should absolutely not be used.

In 2015, the FDA removed this rating system. They felt that the lettering system led to misinterpretation of the information. Now, drug labels have sections dedicated to discussion on the safety of a drug during pregnancy.

Before removing this rating system, the pregnancy category for a single 150 mg dose of fluconazole for a vaginal yeast infection was category C. When fluconazole is used to treat conditions besides a vaginal yeast infection during pregnancy, it was classified as category D.

Can I take fluconazole while trying to conceive?

There is currently no evidence that fluconazole reduces fertility or poses a risk if it’s taken while trying to conceive. However, you should still tell your doctor if you are trying to get pregnant while taking fluconazole.

What can you take for a yeast infection while pregnant?

If you develop a vaginal yeast infection or other fungal infection while pregnant, your doctor may prescribe a different antifungal medication.

In the first trimester of pregnancy, it is best to avoid all oral antifungal drugs, especially if the fungal infection is mild or moderate. Doctors generally consider topical antifungal drugs (that you’ll apply to the infected area) to be safe to use during pregnancy. Examples include:

• butoconazole
• clotrimazole
• miconazole
• terconazole
• tioconazole
• nystatin

If a fungal infection keeps coming back or does not go away even with treatment, oral terbinafine may be a safer choice.

Summary

Fluconazole is a prescription antifungal drug that’s commonly used to treat vaginal yeast infections and other fungal infections.

Although studies are not adequate, research suggests that taking fluconazole during pregnancy increases the risk of birth defects and loss of pregnancy. This can depend on how much fluconazole is taken and for how long. Your doctor can help you decide if the drug’s benefit outweighs the potential risks.

If you have a vaginal yeast infection or other fungal infection, your doctor may prescribe a different drug or an antifungal that you can apply to your skin.