Monograph Details
|
|
Infections & Infestations
> Fungal infections
|
|
DIFLUCAN |
| Manufacturer |
|
Pfizer Labs |
| Legal Classification |
|
Rx
|
| Pharmacological Class |
|
Azole. |
| Generic Name |
|
Fluconazole 50mg, 100mg, 200mg; tabs. |
| Also |
• DIFLUCAN INJECTION
• DIFLUCAN ORAL SUSP
|
| Indications |
|
Oropharyngeal, esophageal, systemic candidiasis. Bone marrow transplant prophylaxis. Cryptococcal meningitis. Candida urinary tract infection (UTI), peritonitis. |
| Children |
|
Individualize. CrCl<50mL/min: reduce dose, see literature. All doses are once daily. Neonates: see literature. Over 2 wks of age: Oropharyngeal candidiasis: 6mg/kg on day 1, then 3mg/kg/day for at least 2 wks. Esophageal candidiasis: 6mg/kg on day 1, then 3mg/kg/day for at least 3 wks; treat for at least 2 wks after symptoms resolve; max 12mg/kg/day. Systemic candidiasis: 6–12mg/kg/day have been used. Cryptococcal meningitis: 12mg/kg on day 1, then 6mg/kg/day for 10–12 wks after negative CSF cultures; max 12mg/kg/day; to suppress relapse in AIDS: 6mg/kg/day. Max for all: 600mg/day. |
| Adults |
|
Individualize. CrCl<50mL/min: reduce dose, see literature. All doses are once daily. Oropharyngeal candidiasis: 200mg on day 1, then 100mg/day for at least 2 wks. Esophageal candidiasis: 200mg on day 1, then 100mg/day for at least 3 wks; treat for at least 2 wks after symptoms resolve; max 400mg/day. Systemic candidiasis: doses of up to 400mg/day have been used. Prophylaxis of candidiasis in bone marrow transplantation: 400mg/day. Cryptococcal meningitis: 400mg on day 1, then 200–400mg/day for 10–12 wks after spinal fluid negative; to suppress relapse in AIDS: 200mg/day. UTI, peritonitis: 50–200mg/day have been used. |
| Contraindications |
|
Concomitant cisapride. |
| Precautions |
|
Proarrhythmic conditions. Monitor liver function. Discontinue if liver disease or progressively worsening rash develops. Elderly. Pregnancy (Cat.C). Nursing mothers: not recommended. |
| Interactions |
|
See Contraindications. Potentiates warfarin, theophylline, oral hypoglycemics, midazolam. May increase serum levels of phenytoin, cyclosporine, zidovudine, sulfonylureas. Thiazides increase fluconazole levels. Monitor levels and/or effects of cyclosporine, phenytoin, sulfonylureas, rifabutin, tacrolimus, theophylline, warfarin. Cimetidine (oral), rifampin may decrease fluconazole levels. Oral contraceptives: see literature. Avoid other hepatotoxic drugs. Caution with other drugs metabolized by CYP450. |
| Adverse Reactions |
|
Nausea, headache, rash, vomiting, abdominal pain, diarrhea; hepatotoxicity, exfoliative dermatitis (rare). |
| How Supplied |
Tabs—30
Susp (35mL)—1
IV (200mg, 400mg)—6 |
| Additional Resources |
|
• Related Prescribing Note |
|
|
|
|
