Fluconazole

C. diff Risk

Low

Oral Bioavailability

Excellent

Spectrum Of Activity

Dosing

100-400 mg PO/IV daily

30+ mL/min0 - 30 mL/min100-400 mg PO/IV daily100-200 mg PO/IV daily

100-400 mg PO/IV daily

Give after dialysis on dialysis days.

400-800 mg PO/IV daily

100-200 mg PO/IV daily

General Information

Adverse Effects

  • Drug interactions

  •  QTc prolongation

  •  Hepatic enzyme abnormalities

  •  Rash

  •  Alopecia

  • GI upset

  • Check LFTs within a week of starting treatment

Drug Monitoring

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

Major Interactions

Many via CYP450 - 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, decreases ergosterol synthesis

Pregnancy category: C