It is important that your doctor check your progress at regular visits. This will allow your doctor to check for any unwanted effects.

If your symptoms do not improve within a few weeks (or months for some infections), or if they become worse, check with your doctor.

These medicines should notbe taken with astemizole (e.g., Hismanal), cisapride (e.g., Propulsid), dofetilide (e.g., Tikosyn) or terfenadine (e.g., Seldane). Doing so may increase the risk of serious side effects affecting the heart.

Liver problems may be more likely to occur if you drink alcoholic beverages while you are taking ketoconazole. Alcoholic beverages may also cause stomach pain, nausea, vomiting, headache, or flushing or redness of the face. Other alcohol-containing preparations (for example, elixirs, cough syrups, tonics) may also cause problems. These problems may occur for at least a day after you stop taking ketoconazole. Therefore, you should not drink alcoholic beverages or use alcohol-containing preparations while you are taking DIFLUCAN and for at least a day after you stop taking it.

If you are taking antacids, cimetidine (e.g., Tagamet), famotidine (e.g., Pepcid), nizatidine (e.g., Axid), omeprazole (e.g., Prilosec), or ranitidine (e.g., Zantac) while you are taking itraconazole or ketoconazole, take the other medicine at least 2 hours after you take itraconazole or ketoconazole . If you take these medicines at the same time that you take itraconazole or ketoconazole, they will keep your antifungal medicine from working properly.

Ketoconazole may cause your eyes to become more sensitive to light than they are normally. Wearing sunglasses and avoiding too much exposure to bright light may help lessen the discomfort.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

• Less common
  • Fever and chills;  skin rash or itching  
  
  

• Rare
  • Dark or amber urine;  fever and sore throat;  loss of appetite;  pale stools;  reddening, blistering, peeling, or loosening of skin and mucous membranes;  stomach pain;  unusual bleeding or bruising;  unusual tiredness or weakness;  yellow eyes or skin 
  
  

• Incidence not known—Itraconazole--occurred during clinical practice for itraconazole
  • Abdominal pain;  black, tarry stools;  blistering, peeling or loosening of skin;  bloating or swelling of face, arms, hands, lower legs, or feet;  blue lips and fingernails ;  blurred vision;  burning, numbness, tingling, or painful sensations;  chest pain;  chills;  continuing vomiting;  convulsions;  cough;  coughing that sometimes produces a pink frothy sputum;  decreased urine output;  difficult, fast, noisy breathing, sometimes with wheezing;  difficulty swallowing;  dilated neck veins;  dry mouth;  extreme fatigue;  fast heartbeat;  fatigue;  flushed, dry skin;  fruit-like breath odor;  general feeling of tiredness or weakness;  hives or welts;  increased hunger;  increased sweating;  increased thirst ;  increased urination;  irregular breathing;  irregular heartbeat;  itching skin;  joint or muscle pain;  large amount of triglyceride in the blood;  large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs;  light-colored stools;  lower back or side pain;  mood changes ;  muscle pain or cramps;  numbness or tingling in hands, feet, or lips;  painful or difficult urination;  pale skin;  pale stools;  puffiness;  rapid weight gain;  ;  red skin lesions, often with a purple center;  red, irritated eyes;  redness of skin;  shortness of breath;  skin rash or itching;  sores, ulcers, or white spots in mouth or on lips;  sweating;  swelling in legs and ankles ;  swelling of face, fingers, feet, or lower legs ;  swelling of the eyelids or around the eyes, face, lips, or tongue;  tightness in chest;  tingling of hands or feet;  troubled breathing;  unexplained weight loss;  unsteadiness or awkwardness;  unusual weight gain or loss;  upper right abdominal pain;  weakness in arms, hands, legs, or feet;  weight gain;  wheezing 
  
  

• Incidence not known—Fluconazole--occurred during clinical practice for fluconazole
  • black, tarry, stools ;  chest pain or discomfort;  convulsions;  cough;  decreased urine;  diarrhea;  dry mouth ;  fainting;  increased thirst ;  irregular or slow heartbeat;  joint or muscle pain;  large amount of cholesterol in the blood;  large amount of triglyceride in the blood;  large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs;  loss of bladder control;  lower back or side pain ;  mood changes;  muscle pain or cramps;  muscle spasm or jerking of all extremities ;  nausea or vomiting;  numbness or tingling in hands, feet, or lips;  painful or difficult urination;  pale skin;  red irritated eyes;  red skin lesions, often with a purple center;  shortness of breath;  sore throat;  sores, ulcers, or white spots in mouth or on lips;  sudden loss of consciousness 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

• Less common
  • Constipation;  diarrhea;  dizziness;  drowsiness;  headache;  nausea;  vomiting 
  
  

• Rare--for ketoconazole
  • Decreased sexual ability in males;  enlargement of the breasts in males;  increased sensitivity of the eyes to light;  menstrual irregularities 
  
  

• Incidence not known—Fluconazole--occurred during clinical practice for fluconazole
  • acid or sour stomach ;  bad unusual or unpleasant taste in mouth;  belching;  change in taste;  hair loss;  heartburn;  indigestion;  stomach discomfort, upset or pain;  swelling of face;  thinning of hair 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, azole antifungals are used in certain patients with the following medical conditions:

• Cryptococcosis
• Cushing's syndrome
• Fungus infections in newborns
• Hirsutism
• Histoplasmosis
• Paronychia (infection of the tissue surrounding the nail)
• Penicillium marneffei infection
• Pneumonia caused by fungus
• Prostate cancer
• Ringworm of the beard, hand, or scalp
• Septicemia (infection of the blood) caused by fungus
• Skin infection (including leishmaniasis and sporotrichosis)

Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.