By inhibiting 14-alpha-demethylase, fluconazole depletes ergosterol and increases membrane permeability.
Fluconazole is a triazole antifungal that inhibits the fungal cytochrome P450-dependent enzyme 14-alpha-demethylase, blocking conversion of lanosterol to ergosterol and halting assembly of a functional cell membrane. Accumulation of toxic 14-methyl sterols disrupts membrane-bound transport proteins, increases permeability, and leads to growth arrest or cell death in susceptible Candida and Cryptococcus species. Its high aqueous solubility and low protein binding support dependable penetration into cerebrospinal fluid and urine, enabling treatment of invasive candidiasis, cryptococcal meningitis, and mucocutaneous infections.
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