Adult Dosing
Candidiasis, oropharyngeal
- 200 mg PO on day 1, then 100 mg PO daily for >2 wks
Candidiasis, esophageal
- 200 mg PO on day 1, then 100 mg PO daily for >3 wks or at least 2 wks following resolution of symptoms
- Max: 400 mg/day
Candidiasis, systemic
Candidiasis, vulvovaginal
- 150 mg PO as a single dose
Urinary tract infections and peritonitis
- Daily doses of 50 to 200 mg have been used
Cryptococcal meningitits
- Treatment regimen: 400 mg PO on day 1, then 200-400 mg PO daily. Continue for 10-12 weeks after CSF culture is negative
- Suppression regimen (patients with HIV): 200 mg PO daily
Fungal Prophylaxis, bone marrow transplant
- 400 mg PO daily
- Begin several days before anticipated onset of neutropenia, continue for 7 days after neutrophil count >1000 cells/mm3
Pediatric Dosing
Candidiasis, oropharyngeal
- 6 mg/kg PO on day 1 [Max 200 mg], followed by 3 mg/kg PO daily for >2 wks
- Max: 100 mg/day
Candidiasis; esophageal
- 6 mg/kg PO on day 1, followed by 3 mg/kg PO qd hrs for >3 wks and for >2 wks following resolution of symptoms
- Max: 400 mg/day
Candidiasis, systemic
Cryptococcal meningitits
- Treatment regimen: 12 mg/kg PO on day 1, then 6 mg/kg PO daily. Continue for 10-12 weeks after CSF culture is negative
- Suppression regimen (patients with HIV): 6 mg/kg PO daily
Fungal Prophylaxis; bone marrow transplant
- 10-12 mg/kg PO daily
- Begin several days before anticipated onset of neutropenia, continue for 7 days after neutrophil count >1000 cells/mm3
[Outline]
Renal Dose Adjustment (Based on CrCl)
- >50 mL/min: No dose adjustments
50 mL/min: Give usual loading dose; reduce subsequent doses by 50%- Hemodialysis: Give usual dose after each session
Hepatic Dose Adjustment
- Hepatic impairment: Use with caution; dose adjustmments not defined
- Some azoles, including fluconazole, have been associated with prolongation of the QT interval. Rare cases of QT prolongation and torsade de pointes in patients taking fluconazole have been reported in post-marketing surveillance
- Fluconazole has been associated with rare cases of serious hepatic toxicity, including fatalities primarily in patients with serious underlying medical conditions. Patients with hx of cardiotoxic chemotherapy, cardiomyopathy, hypokalemia and concomitant medications that increase QT interval are at an increased risk
- Anaphylaxis has occurred rarely with fluconazole therapy
- Exfoliative skin disorders have also been reported; monitor closely if rash develops and discontinue if it progresses
Cautions: Use cautiously in
- Renal impairment (refer dose adjustment section)
- Hepatic impairment (refer dose adjustment section)
- Hx of cardiac disease
- Electrolyte abnormalities
- Geriatric population
- Hx of arrhythmia
- Drugs Metabolized by CYP450. Potent 3A4 Inhibitor. Caution and possible contraindications including astemizole, ergote derivatives, methlysergide, terfenadine, thioridazine, short acting benzodiazepines
Pregnancy Category:C (Single 150 mg for Vaginal Candidiasis); D (Other indications)
Breastfeeding: Fluconazole is excreted in breastmilk; levels in breastmilk are less than those given to infants. This drug is considered acceptable with breastfeeding based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776 ) and based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 19 July 2010). According to manufacturer's data, use during breastfeding is not recommended.
US Trade Name(s)
US Availability
fluconazole (generic)
- TABS: 50, 100, 150, 200 mg
- SUSP: 10 mg/mL, 40 mg/mL
Diflucan
- TABS: 50, 100, 150, 200 mg
- PWDR for SUSP: 10 mg/mL
- PWDR for SUSP: 40 mg/mL
Canadian Trade Name(s)
Canadian Availability
fluconazole (generic)
- TABS: 50, 100 mg
- CAPS: 150 mg
Canesoral
Diflucan
- TABS: 50, 100 mg
- CAPS: 150 mg
- PWDR for SUSP: 50 mg/5 mL (350 mg)
UK Trade Name(s)
UK Availability
fluconazole (generic)
Azocan
Canesten
Diflucan
- CAPS: 50, 150, 200 mg
- PWDR for SUSP: 50 mg/5 mL (35 mL)
- PWDR for SUSP: 200 mg/5 mL (35 mL)
Australian Trade Name(s)
- Canesoral
- Di-Con One
- Diflucan
- Diflucan One
- Dizole
- Dizole One
- Fluzole
- Ozole
- Sandoz Flufeme
Australian Availability
fluconazole (generic)
Canesoral, Di-Con One, Diflucan One, Sandoz Flufeme
Diflucan
- CAPS: 50, 100, 150, 200 mg
- PWDR for SUSP: 50 mg/5 mL (35 mL)
Dizole
Dizole One
Fluzole
Ozole
- CAPS: 50, 100, 150, 200 mg
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Diflucan 10 MG/ML SUSR [Bottle] (PFIZER U.S.)
35 ml = $59.99
105 ml = $176.38 - Fluconazole 150 MG TABS [Box] (IVAX PHARMACEUTICALS)
INC. mg = $12
mg = $24 - Diflucan 100 MG TABS [Bottle] (PFIZER U.S.)
30 mg = $433.98
60 mg = $856.95 - Diflucan 50 MG TABS [Bottle] (PFIZER U.S.)
15 mg = $136.49
45 mg = $367.49 - Diflucan 200 MG TABS [Bottle] (PFIZER U.S.)
4 mg = $98.69
20 mg = $456.7 - Diflucan 40 MG/ML SUSR [Bottle] (PFIZER U.S.)
35 ml = $190.99
105 ml = $565.95
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
