Article Contents ::
Details About Generic Salt :: Fluconazole
Main Medicine Class:: Anti Infectives Sub Medicine Class :: Anti Fungals
13I. ANTI-FUNGALS in 13. ANTI-INFECTIVES |
FLUCONAZOLE |
TRIAZOLE | ANTI-FUNGAL (SYSTEMIC) |
PK: A: well absorbed D: Extensive E: Urine |
Indications & Dose: CANDIDIASIS Prophylactic therapy PO/IV Adult Solid organ: 200-400mg OD 7-14 days, Neutropenic patients: 400mg/day for duration of neutropenia | COCCIDIOIDOMYCOSIS PO/IV Adult Meningeal & disseminated disease: 5-6mg/kg/dose q12h, max 800 mg/day, Relapse suppression: 6mg/kg/day, max 400mg/dayHIV-exposed/positive | CRYPTOCOCCAL MENINGITIS PO/IV Adult Loading dose 12 mg/kg on day 1, MD 6-12mg/kg/day 8 wk, max 800 mg/day | ESOPHAGEAL CANDIDIASIS PO/IV Adult 200mg single dose on day 1, then 100/200mg OD, max 400mg/day for 3 wk, continue for next 2 wk after resolution of symptoms Child 6mg/kg day 1 followed by 3 mg/kg/day, max 12mg/kg/day 3 wk, continue for next 2 wk after resolution of symptoms | FUNGAL INFECT IN IMMUNOCOMPROMISED PATIENTS Prophylactic therapy PO/IV Adult 50-400mg/day | OROPHARYNGEAL CANDIDIASIS PO/IV Adult 200mg as single dose on day 1, then 100/200mg OD, max 400mg OD 2 wks Child 6mg/kg day 1 followed by 3 mg/kg/day 2 wks | RECURRENT VULVOVAGINAL CANDIDIASIS PO Adult Initially 100/150/200mg given every third day for 3 doses to achieve mycologic remission, MD 100/150/200mg once weekly 6 month | SYSTEMIC CANDIDIASIS PO Adult 400mg single dose on day 1, followed by 200mg/day Child 6-12mg/kg/day | VULVOVAGINAL CANDIDIASIS Severe PO Adult Two 150mg doses given 3 days apartin non-pregnant women | Uncomplicated PO Adult 150mg single dosein non-pregnant women |
Contra: Hypersensitivity
Precautions: Renal/hepatic impairment, concomitant use of QTc prolongation agents, patients with proarrhythmic conditions, children <6months, elderly ADR: Serious: Hepatotoxicity, anaphylaxis, angioedema, TEN, SJS, hyperlipidemias, blood disorders, raised liver enzymes, Others: Abdominal pain, diarrhea, headache, flatulence, dizziness, taste disturbances, exfoliative cutaneous reactions, nausea, vomiting DDI: Serious Theophylline clearance decreased, Hydrochlorothiazide increase drug levels, Nevirapine increases risk of hepatotoxicity, Tacrolimus leads to nephrotoxicity, Terfenadine/Astemizole leads to serious CVD & life-threatening arrhythmias, Combined hormonal contraceptives/Amprenavir/Cyclosporine/Rifabutin/Rifampicin/Saquinavir/Tipranavir levels increases, Cisapride levels increases leads to torsades de pointes, Carbamazepine/Amitriptyline/Midazolam levels increases, leads to raise in toxicity, Antidiabetics levels reduces, Phenytoin toxicity raises Diet: With/without food Monitor: Periodic LFTs, renal function tests & potassium levels |