Fluconazole(floo kon’ a zole)
Apo-Fluconazole (CAN), Diflucan, Gen-Fluconazole (CAN), PMS-Fluconazole (CAN)
PREGNANCY CATEGORY D
Drug Class
Antifungal
Therapeutic Actions
Binds to sterols in the fungal cell membrane, changing membrane permeability; fungicidal or fungistatic depending on concentration and organism.
Indications
Treatment of oropharyngeal, esophageal, vaginal, and systemic candidiasis, UTI and peritonitis caused by Candida
Treatment of cryptococcal meningitis
Prophylaxis of candidiasis in bone marrow transplants
Contraindications and Cautions
Contraindicated with hypersensitivity to fluconazole, lactation.
Use cautiously with renal or hepatic impairment.
Available Forms
Tablets—50, 100, 150, 200 mg; powder for oral suspension—10, 40 mg/mL; injection—2 mg/mL
Dosages
Individualize dosage; same for oral or IV routes because of rapid and almost complete absorption.
Adults
Oropharyngeal candidiasis: 200 mg PO or IV on the first day, followed by 100 mg daily. Continue treatment for at least 2 wk to decrease likelihood of relapse.
Esophageal candidiasis: 200 mg PO or IV on the first day, followed by 100 mg daily. Dosage up to 400 mg/day may be used in severe cases. Treat for a minimum of 3 wk; at least 2 wk after resolution.
Vaginal candidiasis: 150 mg PO as a single dose.
Systemic candidiasis: 400 mg PO or IV daily.
Candida UTI and peritonitis: 50–200 mg/day PO.
Cryptococcal meningitis: 400 mg PO or IV on the first day, followed by 200 mg daily. 400 mg daily may be needed. Continue treatment for 10–12 wk after cultures of CSF become negative.
Suppression of cryptococcal meningitis in AIDS patients: 200 mg daily PO or IV.
Prevention of candidiasis in bone marrow transplants: 400 mg PO daily for several days before onset of neutropenia and for 7 days after neutrophil count rises above 1,000 cells/mm3.
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