Fluconazole Safety in Pregnancy

Written by Clay Smith

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Oral fluconazole appears to be safe to use in pregnancy.

Why does this matter?
Vaginal candidiasis is common in pregnancy.  Oral fluconazole 150mg once is an effective, simple, and non-messy treatment.  However, in 2016, JAMA published an article that found increased risk of stillbirth and miscarriage in women who received fluconazole.  This research letter in JAMA Internal Medicine was even bigger and was reassuring.

To the relief of pregnant women everywhere...
This small research letter included over 10,000 pregnant women exposed to fluconazole compared to unexposed pregnant women.  They found no increased risk of stillbirth or neonatal death, even at doses over 300mg.  This study was over three times larger than the original JAMA article in 2016.  It appears that fluconazole 150mg is safe to use for yeast infection during pregnancy.  This is preferable to the messy topical preparations requiring several days of therapy.

Source
Oral Fluconazole in Pregnancy and Risk of Stillbirth and Neonatal Death.  JAMA. 2018 Jun 12;319(22):2333-2335. doi: 10.1001/jama.2018.6237.
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Reviewed by Thomas Davis

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