Alopecia associated with fluconazole therapy - PubMed (original) (raw)
Alopecia associated with fluconazole therapy
P G Pappas et al. Ann Intern Med. 1995.
Abstract
Objective: To describe the association between fluconazole and reversible alopecia.
Design: A retrospective survey of 1) patients enrolled in NIAID Mycoses Study Group (MSG) protocols involving the long-term use of fluconazole for treatment of endemic mycoses and 2) patients treated with fluconazole outside of a protocol setting but by the MSG investigators who were MSG members.
Setting: 26 MSG sites in the United States.
Patients: 33 patients with various deep and superficial mycoses who developed alopecia while receiving fluconazole.
Results: 11 of 26 investigators reported a total of 33 patients with substantial alopecia related to fluconazole therapy. Underlying mycoses included blastomycosis, sporotrichosis, histoplasmosis, cryptococcosis, coccidioidomycosis, and mucosal candidiasis. In separate MSG studies, 17 of 136 (12.5%) and 8 of 40 (20%) patients had substantial reversible alopecia associated with fluconazole therapy. Eight patients who were not in the protocol had similar adverse effects. Twenty-nine of 33 patients (88%) received at least 400 mg of fluconazole daily for a mean of 7.1 months. Alopecia developed a median of 3 months after initiation of fluconazole therapy and involved the scalp in all patients. Other sites were involved in about one third of patients. Three patients required wigs because of extensive hair loss. Alopecia resolved within 6 months of discontinuation of fluconazole therapy or reduction of the daily dose by at least 50%.
Conclusions: Alopecia appears to be a common adverse event associated with higher-dose (400 mg/d) fluconazole given for 2 months or longer. This effect may be severe but is reversed by discontinuing fluconazole therapy or substantially reducing the daily dose.
Comment in
- Alopecia associated with fluconazole therapy.
Goldsmith LA. Goldsmith LA. Ann Intern Med. 1996 Jul 15;125(2):153; author reply 153-4. doi: 10.7326/0003-4819-125-2-199607150-00020. Ann Intern Med. 1996. PMID: 8678374 No abstract available. - Alopecia associated with fluconazole therapy.
Shear NH. Shear NH. Ann Intern Med. 1996 Jul 15;125(2):153; author reply 153-4. doi: 10.7326/0003-4819-125-2-199607150-00021. Ann Intern Med. 1996. PMID: 8678375 No abstract available.
Similar articles
- Safety evaluation of chronic fluconazole therapy. Fluconazole Pan-American Study Group.
Stevens DA, Diaz M, Negroni R, Montero-Gei F, Castro LG, Sampaio SA, Borelli D, Restrepo A, Franco L, Bran JL, Arathoon EG. Stevens DA, et al. Chemotherapy. 1997 Sep-Oct;43(5):371-7. doi: 10.1159/000239592. Chemotherapy. 1997. PMID: 9309372 Clinical Trial. - A Pan-American 5-year study of fluconazole therapy for deep mycoses in the immunocompetent host. Pan-American Study Group.
Diaz M, Negroni R, Montero-Gei F, Castro LG, Sampaio SA, Borelli D, Restrepo A, Franco L, Bran JL, Arathoon EG, et al. Diaz M, et al. Clin Infect Dis. 1992 Mar;14 Suppl 1:S68-76. doi: 10.1093/clinids/14.supplement_1.s68. Clin Infect Dis. 1992. PMID: 1562698 Clinical Trial. - Tolerability of long-term fluconazole therapy.
Davis MR, Nguyen MH, Donnelley MA, Thompson Iii GR. Davis MR, et al. J Antimicrob Chemother. 2019 Mar 1;74(3):768-771. doi: 10.1093/jac/dky501. J Antimicrob Chemother. 2019. PMID: 30535104 - Fluconazole. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in superficial and systemic mycoses.
Grant SM, Clissold SP. Grant SM, et al. Drugs. 1990 Jun;39(6):877-916. doi: 10.2165/00003495-199039060-00006. Drugs. 1990. PMID: 2196167 Review. - Oral azole drugs as systemic antifungal therapy.
Como JA, Dismukes WE. Como JA, et al. N Engl J Med. 1994 Jan 27;330(4):263-72. doi: 10.1056/NEJM199401273300407. N Engl J Med. 1994. PMID: 8272088 Review.
Cited by
- Invasive fungal infections in acute leukemia.
Bhatt VR, Viola GM, Ferrajoli A. Bhatt VR, et al. Ther Adv Hematol. 2011 Aug;2(4):231-47. doi: 10.1177/2040620711410098. Ther Adv Hematol. 2011. PMID: 23556092 Free PMC article. - Adverse Effects Associated with Long-Term Administration of Azole Antifungal Agents.
Benitez LL, Carver PL. Benitez LL, et al. Drugs. 2019 Jun;79(8):833-853. doi: 10.1007/s40265-019-01127-8. Drugs. 2019. PMID: 31093949 Review. - Isavuconazole in the Treatment of Coccidioidal Meningitis.
Heidari A, Quinlan M, Benjamin DJ, Laurence B, Mu A, Ngai T, Hoffman WJ, Cohen SH, McHardy I, Johnson R, Thompson GR 3rd. Heidari A, et al. Antimicrob Agents Chemother. 2019 Feb 26;63(3):e02232-18. doi: 10.1128/AAC.02232-18. Print 2019 Mar. Antimicrob Agents Chemother. 2019. PMID: 30559134 Free PMC article. - A case report of Coccidioides posadasii meningoencephalitis in an immunocompetent host.
Lang R, Stokes W, Lemaire J, Johnson A, Conly J. Lang R, et al. BMC Infect Dis. 2019 Aug 16;19(1):722. doi: 10.1186/s12879-019-4329-0. BMC Infect Dis. 2019. PMID: 31420023 Free PMC article. - Examination of Fluconazole-Induced Alopecia in an Animal Model and Human Cohort.
Thompson GR 3rd, Krois CR, Affolter VK, Everett AD, Varjonen EK, Sharon VR, Singapuri A, Dennis M, McHardy I, Yoo HS, Fedor DM, Wiederhold NP, Aaron PA, Gelli A, Napoli JL, White SD. Thompson GR 3rd, et al. Antimicrob Agents Chemother. 2019 Jan 29;63(2):e01384-18. doi: 10.1128/AAC.01384-18. Print 2019 Feb. Antimicrob Agents Chemother. 2019. PMID: 30455235 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources