Fluconazole

C difficile risk
Low
Oral Bioavailability
Excellent

Dosing

Invasive/CNS/Candidemia 800mg IV load, then 400 - 800 mg IV q24h

Serious Infections (e.g. Pyelo, IA, Pulmonary) 400 - 600mg IV daily

Other indications 100-400mg IV/PO daily

CrCl 0 - 50CrCl > 50- Invasive/candidemia: 800 mg LD, then 200 - 400 mg q24h

  • Serious infections: 600 mg load, then 200 mg q24h

  • Other: 100- 200 mg q24h 400mg IV/PO q24h

Give full dose by indication after each HD session

Varies based on type of CRRT

General Information

Candida infections both mucocutaneous and invasive - i.e. Candidemia.

Cryptococcus and Coccidioides infections.

Antifungal prophylaxis in immunocompromised.

Consider QTc monitoring if concomitant drugs affecting the interval or elevated baseline measurement.

  • Drug interactions

  • QTc prolongation

  • Hepatic enzyme abnormalities

  • Rash

  • Alopecia

  • GI upset

Many via CYP450. Suggest review specific patient medications.

Fluconazole increases levels of phenytoin, cyclosporine, tacrolimus, warfarin, oral hypoglycemics.

Risk when combining with other QTc prolonging medications.

Antimicrobial class: Triazole antifungal

Pregnancy category: C

Average serum half life: 20 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Therapeutic

Biliary penetration: Therapeutic

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