Fluconazole

C. diff Risk

Low

Oral Bioavailability

Excellent

Spectrum Of Activity

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

CrCl Greater Than 50 mL/minCrCl 10-49 mL/minCrCl Less Than 10 mL/min100-400 mg q24h50% of dose q24h25% of dose q24h

General Information

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

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

Cryptococcus and Coccidioides infections.

Antifungal prophylaxis in immunocompromised.