Fluconazole

C difficile risk
N/A
Oral Bioavailability
Excellent

Dosing

eGFR 0 - 50eGFR > 50200mg IV/PO q24h400mg IV/PO q24h

Give full dose by indication after each HD session

100-400mg IV/PO q24h based upon indication

Candidemia (suspected or confirmed)
Loading dose = 800mg PO/IV then 400-800 mg PO/IV daily

Serious Infections
(e.g. Candidemia, CNS/Endophthalmitis)
400-800mg PO/IV daily

Other indications
100-400mg PO/IV daily

General Information

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

Cryptococcus and Coccidioides infections.

Antifungal prophylaxis in immunocompromised.

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

  • 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

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Therapeutic

Biliary penetration: Therapeutic