Fluconazole is not approved for the treatment of onychomycosis in North America. The more common adverse effects observed with fluconazole affect the gastrointestinal tract, cutaneous system and central nervous system.174,194 Adverse events do not commonly occur, and those experienced are usually of mild to moderate severity and are reversible. Only a small proportion of patients discontinue treatment with fluconazole. Cisapride and terfenadine are contraindicated with fluconazole. Some drug interactions may occur with the triazole; in certain cases, the drug interactions arise because fluconazole inhibits cytochrome P450 CYP2C9 and at higher doses the triazole may inhibit cytochrome P450 CYP3A4.173174

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