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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Low ACTH, Hashimoto Thyroiditis And Post Menopausal. On Diflucan And Fungal Cream. Will The Medicines Contradict?

Hello

I was on diflucan and fungal cream (topical) for tinea versicolor and my ACTH was low and my estrogen raised. I jave addison diseases, Hashimoto Thyroiditis and post menopausal. Their is conflicting information about how antifungals are cytochrome inhibtors or inducers. I always learned in medical school (nursing) it was from inhibitor so other meds like my hydrocortisone and florinef i take for Addisons will build up due to inhibiting the enzymes.

When I ask a doctor that say, don't know.

Linda
Thu, 23 May 2013
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Internal Medicine Specialist 's  Response
Hi,
Welcome to HCM,
You have addison disease and Hashimoto Thyroiditis. Now for fungal infection you have been prescribed Fluconazole(Diflucan).
I am happy to know you take care of your health and keep knowledge of drug interaction.
Let me explain you Fluconazole is an inhibitor of the human cytochrome P450 system, CYP3A4 to lesser extent.
In theory, therefore, fluconazole decreases the metabolism and increases the concentration of any drug metabolised by these enzymes.
fluconazole + fludrocortisone & fluconazole + hydrocortisone
fluconazole will increase the level or effect of fludrocortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
But antifungal are given for short time and topical cream is safe.
Please take care.
Dr.Akhilesh Dubey m.D.
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Have Low ACTH, Hashimoto Thyroiditis And Post Menopausal. On Diflucan And Fungal Cream. Will The Medicines Contradict?

Hi, Welcome to HCM, You have addison disease and Hashimoto Thyroiditis. Now for fungal infection you have been prescribed Fluconazole(Diflucan). I am happy to know you take care of your health and keep knowledge of drug interaction. Let me explain you Fluconazole is an inhibitor of the human cytochrome P450 system, CYP3A4 to lesser extent. In theory, therefore, fluconazole decreases the metabolism and increases the concentration of any drug metabolised by these enzymes. fluconazole + fludrocortisone & fluconazole + hydrocortisone fluconazole will increase the level or effect of fludrocortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. But antifungal are given for short time and topical cream is safe. Please take care. Dr.Akhilesh Dubey m.D.