Loading dose for Candidemia: 800 mg IV
Serious infections (Candidemia, CNS/Endophthalmitis): 400 - 800 mg IV/PO daily
Other indications: 100 - 400 mg IV/PO daily
Loading dose: 25 mg/kg IV/PO
Maintenance dose: 12 mg/kg/dose IV/PO Q24H
Age 0-14 DaysAge > 14 DaysNote:6 mg/kg/dose PO/IV Q72H6 mg/kg/day PO/IV Q48HFungal prophylaxis can be continued until patient is no longer considered high-risk for invasive candidiasis
Loading Dose: 6 mg/kg PO
Maintenance dose: 3 mg/kg/dose PO Q24H x 7 days
Infuse over 2 hours
IV: 2 mg/mL
PO: 10 mg/mL
Supplied by Manufacturer
Infuse over 2 hours
0 - 30 eGFR30 - 50 eGFR50+ eGFR100 - 200mg IV/PO q24h (higher doses may be required for severe infections)100 - 200mg IV/PO q24h (400 mg IV/PO q24h for invasive infections)No dose adjustment required
Increase dosing interval in neonates with impaired renal function
Candida infections both mucocutaneous and invasive - i.e. Candidemia
Cryptococcus and Coccidioides infections
Antifungal prophylaxis in immunocompromised
High dose (≥ 400 mg/day):
Low dose (150 - 300 mg/day, short course): (including those used for vaginal yeast infections)
Does not appear to be associated with stillbirth at any dose
Recommended not to use oral fluconazole to treat vaginal yeast infections in pregnancy. First line therapy in pregnancy is 7 days topical antifungal agents (ie. clotrimazole, miconazole)
Fluconazole transfers into breastmilk.
The relative infant dose (RID) is reported as 16-22%.
Based on limited data, no adverse effects have been reported in breastfeeding infants.
Fluconazole is used at therapeutic doses to treat invasive Candida infections in neonates.
Consider QTc monitoring in patients at increased risk.
Liver function tests, check baseline and one week after starting treatment.
Multiple drug interactions possible, consult pharmacy.
Hepatic enzyme abnormalities, hepatitis
Multiple drug interactions possible. Inhibits CYP2C19 (strong), CYP2C9 (moderate), CYP3A4 (moderate).
Inhibits metabolism of phenytoin (increase phenytoin plasma levels) and careful monitoring of phenytoin serum concentrations is required.
Inhibits metabolism of zidovudine (ZDV). Monitor patients closely for adverse effects of ZDV.
Inhibits metabolism of cisapride (contraindicated in patients receiving cisapride).
Antimicrobial class: Triazole antifungal, decreases ergosterol synthesis