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
St.John's, NFLD
Carolyn Whisken
Pharmacist
Hamilton, ON
Aaron Wong
Dermatologist
Vancouver, BC
Jensen Yeung
Dermatologist
Toronto, ON
Powered by a multidisciplinary team of experts.
FAQ
You're probably
wondering...
-
What is oral candidiasis?Oral thrush, also known as oropharyngeal candidiasis, is a fungal infection in the mouth caused by the yeast Candida. It results in white lesions, usually on your tongue or inner cheeks, but it can also affect the roof of your mouth, gums, tonsils, or the back of your throat.
-
How can I tell if my patient has oral thrush?Symptoms of oral thrush include: White, cream-colored, or yellow spots in the mouth that can be wiped away to leave red areas that may bleed slightly. Loss of taste or an unpleasant taste in the mouth. Redness inside the mouth and throat. Cracks at the corners of the mouth. A painful, burning sensation in the mouth.
-
Who is at risk of developing oral thrush?While anyone can develop oral thrush, it is more common in babies and older adults due to their weaker immune systems. People with certain medical conditions, such as diabetes, and those undergoing treatments that can affect saliva production or compromise the immune system (like chemotherapy) are also at higher risk.
-
How can my patients prevent oral thrush?Maintaining good oral hygiene is key to preventing oral thrush. This includes brushing your teeth at least twice a day, flossing daily, and visiting the dentist regularly. If you wear dentures, ensure they fit properly and clean them daily. It’s also important to manage well-controlled blood sugar levels if you have diabetes and to limit the use of antibiotics and corticosteroids when possible.
-
When do I know if it's something other than oral thrush?You have symptoms of oral thrush that are uncomfortable or persistent. The infection spreads, causing symptoms in the esophagus or other parts of the body.
-
Who can prescribe for oral candidiasis in Canada?Take action! This is a common condition that can be treated by prescribing pharmacists, dermatologists, GPs and NPs.
Are you a Canadian
HCP with a question we haven't answered here?
References Cited
-
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.
-
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
-
[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
-
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?
-
May be asymptomatic or associated with localized mucosal pain, altered taste, or a sensation of oral fullness
-
Whitish plaques can be visualized on the tongue, as well as buccal and palatal surfaces
-
Plaques are not firmly affixed to the mucosa and can easily be scraped off
-
When white patches wiped off, they may leave red spots that can bleed.