Fluconazole

General

• Type: Antifungal
• Dosage Forms: IV; PO
• Common Trade Names: Diflucan

Adult Dosing

General

Candidiasis, oropharyngeal/esophageal

• 100mg PO qday x 2 week to prevent relapse

Candida vaginitis

• Uncomplicated: 150mg PO x 1

Indications by Disease

Disease	Dose	Context
Acute necrotizing ulcerative gingivitis	200mg PO daily x 14 days	Immunocompromised
Candida vulvovaginitis	150mg PO once	Preferred; a second dose at 72hrs may be given if still symptomatic
Candida vulvovaginitis	150mg PO q72h x 3 doses	Severe or immunosuppressed
Candida vulvovaginitis	150mg PO qweek x 6 months	Recurrent; long-term suppressive therapy
Cryptococcosis	400mg PO/IV q24hrs x 6-12 months	Pulmonary not AIDS associated
Cryptococcosis	400mg PO q24hrs x 6-12 months	Pulmonary with AIDS
Cryptococcosis	400mg PO q24hrs x 8 weeks	Meningitis consolidation not AIDS
Cryptococcosis	400mg PO q24hrs x 8 weeks	Meningitis consolidation with AIDS
Oropharyngeal candidiasis	200 mg PO on day one, followed by 100 mg daily for two weeks	Adult

Pediatric Dosing

Candidiasis, oropharyngeal/esophageal:

• > 14 days old: 6mg/kg PO x 1, then 3mg/kg q24h x 7-14 days, max: 100mg/day

Tinea Capitis: > 14 days old: 3-6mg/kg PO q24h x 6 weeks

Indications by Disease

Disease	Dose	Context
Cryptococcosis	6-12mg/kg PO daily x 8 weeks (max 400mg)	Pediatric Consolidation
Oropharyngeal candidiasis	6 mg/kg PO on day one, followed by 3 mg/kg daily for two weeks	Pediatric
Tinea capitis	6mg/kg PO daily (max 400mg) x 3-6 weeks	Second line

Special Populations

• Pregnancy Rating: D
• Lactation Risk Categories: safety unknown
• Renal Dosing
  • Adult:CrCrl < 50, give usual loading dose x 1 then decrease dose 50%
  • Pediatric: CrCrl < 50, give usual loading dose x 1 then decrease dose 50%
• Hepatic Dosing
  • Adult: not defined
  • Pediatric: not defined

Contraindications

• Allergy to class/drug

Adverse Reactions

Serious

• hepatotoxicity
• seizures
• leukopenia
• thrombocytopenia
• anaphylaxis
• steven-johnson syndrome
• QT prolongation

Common

• Nausea
• Rash
• Headache
• vomiting
• diarrhea
• Transaminitis

Pharmacology

• Half-life: 30 hour
• Metabolism: Liver
• Excretion: urine
• Mechanism of Action: inhibits cytochrome P450 and sterol c-14 alpha-demethylation

See Also

• Antifungals
• Fungal infections

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