Fluconazole

Antifungal, Systemic · Triazole antifungal

Indications

See under dosage.

Dosage

Vaginal candidiasis and candidal balanitis: Adults: Orally, a single dose of 150 mg. Mucosal candidiasis (except genital): Adults: Orally, 50 mg daily (100 mg daily in unusually difficult infections) given for 7-14 days in oropharyngeal candidiasis (max 14 days except in severely immunocompromised patients); for 14 days in atrophic oral candidiasis associated with dentures; for 14-30 days in other mucosal infections (e.g. oesophagitis, candiduria, non-invasive bronchopulmonary infections). Children: Orally or by IV infusion, 3-6 mg/kg on first day then 3 mg/kg daily (every 72 hr in neonates up to 2 wk old, every 48 hr in neonates of 2-4 wk old). Tinea pedis, corporis, cruris, versicolor and dermal candidiasis: Adults: Orally 50 mg daily for 2-4 wk (for up to 6 wk in tinea pedis); max duration of treatment 6 wk. Invasive candidal infections (including candidaemia and disseminated…

Administration

IV: Fluconazole be administered by IV Infusion over approx 1-2 hours; do not exceed 200 mg/hour when giving IV Infusion. Standard diluent: 200 mg/100 mL NS (premixed); 400 mg/200 mL NS (premixed). Compatibility: Stable in D5W, LR, NS. Y-site administration: Drug to Drug IV Compatibility: Acyclovir, amikacin, amiodarone, aztreonam, bumetanide, cephazolin, cefepime, cimetidine, ciprofloxacin, cisatracurium, dexamethasone, diltiazem, diphenhydramine, dobutamine, dopamine, enalapril, epinephrine, esmolol, famotidine, fentanyl, gentamicin, heparin, hydrocortisone, hydromorphone, insulin regular, labetalol, lansoprazole, levofloxacin, linezolid, lorazepam, magnesium sulphate, meropenem, methylprednisolone, metoclopramide, metronidazole, midazolam, morphine, nitroglycerin, nitroprusside, norepinephrine, ondansetron, phenylephrine, piperacillin/tazobactam, propofol, ranitidine, tobramycin,…

Adverse Effects

GI upset, headache, rash, altered LFTs. Reports of Stevens-Johnson syndrome and toxic epidermal necrolysis (discontinue).

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Precautions: Renal impairment and hepatic impairment. Risk of serious hepatic reactions; monitor patients with altered LFTs and discontinue if symptoms occur. Proarrhythmic conditions.

Interactions

Anticoagulants, oral sulfonylureas, phenytoin, cisapride, rifampicin, rifabutin, cyclosporin, astemizole, zidovudine, other drugs metabolised by P450, benzodiazepines, theophylline, tacrolimus, sirolimus, everolimus, olaparib, calcium channel blockers, cyclophosphamide, NSAIDs, losartan, statins, protease inhibitors, alfentanil, fentanyl, methadone, amitriptyline, nortriptyline, carbamazepine, tofacitinib, drugs that prolong QT interval.

Advice to Patient

Take with or without meals. Take at regular intervals, as scheduled. Contact prescriber if there is skin redness, rash, irritation, constant abdominal discomfort, right-upper-quadrant abdominal pain, nausea, vomiting, diarrhoea, headache, changes in urinary pattern, increased dryness of eyes or mouth, colour change of urine or stool. Complete full course of therapy even if you feel better. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Keep yourself in a hygienic condition to prevent reinfection. Have blood tests done, as advised by prescriber. If you have diabetes, monitor blood glucose regularly and inform prescriber about the changes.

Pharmacokinetics

Absorption: Oral: Well absorbed. Bioavailability: Oral: >90%. Half-life elimination: Normal renal function: Approx. 30 hrs. Elderly: 46.2 hrs. Neonates (gestational age 26-29 wks): 73.6-46.6 hrs (decreases with increasing postnatal age). Paediatric patients 9 mths-15 yrs: 19.5-25 hrs. Time to peak, serum: Oral: 1-2 hrs. Excretion: Urine.

Brands with this active ingredient

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.