I just thought I would share this information for those of you who may have a sensitivity to diflucan. I took it, and experienced severe preventricular contractions, and had to see the cardiologist. After a second attempt with it, I had the same experience. Everyone is different, but since some of us already have cardiac issues, I wanted to share this with those who may experience problems.

I was surprised that it lists rifampin as a drug NOT to mix with it.

What To Tell Your Doctor Before You Start DIFLUCAN?

Do not take Diflucan if you take certain medicines. They can cause serious problems.

Therefore, tell your doctor about all the medicines you take including:

* diabetes medicines you take by mouth such as glyburide, tolbutamide, glipizide

* blood thinners such as warfarin

* cyclosporine (used to prevent rejection of organ transplants)

* rifampin or rifabutin (used for tuberculosis)

* astemizole (used for allergies)

* tacrolimus (used to prevent rejection of organ transplants)

* phenytoin (used for seizures)

* theophylline (used for asthma)

* cisapride (Propulsid; used for stomach acid problems)

Since there are many brand names for these medicines, check with your doctor or pharmacist if you have any questions.

* are taking any over-the-counter medicines you can buy without a prescription, including natural or herbal remedies

* have any liver problems.

* have any other medical conditions

* are pregnant, plan to become pregnant, or think you might be pregnant. Your doctor will discuss whether DIFLUCAN is right for you.

* are breast-feeding. DIFLUCAN can pass through breast milk to the baby.

* are allergic to any other medicines including those used to treat yeast and other fungal infections.

* are allergic to any of the ingredients in DIFLUCAN. The main ingredient of DIFLUCAN is fluconazole. If you need to know the inactive ingredients, ask your doctor or pharmacist.

Who Should Not Take DIFLUCAN?

To avoid a possible serious reaction, do NOT take DIFLUCAN if you are taking cisapride (Propulsid) since it can cause changes in heartbeat in some people if taken with DIFLUCAN.

What complicates this though is the fact that Dr. Schardt who is proposing that diflucan can weaken the lyme through inhibition of the P450 enzyme - wonder if this inhibition and weakening of the lyme could cause herxheimer reactions?

Thanks again. Have to say after taking diflucan for a week I am feeling the best I have in nine months worth of treatment...

I am so glad that this diflucan works for you! I wish I could try this, but can't...

I am sorry you can't try it too.

So what do these delayed heart beats feel like?

I have been having heart palpitations on and off since getting sick with lyme and coinfections.

I have had two ekg's, one before treatment, and one after four months of treatment...nothing abnormal showing up in the two minutes I am hooked up to the machine.

As well, had a sonogram of the heart.

So, I had these beats that felt arrythmic. I could feel a very strong thump, but it was clearly at the wrong time. And, they happened all day long, every couple of minutes. So, it was, for me, a hard thump which was clearly noticeable, and as if the beat was later than it should be.

NOT FUN!

A prolonged QT interval can predispose to ventricular arrythmia (torsades de pointes).

The sensation of palpitations is not always related to abnormal electrical activity in the heart!

At first I was confused when my LLMD rx'd me Ketek Mon-Fri and Diflucan on weekends, because I thought this was a no-no.

However, having spoken to a few pharmacists about it, it seems it is OK. It is the other azoles that are listed in pharmacy books, not Fluconazole.

In addition, I was told that taking them together means, within say 2 hours of each other.

So, it is OK to take a day apart. I have been doing that now for 11-12 weeks and it's been fine.

Best to put the brakes on BOTH pathways SIMULTANEOUSLY. I repeat, simulantaneously.

There are 3 things that can do this. Two come with risks, so I will not post them. The third is of course, Mg.

But...there maybe another way. Bb we know is H2O2 resistant. H2O2 normally is produced very, very briefly inside our cells every split second. It is capable of knocking out most pathogens. This is how we normally stay healthy.

But, H2O2 (hydrogen peroxide) is an acid...and Bb loves acid conditions. Our cells can't stay acidic or they die.

In steps an enzyme called catalase to break down H2O2 into H2O and O.

This is happening constantly. VERY fast.

Apparently there are 2 other enzymes that also help to break down H2O2 into H2O and O.

What if we replace those 3 enzymes?

However, Erica, I would like more specific information on your problem. I have worn a 24-hour monitor in the past, which showed a lot of PVC's (and tachycardia). I also have palpitations (bump!) on Diflucan.

Noone has ever connected my PVC's with prolonged QT interval, or torsades de pointes, or any truly dangerous arrythmias.

