{"hq_id":"hq-c-org-002104","name":"Fluconazole","context":"human_adult","risk_level":"moderate","schema":"legacy","note":"Synthesis unavailable: compound lacks vectorizable regulatory classifications. Raw safety data returned.","data":{"risk_level":"moderate","summary":"Fluconazole is a first-generation bis-triazole antifungal and the most widely prescribed systemic antifungal worldwide (WHO Essential Medicine). Mechanism: inhibits lanosterol 14-alpha-demethylase (CYP51A1), blocking ergosterol biosynthesis in fungal cell membranes. Excellent oral bioavailability (>90%), good CNS penetration (60-80% of plasma levels in CSF), and relatively favorable safety profile compared to amphotericin B. Primary indications: oropharyngeal/esophageal candidiasis, vulvovaginal candidiasis, cryptococcal meningitis maintenance therapy, and systemic candidiasis. Key safety concerns: CYP2C9 and CYP3A4 inhibition causing significant drug interactions (warfarin, phenytoin, cyclosporine, tacrolimus); hepatotoxicity (rare but serious, ALT elevation in 5-7%); QTc prolongation at high doses; and teratogenicity — FDA pregnancy category D based on case reports of craniofacial, skeletal, and cardiac malformations with first-trimester exposure to doses >400 mg/day (Pursley et al. 1996). Single-dose 150 mg for vulvovaginal candidiasis appears safe in pregnancy. Resistance: C. krusei is intrinsically resistant; C. glabrata shows increasing resistance (15-25% in US ICUs).","source_refs":["aletheia_fungi_batch_2026"]},"meta":{"synthesis_version":"n/a","timestamp":"2026-07-27T02:34:46.470Z"},"_notice":"ALETHEIA output is reference data, not professional advice. Not a substitute for primary agency sources or qualified professionals. See https://aletheia.holisticquality.io/disclaimer.","_disclaimer_url":"https://aletheia.holisticquality.io/disclaimer","available_contexts":["human_adult"]}