The NICE British National Formulary (BNF) and British National Formulary for Children (BNFc) sites are only available to users in the UK, Crown Dependencies and British Overseas Territories. If you believe you are seeing this page in error please contact us. Read the Patient Information Leaflet if available from your pharmacist before you start taking fluconazole and each time you get a refill. If you have any questions, ask your doctor or pharmacist. Take this medication by mouth with or without food as directed by your doctor, usually once daily. If you are taking the liquid suspension form of this medication, shake the bottle well before each dose. Carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. Dosage is based on your medical condition and response to treatment. Generally in children, the dose should not exceed 600 milligrams daily unless directed by the doctor.
One hundred courses of fluconazole treatment in a university hospital and 81 courses in a non-university teaching hospital have been analysed in a prospective audit to evaluate prescribing practices. The quality of treatments was assessed by an infectious disease specialist and a pharmacist according to standard guidelines. In the non-university hospital, prescribed dosages were lower than in the university hospital, and often below the recommended dose. Mean duration of treatment for oesophageal candidosis and disseminated infections was considerably shorter in the non-university hospital compared with the university hospital, and often judged too short. Microbiological samples were examined in 75% of the cases in both hospitals. The expert reviewers agreed with the indication to use fluconazole in 58–100% of cases in the university hospital and 42–80% in the non-university hospital, depending on the type of infection. There did not appear to be a major problem with inappropriate use of fluconazole. QT prolongation Torsades de pointes Alopecia Anaphylactic reactions Angioedema Cholestasis Dizziness Dyspnea Hepatic failure Hepatitis Hypertriglyceridemia Hypokalemia Increased alkaline phosphatase Increased ALT/AST Jaundice Leukopenia Pallor Seizures Stevens-Johnson syndrome Taste perversion Thrombocytopenia Toxic epidermal necrolysis Hypersensitivity to other azoles Use caution in proarrhythmic conditions and renal impairment Use extreme caution or avoid in congenital long-QT patients and patients with conditions that increase QT-prolongation risk Fluconazole inhibits CYP2C9, CYP2C19, and CYP3A4 isoenzymes; coadministration with drugs that are substrates if these isoenzymes may be contraindicated or warrant dosage modifications Capsules contain lactose and should not be given to patients with rare hereditary problems of galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption Powder for oral suspension contains sucrose and should not be used in patients with hereditary fructose, glucose/galactose malabsorption or sucrase-isomaltase deficiency Syrup contains glycerol; may cause headache, stomach upset, and diarrhea Hepatotoxicity reported with use; use with caution in patients with hepatic impairment Rare exfoliative skin disorders reported; monitor closely if rash develops and discontinue if it progresses When driving vehicles or operating machines, it should be taken into account that dizziness or seizures may occasionally occur Candida krusei is inherently resistant Convenience and efficacy of single dose oral tablet of fluconazole regimen for the treatment of vaginal yeast infections should be weighed against acceptability of higher incidence of drug related adverse events with fluconazole (26%) versus intravaginal agents (16%) If drug is used during pregnancy or if patient becomes pregnant while taking the drug, patient should be informed of potential hazard to fetus; effective contraceptive measures should be considered in women of child-bearing potential who are being treated with 400 to 800 mg/day and should continue throughout the treatment period and for approximately 1 week (5 to 6 half-lives) after the final dose Highly selective inhibitor of fungal cytochrome P-450-dependent enzyme lanosterol 14-alpha-demethylase Subsequent loss of normal sterols correlates with accumulation of 14 alpha-methyl sterols in fungi and