Fluconazole, known commonly as the brand name Driflucan, is an antifungal drug taken mainly orally in the form of a pill, but can also be applied topically. Fluconazole targets Candida albicans, Candida glabrata, Candida parapsilosis, Candida tropicalis, and Cryptococcus neoformans. Each of these species of fungus cause different kinds of fungal infections in the body. For example, candida albicans commonly causes systemic infections while Cryptococcus neoformans commonly causes meningitis. In the case of meningitis, it is assumed that the transporter P-glycoprotein 1 must be capable of transporting Fluconazole across the blood-brain barrier. It is speculated that the swelling caused by meningitis makes this easier. Once in the target area Fluconazole inhibits the enzyme Cytochrome P450 51 or Lanosterol 14-alpha demethylase of yeast cells. It does this by binding the free nitrogen atom located on the azole ring to an iron atom of Lanosterol 14-alpha demethylase. This enzyme catalyzes the reaction of lanosterol with 3 oxygen and 3 NADPH to become 4,4-Dimethylcholesta-8,14,24-trienol with byproducts of formic acid, 4 hydrogen ions, 4 water, and 3 NADP+. This reaction is the first step in the ergosterol biosynthesis pathway which is integral to cell membrane integrity. With this process inhibited by Fluconazole, the fungal cell cannot produce more fungi cells, and cannot keep the integrity of its own cell.

Fluconazole Pathway References