Fluconazole

C difficile risk
Low
Oral Bioavailability
Excellent
Cost
IV $12/d PO $1/d

Dosing

400 mg PO/IV q24h

  • Consider 800 mg loading dose x 1

CrCl > 50 mL/minCrCl 30 - 50 mL/minCrCl < 30 mL/minNo renal adjustment required 200 - 400 mg PO/IV q24h200 mg PO/IV q24h

OR400 mg PO/IV qHD

  • Give dose after dialysis on HD days; none on non-HD days200 mg PO/IV q24h

  • Give dose after dialysis on HD daysNote: Dosing protocols in chronic HD patients may differ

100 - 200 mg PO/IV q24h

400 - 800 mg PO/IV q24h

General Information

  • Candida infections both muccocutaneous and invasive (ie. Candidemia)

  • Cryptococcus and Coccidioides infections

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

  • 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

Biliary penetration: Therapeutic

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Therapeutic

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