April 29, 2017
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Fluconazole

Medical and Pharmacy Editor:

Brand Name: Diflucan

Generic Name: Fluconazole

Drug Class: Antifungals, Systemic

What Is Fluconazole and How Does It Work?

Fluconazole is used to treat vaginal yeast infections. It works by stopping the growth of common types of vaginal yeast (fungus). This medication belongs to a class of drugs called azole antifungals.

Fluconazole is available under the following different brand names: Diflucan.

Dosages of Fluconazole:

Adult and Pediatric Dosage Forms and Strengths

Injected solution

  • 2 mg/mL

Oral suspension

  • 10 mg/mL
  • 40 mg/mL

Tablets

  • 50 mg
  • 100 mg
  • 150 mg
  • 200 mg

Dosage Considerations – Should be Given as Follows:

Oropharyngeal Candidiasis

Adult: 200 mg orally on Day 1, THEN 100 mg once/day

Pediatric: 6 mg/kg orally on Day 1, THEN 3 mg/kg once/day; not to exceed 600 mg/day

Dosing considerations

  • Treatment should be administered for at least 2 weeks to decrease likelihood of relapse

Esophageal Candidiasis

Adult: 200 mg orally on Day 1, THEN 100 mg once/day; doses up to 400 mg/day may be used based on patient's response

Pediatric: 6 mg/kg orally on Day 1, THEN 3 mg/kg once/day

Doses up to 12 mg/kg/day may be used, based on patient's response

Dosing considerations

  • Treat for a minimum of 3 weeks and for at least 2 weeks following resolution of symptoms

Cryptococcal Meningitis

Adult

  • 400 mg orally on Day 1, THEN 200 mg orally once/day
  • Dosage of up to 400 mg once/day may be used based on patient's response
  • Suppression of relapse in patients with AIDS: 200 mg orally once/day

Pediatric

  • 12 mg/kg orally/intravenously (IV) on Day 1, THEN 6 mg/kg once/day
  • Dose of 12 mg/kg once daily may be used, based on patient's response
  • Suppression in children with AIDS: 6 mg/kg once daily

Dosing considerations

  • Recommended duration of therapy is 10-12 weeks after cerebrospinal fluid becomes culture negative

Prophylaxis of Candidiasis with BMT

Prevention of candidiasis incidence in patients undergoing bone marrow transplant

400 mg orally once/day

Dosing considerations

  • Patients who are anticipated to have severe granulocytopenia should start prophylaxis several days before anticipated onset of neutropenia and continue for 7 days after neutrophil count rises greater than 1000 cells per mm≥

Vaginal Candidiasis

Uncomplicated: 150 mg orally as a single dose

Complicated: 150 mg orally every 72 hours for 3 doses

Recurrent: 150 mg orally once/day for 10-14 days followed by 150 mg once weekly for 6 months

Candida UTI/Peritonitis

50-200 mg orally once/day

Systemic Candida Infections, Pediatric

6-12 mg/kg/day orally/intravenously (IV); not to exceed 600 mg/day

Premature Neonates

26-29 weeks' gestation: 6-12 mg/kg intravenously (IV)/orally

Maintenance: 3-6 mg/kg IV/orally once/day

Maintenance dose interval

  • 26-29 weeks' gestation: every 72 hours; administer every 24 hours after 2 weeks of life

Dosage Modifications

Hepatic impairment: Not studied

Renal impairment

  • Percent of recommended dose:
  • -CrCl greater than 50 mL/min: 100% of dose
  • -CrCl up to 50 mL/min: 50% dose
  • -Regular dialysis: 100% dose after each dialysis; on non-dialysis days, reduce dose according to creatinine clearance
Medically Reviewed by a Doctor on 4/14/2017



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