My doctor told me years ago that my PVC's and tach. were not dangerous at all.

When Diflucan does this to me, I do in fact figure that it is a "herx" or an interaction with biaxin or zithromax (if these build up in my system, as a result of the drug combination w/Diflucan, thten I would also hav a "herx").

I have been stopping zithro when taking Diflucan (staying on mino) na dthen I attribute palpitations to not taking enough Lyme meds!

Pharmacologic action:

I've read the German Dr.s take on it.

I've read a lot of posts which hint at it's efficacy.

"Management of prolonged QT interval during a massive transfusion: calcium, magnesium or both?

Meikle A, Milne B.

Department of Anesthesia, Queen's University, Kingston, Ontario, Canada. [email protected]

PURPOSE: This case report describes the intra-operative management of a prolonged QT interval in the setting of massive transfusion. CLINICAL FEATURES: A previously healthy, 45-yr-old man presented for repair of a class IV thoraco-abdominal aneurysm. The initial stages of the operation were relatively uneventful, with the exception of an estimated blood loss of 5.0 L. At this point the patient's QT interval became markedly prolonged, and subsequently narrowed in response to supplemental calcium and magnesium. A blood sample taken just before QT prolongation revealed an ionized calcium of 0.98 mmol x L(-1) and an ionized magnesium of 0.37 mmol x L(-1),

***indicating, that low magnesium may have contributed to the QT interval prolongation.

***CONCLUSION: This case illustrates the importance of following both ionized calcium and magnesium in the setting of a massive transfusion."

PMID: 10958097

Lyddie, I certainly don't mean to alarm you.
A prolonged QT interval CAN predispose to ventricular arrythmia (torsades de pointes), but won't necessarily--

The sensation of palpitations is not always related to abnormal electrical activity in the heart! So, I think that you and your doctor are correct, that this is fine for you to live with. By now, any abnormal electrical activity should have manifested itself. Different people have different sensitivities, and I wanted people to be cognizant of the possible interactions with meds due to the common use of diflucan.

I'm sure that your in good hands, and that your palpitations are merely a nuisance. You have had them for so long; I would trust your doctor! From what I understand, (from my doctor) diflucan can cause a prolonged QT interval....but this would only impact a few sensitive people.

Are your palpitations all day?

my best!

I also think that the Ketek leaflet or website states that one shoudl make sure to not take it when you you have low magnesium or low potassium

I dont' really worry about them because after 20+ years I am still alive and kicking!

But I do need Diflucan from time to time and worry about the palp.'s I seem to get on it and whether it is a dangerous drug for me.

Finally, you, like me, had PVC's on the monitor. Did the tape also show prolonged QT interval, or did you have other tests besides the monitor? Or did your doctor just tell you that with PVC's you are at risk on Diflucan for prolonged QT interval etc? Or are you assuming that with PVC's on the tape, you need to be careful?

I am sure that after 20 yrs, like you stated, you're probably fine...I don't know if he saw a prolonged QT interval on the monitor...that's a very good question.

I will try to find out more details for you, and get back wiht some.

I don't mean to alarm you, as I'm sure that your dr. knows what to look for. Although, have you consulted with him subsequent to your use of diflucan?

I'm sorry about your mom; I'm also sure that your dr. knows about this, and how it may or may not impact your predisposition for any abnormal electrical discharge.

I had palpitations prior to any diflucan. they resolved with abx. When I had that unusual thumping, I went to have it checked out. SO in my case, it was not due to a herx. It would only happen when I took the diflucan. And it would happen all day long. The thumping was very different from the previously experienced palpitations.

Your question regarding the diflucan killing the spirochetes...the German doctor feels it weakens them by inhibiting the P450 enzyme pathway (I might be wrong about referring to it as an enzyme) anyway it is the same pathway our liver's use to detox our bodies of chemicals and toxins (medications too) - Lyme uses this same pathway or I think of it as enzyme for its survival.

The German doctor is proposing that by inhibiting this pathway it is weakening the lyme...he then prescribes a round of a less broadspectrum ABX which then targets the weakened lyme. As well, he feels that by weakening it then our immune systems can kick it more easily.

I am trying it and while hopeful very scared too that I am going to backslide...We shall see.

I am just curious how a diagnosis of PVC's turned into a diagnosis of prolonged QT interval for you. I mean, has an MD told you that you have this?

People with the type of PVC's I have should be able to take Diflucan, I thought.