A Tool Tailor Made
For Your Practice
IMAGES
What does oral candidiasis look like?
ABOUT
About
Oral Candidiasis + HCP Resources
Welcome to a practical and quick resource, designed specifically for busy Canadian healthcare providers.
This platform is dedicated to supporting your practice with a focus on the diagnosis and treatment of oral candidiasis, including a comprehensive and accessible comparison tool for download.
Brought to you by a multidisciplinary faculty from across Canada with practitioners from rheumatology, dermatology, and pharmacy.
Our goal is to equip you with the latest insights, research findings, and clinical strategies to enhance patient care,
efficiently.
Click here to see by Province who can prescribe for oral candidiasis treatments in Canada.
APPROACH
Drug-Drug Interactions.
*High interaction potential.
Itraconazole is a potent inhibitor of cytochrome P450 3A4 (CYP3A4), associated with numerous drug-drug interactions (DDI). This may lead to increased plasma concentrations of drugs metabolized by this pathway which may increase or prolong both therapeutic and adverse effects to such an extent that a potentially serious situation may occur. Please refer to an interaction checker to assess drug-drug interactions on a case by case basis.
Contraindications: methadone, disopyramide, dronedarone, quinidine, ticagrelor, ergot alkaloids, such as dihydroergotamine, ergometrine (ergonovine), ergotamine, irinotecan, lurasidone, pimozide, triazolam, felodipine, ivabradine, ranolazine, eplerenone, domperidone, naloxegol, lomitapide, lovastatin, simvastatin, fesoterodine (in subjects with moderate to severe renal impairment, or moderate to severe hepatic impairment), solifenacin (in subjects with severe renal impairment or moderate to severe hepatic impairment), eletriptan, colchicine (in subjects with renal or hepatic impairment).
PLEASE NOTE: LIST ABOVE IS NOT EXHAUSTIVE AND WE ENCOURAGE YOU TO ASSESS CASE BY CASE
Fluconazole is a potent inhibitor of cytochrome CYP2C9 and a moderate CYP3A4 inhibitor.
There is a risk of increased plasma concentration compounds metabolized by CYP2C9 and CYP3A4 co-administered with fluconazole. Therefore, caution should be exercised when using these combinations and the patients should be carefully monitored.
The enzyme inhibiting effect of fluconazole persists 4-5 days after discontinuation of fluconazole treatment due to the long half-life of fluconazole
Statins (ie. atorvastatin, lovastatin, and simvastatin), benzodiazepines (ie. midazolam, triazolam, and diazepam), warfarin, systemic calcineurin inhibitors (ie. cyclosporine and tacrolimus), system corticosteroids (ie. prednisone), phenytoin.
PLEASE NOTE: LIST ABOVE IS NOT EXHAUSTIVE AND WE ENCOURAGE YOU TO ASSESS CASE BY CASE
QT-Prolonging Medications (Note: List below is not exhaustive)
Antipsychotics: Haloperidol, ziprasidone, quetiapine, thioridazine, olanzapine, risperidone, droperidol
Antiarrhythmics: Amiodarone, sotalol, dofetilide, procainamide, quinidine, flecainide
Antibiotics: Macrolides, fluoroquinolones
Antidepressants: Amitriptyline, imipramine, citalopram, amitriptyline
Others: Methadone, sumatriptan, ondansetron, cisapride
FACULTY
Meet the Faculty
Jon Chan
Rheumatologist
Vancouver, BC
Lara Kassam
Pharmacist
Montreal, QC
Lauren Lam
Dermatologist
Calgary, AB
Irina Turchin
Dermatologist
Fredericton, NB
Carolyn Whisken
Pharmacist
Hamilton, ON
Aaron Wong
Dermatologist
Vancouver, BC
Jensen Yeung
Dermatologist
Toronto, ON
Powered by a multidisciplinary team of experts.
FAQ
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References Cited
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Armstrong AW, Blauvelt A, Mrowietz U, Strober B, Gisondi P, Merola JF, Langley RG, Ståhle M, Lebwohl M, Netea MG, Nunez Gomez N. A practical guide to the management of oral candidiasis in patients with plaque psoriasis receiving treatments that target interleukin-17. Dermatology and Therapy. 2022 Mar;12(3):787-800.
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CPS [Internet]. Ottawa (ON): Canadian Pharmacists Association; c2016 [updated 2020 01 29; citef 2024 05 01]. Itraconazole[product monograph]. Available from:https://cps-pharmacists-ca.eu1.proxy.openathens.net/search
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[Internet]. Kirkland (QC):Pfizer Canada Inc; c2018 [updated 2018 01 06; cited 2024 05 01].Fluconazole [product monograph]. Available from:https://pdf.hres.ca/dpd_pm/00045911.PDF
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Yeung J, Bunce PE, Lynde CW, Turchin I, Vender RB. Review and practical guidance on managing fungal infections in patients with psoriasis receiving anti-IL-17 therapies. Journal of Cutaneous Medicine and Surgery. 2022 Jul;26(1_suppl):3S-23S.
IMAGES
What does oral candidiasis look like?
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May be asymptomatic or associated with localized mucosal pain, altered taste, or a sensation of oral fullness
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Whitish plaques can be visualized on the tongue, as well as buccal and palatal surfaces
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Plaques are not firmly affixed to the mucosa and can easily be scraped off
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When white patches wiped off, they may leave red spots that can bleed.