Fluconazole

C. diff Risk

Low

Oral Bioavailability

Excellent

Approximate Cost

Dosing

Loading dose for Candidemia 800 mg IV/PO Serious Infections (e.g. Candidemia, CNS/Endophthalmitis/Endocarditis) 400-800 mg IV/PO daily Other indications 100-400 mg IV/PO daily

25% of dose q24h
CrCl Less Than 10 mL/min

50% of dose q24h
CrCl 10-49 mL/min

100-400 mg q24h
CrCl Greater Than 50 mL/min

General Information

Common Usage

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

Cryptococcus and Coccidioides infections.

Antifungal prophylaxis in immunocompromised.

Drug Monitoring

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

Adverse Effects

  • Drug interactions

  • QTc prolongation

  • Hepatic enzyme abnormalities

  • Rash

  • Alopecia

  • GI upset

Major Interactions

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.

Pharmacology

Antimicrobial class: Triazole antifungal

Pregnancy category: C

Average serum half life: 20 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

Biliary penetration: Therapeutic

CSF penetration: Therapeutic