


Fluconazole 100mg (2 mg/ml) Inj
Trade Name
Prescriber Category
:
:
Diflucan
A
Department
Antimicrobial Restriction
:
:
-
Yellow Category
INDICATION (BLUE BOOK / UKK)
i) Cryptococcosis a) cryptococcal meningitis and infections of other sites (e.g.,pulmonary, cutaneous) b) Prevention of relapse of cryptococcal meningitis in patients in AIDS after a full course of primary therapy ii) Systemic candidiasis, including candidemia, disseminated candidiasis and other forms of invasive candidal infections. These include infections of the peritoneum, endocardium, eye, and pulmonary and urinary tracts. iii) Mucosal candidiasis. a) Oropharyngeal candidiasis b) Chronic oral atrophic candidiasis (denture sore mouth) c) Oesophageal, non‐invasive bronchopulmonary infections, candiduria, mucocutaneous candidiasis d) Prevention of relapse of oropharyngeal candidiasis in patients with AIDS, after a full course of primary therapy iv) Genital candidiasis. a) Vaginal candidiasis (acute or recurrent) b) Prophylaxis of recurrent vaginal candidiasis (three or more episodes a year) c) Candidal balanitis. v) Prevention of fungal infections in patients with malignancy who are predisposed to such infections as a result of cytotoxic chemotherapy or radiotherapy. vi) Dermatomycosis a) Tinea pedis, tinea corporis, tinea cruris and dermal Candida infections b) Tinea versicolor
DOSING FOR ADULTS GUIDE [DIAMS HSgB]
Dose range:
100–1,200 mg PO or IV q24h
(dose and route of administration depends on type of infection)
Oropharyngeal Candidiasis (Oral thrush):
Fluconazole 100 mg PO q24h
Esophageal Candidiasis:
Fluconazole 200-400 mg PO or IV q24h
Invasive Candidemia:
800 mg LD, followed by 400 mg IV q24h
Refer to HSgB Antibiotic Guideline for dosing regimen for Opportunistic Infections in HIV patients.
RENAL DOSE ADJUSTMENT IN ADULTS GUIDE [DIAMS HSgB]
CrCl ≤50 ml/min:
50% of dose q24h
HD:
100% of dose on dialysis days only [Administer dose after dialysis]
OR
50% of dose q24h [On dialysis days, administer dose after dialysis]
IV TO PO GUIDE [DIAMS HSgB]
IV Fluconazole:
200 mg q24h --> Cap Fluconazole 200 mg OD
400 mg q24h --> Cap Fluconazole 400mg q24h
800 mg q24h --> Cap Fluconazole BD
Bioavailability: >90%
For Opportunistic Infection, dose of Fluconazole may go up to 1200 mg/day
EXTENDED INFUSION GUIDE [DIAMS HSgB]
In-progress
SPECIAL MONITORING & PRECAUTION GUIDE [DIAMS HSgB]
In-progress
ALTERNATIVE DOSING (BLUE BOOK / HSgB DRUG LIST)
i) a) 400mg on Day1 followed by 200mg to 400mg once daily usually at least 6 to 8 weeks for cryptococcal meningitis. CHILD ≥4 weeks-11 years: Treatment:6-12mg/kgoncedaily. b) 200 mg once daily indefinitely. CHILD:- Maintenance: 6mg/kg once daily ii) 400 mg on Day 1 followed by 200 mg once daily CHILD ≥ 4weeks-11years: 6-12mg/kg once daily. iii) a) 50mg to 100mg once daily for 7 to 14 days CHILD:- Loading dose: 6mg/kg on Day 1 followed by 3mg/kg daily. b) 50 mg once daily for 14 days concurrently with local antiseptic measures to the denture c) 50 mg to 100 mg once daily for 14 to 30 days. CHILD:- 0-14days: Initially, 6mg/kg, followed by 3mg/kg every 72 hours. Max: 12 mg/kg 72 hourly. 15-27 days: Initially, 6mg/kg, followed by 3 mg/kg every 48 hours. Max: 12 mg/kg 48 hourly. 28 days-11 years: Initially, 6 mg/kg, followed by 3 mg/kg once daily. d)150 mg once weekly. iv) a) 150 mg as a single oral dose. b) 150 mg once-monthly dose may be used for usually4 to 12 months c) 150 mg as a single oral dose. v) 50 mg to 400 mg once daily vi) a) 150 mg once weekly or 50 mg once daily for normally 2 to 6 weeks b)300mg once weekly for 2weeks; a third weekly dose of 300-400mg. An alternate dosing regimen is 50mg once daily for 2 to 4 weeks. Dosing is individualised and according to product insert/protocol.