Fluconazole

Listed in Dosage.

Adult: PO Oropharyngeal candidiasis Treatment: Initially, 200-400 mg on Day 1, followed by 100-200 mg once daily for 7-21 days (until disease is in remission). Prevention of relapse in patients with HIV: 100-200 mg once daily, or 200 mg 3 times a week. Oesophageal candidiasis Treatment: Initially, 200-400 mg on Day 1, followed by 100-200 mg once daily for 14-30 days (until disease is in remission). Prevention of relapse in patients with HIV: 100-200 mg once daily, or 200 mg 3 times a week. Candiduria 200-400 mg once daily for 7-21 days. Chronic atrophic candidiasis 50 mg once daily for 14 days. Chronic mucocutaneous candidiasis 50-100 mg once daily for up to 28 days. Candidal balanitis; Vaginal candidiasis 150 mg given as a single dose. Treatment and prophylaxis of recurrent vaginal candidiasis (4 or more episodes a year): 150 mg every third day for a total of 3 doses (Day 1, 4, and 7), followed by a 150 mg once weekly maintenance dose (6 months). Dermatophytosis Tinea pedis, Tinea corporis, Tinea cruris, Candida infections: 150 mg once a week, or 50 mg once daily. Tinea versicolor: 300-400 mg once a week for 1-3 weeks, or 50 mg once daily for 2-4 weeks. Invasive candidiasis Initially, 800 mg on Day 1, followed by 400 mg once daily for 2 weeks. Cryptococcal meningitis Initially, 400 mg on Day 1, followed by 200-400 mg once daily, for at least 6-8 weeks. Prevention of relapse in patients with high risk of recurrence: 200 mg once daily. Coccidioidomycosis 200-400mg once daily for 11-24 months, or longer depending on severity of infection, clinical or mycologic response. Prophylaxis of fungal infections in immunocompromised patients In patients with prolonged neutropenia: 200-400 mg once daily. IV Oropharyngeal candidiasis Treatment: Initially, 200-400 mg on Day 1, followed by 100-200 mg once daily for 7-21 days (until disease is in remission). Prevention of relapse in patients with HIV: 100-200 mg once daily, or 200 mg 3 times a week. Oesophageal candidiasis Treatment: Initially, 200-400 mg on Day 1, followed by 100-200 mg once daily for 14-30 days (until disease is in remission). Prevention of relapse in patients with HIV: 100-200 mg once daily, or 200 mg 3 times a week. Candiduria 200-400 mg once daily for 7-21 days. Chronic atrophic candidiasis 50 mg once daily for 14 days. Chronic mucocutaneous candidiasis 50-100 mg once daily for up to 28 days. Invasive candidiasis Initially, 800 mg on Day 1, followed by 400 mg once daily for 2 weeks. Cryptococcal meningitis Initially, 400 mg on Day 1, followed by 200-400 mg once daily, for at least 6-8 weeks. Prevention of relapse in patients with high risk of recurrence: 200 mg once daily. Coccidioidomycosis 200-400mg once daily for 11-24 months, or longer depending on severity of infection, clinical or mycologic response. Prophylaxis of fungal infections in immunocompromised patients 200-400 mg once daily.

May be taken with or without food.

Hypersensitivity. Concomitant use with astemizole, cisapride, quinidine, terfenadine, pimozide, erythromycin.

Patients with potentially proarrhythmic conditions (e.g. hypokalaemia, electrolyte abnormality, advanced cardiac failure), serious underlying disease (e.g. AIDS, malignancy). Renal and hepatic impairment. Children and elderly. Pregnancy and lactation. Patient Counselling This drug may cause dizziness or seizures, if affected, do not drive or operate machinery. Monitoring Parameters Monitor LFTs, renal function tests and serum K levels periodically.

Significant: QT interval prolongation. Rarely, anaphylaxis. Blood and lymphatic system disorders: Agranulocytosis, anaemia, leucopenia, thrombocytopenia, neutropenia. Gastrointestinal disorders: Nausea, vomiting, diarrhoea, abdominal pain, flatulence, dyspepsia, constipation, dry mouth. General disorders and administration site conditions: Fatigue, malaise, asthenia, fever. Immune system disorders: Angioedema, urticaria. Metabolism and nutrition disorders: Hypercholesteremia, hypertriglyceridaemia, hyperlipidaemia, hypokalaemia, anorexia. Musculoskeletal and connective tissue disorders: Myalgia. Nervous system disorders: Headache, dizziness, dysgeusia, paraesthesia, tremor, vertigo. Psychiatric disorders: Insomnia, somnolence. Skin and subcutaneous tissue disorders: Rash, pruritus, increased sweating, alopecia.
Potentially Fatal: Hepatic toxicity (e.g. cholestasis, hepatocellular damage, hepatitis, fulminant hepatic failure), ventricular arrhythmia, torsade de pointes. Rarely, Stevens-Johnson syndrome, toxic epidermal necrolysis.

May increase prothrombin time with anticoagulants (e.g. warfarin). May increase serum concentrations of drugs metabolised by CYP3A4 and CYP2C9 isoenzymes (e.g. bosentan, ciclosporin, midazolam, nevirapine, amitriptyline, nortriptyline, phenytoin, rifabutin, sulfonylurea, nateglinide, celecoxib, parecoxib, tacrolimus, triazolam, zidovudine). May increase risk of myopathy and rhabdomyolysis with HMG-CoA reductase inhibitors (e.g. simvastatin, atorvastatin). May decrease plasma clearance of theophylline. May reduce plasma concentration with rifampicin.

Antifungals

J02AC01 - fluconazole ; Belongs to the class of triazole derivatives. Used in the systemic treatment of mycotic infections.
D01AC15 - fluconazole ; Belongs to the class of imidazole and triazole derivatives. Used in the topical treatment of fungal infection.