Hi
has anyone taken daily 5mg prednisalone and flucanazole ( 1 week 50mg daily course) at the same time ?
I need to know if it's dangerous to mix the 2.. bnf website says there are contraindications, but what happens in real life ?
any advice would be great , if some people have taken both at the same time
many thanks
I think you should check with your pharmacist
I have taken fluconazole twice whilst on prednisolone. The first time I was on 10mg prednisolone , I had 3 weeks of fluconazole. The second time I was on 7.5mg and took a 2 week course. My understanding is there is a theoretical risk that the prednisolone taken with fluconazole can cause hypokalaemia, which is low potassium levels, which can cause palpitations, muscle weakness and tingling, among other symptoms. However I am not a Dr and you should discuss any concern with your prescribing Dr or pharmacist.
that's helpful, many thanks, prednisalone does cause a flare up in oral thrush for me, it's done it before, but waiting weeks in between taking flucanazole and then pred when I need to take my pred now to stop a flare is not helping my ra.
I had to have a tongue biopsy in 2016, as thth thought I’d squamous cell carcinoma. Thankfully it came back as an unusual candidia infection called chronic hyperplastic candidia. It can turn cancerous, so they prescribed me Nystatin to take 1 week in every 4 to try and prevent its recurrence. I did stop once for 6 months on gps advice, but that’s when it returned and needed further fluconazole. So now I continue 1 week in 4, and do far so good 👍
that's interesting, did you have to stop any of your ra meds to take flucanazole?
hydroxychloroquine is not supposed to be taken with flucanazole..
my oral thrush keeps coming back, I am diabetic so grow infections easily and the immunesuppressant of the ra drugs disables my imune system from fighting off the candida. it could also be that mtx affects the oral area but swapping to mtx injections does not seem to have helped. when I stop my mtx the oral thrush goes away because my own immune system has kicked back in.
I have ankylosing spondylitis rather than RA. The first time I took Fluconazole I was on steroids and Azathioprine. The more recent time, I was on my biologic, 25mg MTX and both prednisolone and hydrocortisone. I’m also on another immunosuppressant for my lungs. So I’m also quite immunosuppressed, but have never stopped any meds whilst on fluconazole. Check with your pharmacist or Dr though
ok thanks, please could you tell me what dose of pred were you on at the same time as taking flucanazole ?
I’ve already discussed it in my first comment. See above 🤗
aah yes, sorry forgot. I am trying to work out how far into my pred course I can take the flucanazole. my pred starts at 20mg in the first week, then goes down to 10mg and then 5mg.
Hi was the flucanozole for oral thrush started by the prednisolone ? thanks
no I had it for another Candida infection. Rather than just the white coating you get with thrush, this went into the deeper tissues. I had a tongue biopsy, as they were convinced it was cancer. It’s called hyperplastic candidosis, and can turn cancerous. Do I received 3 weeks of high dose treatment. I was told it was more likely from my immunosuppressants than the prednisolone, but no way of knowing for sure.
I had the tongue biopsy thing mentioned yesterday. please could you tell me what symptoms you had so I can compare with mine. I get white coating on tongue, there are white raised lumps on the back of the tongue, also what looks like white scabs on the back of the tongue, gp says it's thrush, ent consult says he is not so sure and he does not think it's thrush, it could be side effect from mtx, . it looks like thrush to me and mtx is known to upset the oral area. but even nystatin cannot keep it away. if I stop the nystatin it's back within a couple of days.
The pharmacist can check for you and they are the experts. But I think the risk of interaction is very low.
As far as I'm aware (born out by personal experience and from everything I've read and heard) all effective RA meds are nasty. That's why treatment needs to be under the supervision of a specialist, rather than your GP. They are not only nasty individually; they are even nastier in combination. The only thing that makes taking such substances (i.e. toxins) vaguely sensible, is the condition they treat is more horrid than they are! Put another way: in order to poison the condition you have to poison yourself and hope the condition gets the worst of it. That's how I think about it anyway 🙂
The other side is that every person's condition is different, and everyone's responses to treatment are different. I have experienced side effects that aren't listed, and not experienced others that are supposedly ubiquitous. As a consequence, I don't take much notice of what's written on the leaflet, and only ask whether I need to be alert to any potentially life-dangerous reactions. Fortunately, these tend to obvious (e.g. if after taking the med you have convulsions, pass out, are in extreme pain, feel like you're going to die, etc., don't continue taking it!) Also, make sure you don't skip any tests that have been advised (bloods, scans, etc) because they could be monitoring for potentially harmful reactions that don't have obvious symptoms.
It's important you have confidence in whoever is treating your condition and you shouldn't feel embarrassed to ask questions if you have concerns. Asking here is good as well, but the emphasis should be on "as well."
Good luck!
I Googled it and got:
“Fluconazole may increase the blood levels and effects of predniSONE. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications”
It came from drugs.com.
Please be very careful. Check with your doctor or a pharmacist.
ok thanks, I did check with both but no sensible answer, nobody wants the responsibility
I wouldn’t do it. I’d be afraid for my liver. But I don’t take a lot of meds because of the side effects. If I try them and have one side effect, I won’t continue them.
I don't blame you, I am soo careful myself
Hi, can you send me a link to the advice - I can't find it..thanks
Hi, Lindy. I went back and searched Google the same way - fluticazone and prednisolone - but this time it said no interactions were found. When I sent you the first results, I double checked both the website I was on and that the two medications were listed correctly. Either someone called them on it or they were wrong from the beginning. But I copied what was on my screen and put quotes around it so you’d know it was them, not me, saying it. I wish I had sent the screenshot rather than just the wording. Sorry if this mislead you in anyway. Didn’t mean for it to do that. Seems like every good thing I try to do lately backfires on me. I am sure this is why they say don’t Google your health questions. Take care and best wishes.
Hi, I found it drugs.com/interactions-chec...
but there is no mention of this on the bnf bnf.nice.org.uk/interaction...
thanks
Anyone had Covid booster & flu vacciination at same time? 
Is all methotrexate the same?
Are the nras & nras.healthunlocked the same.
Can I take two dmards at the same time?
