Indications
Fluconazole is indicated in
- Superficial candidal infections such as oral or vaginal thrush
- Esophagitis caused by Candida or other susceptible species
- Maintenance therapy of cryptococcal meningitis
- Disseminated candidiasis
- Prophylaxis for fungal infection in neutropenic cancer patients
- Acute treatment of other systemic fungal infections
- Dermatophyte and Candida skin infections
- Fungal UTIs
Therapeutic Class
Pharmacology
Dosage
Oral-
Adults:
- Oropharyngeal Candidiasis: 200 mg on the first day, followed by 100 mg once daily for 7-14 days.
- Esophageal Candidiasis: 200 mg on the first day, followed by 100 mg once daily for 2-3 weeks.
- Systemic Candidiasis and Cryptococcal Meningitis: 400 mg daily followed by 200 mg once daily. The recommended duration of treatment for initial therapy of cryptococcal meningitis is 10 to 12 weeks.
- Acute or recurrent vaginal candidiasis: Single dose of 150 mg.
- Urinary Tract Infections and Peritonitis: 50 to 200 mg once daily. Prophylaxis in Patients Undergoing Bone Marrow Transplantation: 400 mg once daily.
Children:
- Oropharyngeal Candidiasis: 6 mg/kg on the first day, followed by 3 mg/kg once daily. Treatment should be administered for at least 2 weeks to decrease the likelihood of relapse.
- Esophageal Candidiasis: 6 mg/kg on the first day, followed by 3 mg/kg once daily.
- Cryptococcal meningitis: Initial therapy should be started with 6 to 12 mg/kg daily. Doses up to 12 mg/kg/day may be used for three weeks and treatment for initial therapy of cryptococcal meningitis is 10 to 12 weeks.
Intravenous-
Adult & child: Invasive candidal infections including candidaemia and disseminated candidiasis and cryptococcal infections including meningitis, by IV, 400 mg initially then 200 mg daily, increased if necessary to 400 mg daily, treatment continued according to response (at least 6-8 weeks for cryptococcal meningitis); Child 6-12 mg/kg daily (every 72 hours in neonate up to 2 weeks old, every 48 hours in neonate 2-4 weeks old); maximum 400 mg daily.
Prevention of relapse of cryptococcal meningitis, by IV, 100-200 mg daily.
Administration
Interaction
Contraindications
Side Effects
Pregnancy & Lactation
Use in pregnancy: Fluconazole should be used in pregnancy only if the potential benefit justifies the possible risk to the foetus.
Use in lactation: Fluconazole is secreted in human milk at concentrations similar to plasma. Therefore, the use of Flouconazole in nursing mother is not recommended.
Precautions & Warnings
in lactating mothers is not recommended.