Fluconazole - Renal Dosing

In the setting of rapidly improving or worsening renal function, calculations of CrCl are inaccurate. Dosing should be based on estimated renal function instead.

If improving renal function, actual CrCl is likely higher than calculated CrCl.

If worsening renal function, actual CrCl is likely lower than calculated CrCl.

CrCl ≥30 mL/min

100-400mg PO/IV Q24h

CrCl <30 mL/min

50-200mg PO/IV Q24h

Full dose after HD

400-800mg PO/IV Q24h