Fluconazole has high oral bioavailability – consider initiating with/switching to oral therapy when patient tolerating orals
CrCl >50 mL/min
Oropharyngeal Candidiasis: 100mg daily
Esophageal Candidiasis: 200mg daily
Severe Infections : 400mg daily
Other: 100 - 400 mg IV/PO Q24h
CrCl 10 - 50 mL/min
50 - 200 mg IV/PO Q24h
CrCl <10 mL/min (ESRD not on HD)
50 -100 mg IV/PO Q24h
Dialysis (HD)
200 mg IV/PO daily
Dialysis (CRRT)
400 – 800 mg IV/PO Q24h