All anti-fungal drugs can have the tendency to give side-effects, ranging from the mild to the extreme. Here are some of the most commonly experienced side-effects.
Topical creams and ointments may cause mild burning. Some people are highly sensitive and may have a widespread skin reaction with blisters and peeling. A number of lotions and creams also include a steroid to lessen inflammation which may trigger itchiness, irritation or dryness. Vaginal tablets do not often cause problems, but in a few women they may lead to vaginal burning or itching or skin rash. Some women experience cramps or headaches. Clotrimazole lozenges may cause minor changes in liver function, but this may not require stopping the drug.
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Oral irritation and nausea are rare side effects of Nystatin lozenges. Nystatin oral rinse (Mycostatin) is almost non-toxic, but it may cause gut problems if excessive doses are taken. Stop if you notice any side effects with topical treatments and do tell your doctor.
Side effects for the oral azole drugs are similar, but some studies show they’re more common with Itraconazole. The most common are nausea, vomiting and belly pains. Others include dizziness, drowsiness, fever, diarrhea, headaches, rash and changes in taste. By far the most significant problem is liver toxicity, however this is uncommon and typically reverses once the medication is discontinued. Nevertheless, liver function should be carefully monitored when you commence with any pharmaceutical anti fungal, particularly with ketoconazole, ask for an LFT (liver function blood test). Don’t be afraid to ask your doctor for at least six monthly blood tests to assess your immune system, kidney and liver function.
Amphotericin B has many side effects, some quite strong and severe. Therefore, it is only used in cases when there’s a direct threat to a person’s life or all other treatments have failed. Main side effects include kidney problems and low red blood cells, known as anemia.
Others side effects include fever, chills, and changes in blood pressure, changes in appetite, nausea, vomiting and headache. These reactions occur one to three hours after an infusion, are most severe with the first few doses, and diminish with later treatments. Side effects are generally the same with all amphotericin drugs, though some forms of this drug may be slightly less toxic than others.