Therapeutic Action
Antifungal
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Drug reference
Antifungal
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Oesophageal candidiasis Moderate to severe oropharyngeal candidiasis Secondary prophylaxis of recurrent candidiasis in immunocompromised patients Cryptococcal meningitis, after treatment with amphotericin B + flucytosine or in combination with amphotericin B or flucytosine Secondary prophylaxis of cryptococcal infections
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Administer with caution to patients with hepatic or renal impairment, cardiac disorders (bradycardia, heart rhythm disorders, etc.). Reduce the dose by half in patients with renal impairment. May cause: gastrointestinal disturbances, headache, skin reactions sometimes severe, anaphylactic reactions; severe hepatic disorders, haematologic (leukopenia, thrombocytopenia) and cardiac disorders (QT-prolongation). Stop treatment in the event of anaphylactic reaction, hepatic disorders or severe skin reaction. In the event of prolonged treatment, monitor hepatic function. Do not administer simultaneously with rifampicin, administer 12 hours apart (rifampicin in the morning, fluconazole in the evening). Avoid or monitor combination with: drugs that prolong the QT interval (amiodarone, chloroquine, erythromycin, haloperidol, mefloquine, pentamidine, quinine); warfarin, carbamazepine, phenytoin, rifabutin, benzodiazepines, calcium-channel blockers, certain antiretrovirals (e.g. nevirapine, zidovudine): increased plasma concentrations of these drugs. Pregnancy and breast-feeding: to be used only in severe or life-threatening infections, particularly during the first trimester of pregnancy (risk of foetal malformations).
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50 mg and 200 mg capsules 50 mg/5 ml oral suspension
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Oesophageal candidiasis, oropharyngeal candidiasis, secondary prophylaxis of recurrent candidiasis Child 1 month and over: 3 to 6 mg/kg (max. 200 mg) once daily Adult: 50 to 200 mg (max. 400 mg) once daily The treatment lasts 14 to 21 days for oesophageal candidiasis; 7 to 14 days for oropharyngeal candidiasis; as long as required for secondary prophylaxis. Cryptococcal meningitis 12 mg/kg once daily for 1 week Child then 6 to 12 mg/kg once daily for 8 weeks After treatment with ≥ 1 month Max. 800 mg once daily amphotericin B + flucytosine 1200 mg once daily for 1 week Adult then 800 mg once daily for 8 weeks or 12 mg/kg once daily for 2 weeks (with amphotericin B or Child flucytosine) ≥ 1 month then 6 to 12 mg/kg once daily for 8 weeks In combination with Max. 800 mg once daily amphotericin B or flucytosine 1200 mg once daily for 2 weeks (with amphotericin B or Adult flucytosine) then 800 mg once daily for 8 weeks Secondary prophylaxis of cryptococcal infections Child: 6 mg/kg (max. 200 mg) once daily, as long as required Adult: 200 mg once daily, as long as required
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As in neonates the half-life of fluconazole is prolonged, it should be administered every 72 hours (neonates < 14 days) or every 48 hours (neonates ≥ 14 days). For the treatment of histoplasmosis, fluconazole is less effective than itraconazole. In patients unable to tolerate itraconazole, the dose of fluconazole is: child: 10 to 12 mg/kg (max. 400 mg) once daily for 6 to 12 weeks adult: 400 mg on D1 then 200 to 400 mg once daily for 6 to 12 weeks For the treatment of genital candidiasis (vulvovaginitis, balanitis), fluconazole is only used if local treatment fails: 150 mg single dose in adults.
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– Below 25 °C Once reconstituted, oral suspension keeps for 2 weeks.
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50 to 200 mg (max. 400 mg) once daily
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200 mg once daily, as long as required
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