Fluconazole differs from ketoconazole in that:
Fluconazole does not have anti-androgenic side effects. Ketoconazole is rarely used now a days because of several limitations like: Poor oral bioavailability Limited CNS penetration Powerful inhibition of microsomal enzymes Used in treatment of Cushing Syndrome Anti-androgenic adverse effects like gynaecomastia Fluconazole is preferred agent because it has: Very good oral absorption Maximum CNS penetration (therefore effective in cryptococcal meningitis). No inhibitory action on microsomal enzymes No anti-androgenic propey.
It is not active by the oral route
It is a more potent inhibitor of drug metabolism
It is not effective in cryptococcal meningitis
It is unlikely to produce anti-androgenic side effects
Anti-Fungal Drugs