may be responsible for the fungistatic activity of fluconazole Additive: TMP-SMX Y-site: Amphotericin B, amphotericin B cholesteryl sulfate, ampicillin, calcium gluconate, cefotaxime, ceftazidime(? ), ceftriaxone, cefuroxime, chloramphenicol, clindamycin, co-trimoxazole, diazepam, digoxin, erythromycin lactobionate, furosemide, haloperidol, hydroxyzine, imipenem/cilastatin, pentamidine, piperacillin, ticarcillin, TMP-SMX Solution: D5W, LR Additive: Acyclovir, amikacin, amphotericin B, cefazolin, ceftazidime, ciprofloxacin, clindamycin, gentamicin, heparin, meropenem, metronidazole, morphine, piperacillin, potassium chloride, ranitidine with ondansetron, theophylline Y-site: Acyclovir, aldesleukin, allopurinol, amifostine, amikacin, aminophylline, amiodarone, ampicillin-sulbactam, aztreonam, benztropine, bivalirudin, cefazolin, cefepime, cefotetan, cefoxitin, cefpirome, chlorpromazine, cimetidine, cisatracurium, dexamethasone sodium phosphate, dexmedetomidine, diltiazem, diphenhydramine, dobutamine, docetaxel, dopamine, doxorubicin liposomal, droperidol, etoposide PO4, famotidine, fenoldopam, filgrastim, fludarabine, foscarnet, ganciclovir, gatifloxacin, gemcitabine, gentamicin, granisetron, heparin, hetastarch, hydrocortisone, immune globulin, leucovorin, linezolid, lorazepam, melphalan, meperidine, meropenem, metoclopramide, metronidazole, midazolam, morphine, nafcillin, nitroglycerin, ondansetron, oxacillin, paclitaxel, pancuronium, penicillin G, phenytoin, piperacillin-tazobactam, prochlorperazine, promethazine, propofol, quinupristin-dalfopristin, ranitidine, remifentanil, sargramostim, tacrolimus, teniposide, theophylline, thiotepa, ticarcillin-clavulanate, tobramycin, vancomycin, vecuronium, vinorelbine, zidovudine Tablets: Store below 86° F (30° C) Dry powder: Store below 86° F (30° C); reconstituted suspension should be stored between 86° F (30° C) and 41° F (5° C), and unused portion should be discarded after 2 weeks; protect from freezing Injection (glass bottles): Store between 86° F (30° C) and 41° F (5° C); protect from freezing Injection (Viaflex Plus plastic containers): Store between 77° F (25° C) and 41° F (5° C); protect from freezing The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
150 mg orally as a single dose Infectious Diseases Society of America (IDSA) Recommendations: -Uncomplicated vaginitis: 150 mg orally as a single dose -Management of recurrent vulvovaginal candidiasis (after 10 to 14 days induction therapy): 150 mg orally once a week for 6 months -Complicated vulvovaginal candidiasis: 150 mg orally every 72 hours for 3 doses US CDC Recommendations: -Uncomplicated vulvovaginal candidiasis: 150 mg orally as a single dose -Initial therapy for recurrent vulvovaginal candidiasis: 100 to 200 mg orally every 72 hours for 3 doses -Maintenance therapy for recurrent vulvovaginal candidiasis: 100 to 200 mg orally once a week for 6 months -Severe vulvovaginal candidiasis: 150 mg orally every 72 hours for 2 doses US CDC, National Institutes of Health (NIH), and IDSA Recommendations for HIV-infected Patients: -Uncomplicated vulvovaginal candidiasis: 150 mg orally as a single dose -Severe or recurrent vulvovaginal candidiasis: 100 to 200 mg orally once a day for at least 7 days -Suppressive therapy for vulvovaginal candidiasis: 150 mg orally once a week Comments: -Recommended as preferred therapy -Unless frequent or severe recurrences, suppressive therapy generally not recommended Oropharyngeal candidiasis: 200 mg IV or orally on the first day followed by 100 mg IV or orally once a day Duration of therapy: At least 2 weeks, to reduce the risk of relapse IDSA Recommendations: -Moderate to severe oropharyngeal candidiasis: 100 to 200 mg IV or orally once a day for 7 to 14 days Comments: -Recommended as primary therapy US CDC, NIH, and IDSA Recommendations for HIV-infected Patients: -Initial episodes of oropharyngeal candidiasis: 100 mg orally once a day for 7 to 14 days -Suppressive therapy for oropharyngeal candidiasis: 100 mg orally once a day or 3 times a week Comments: -Recommended as preferred oral therapy -Unless frequent or severe recurrences, suppressive therapy generally not recommended Doses up to 400 mg/day have been used. Comments: -Optimal therapeutic dose and therapy duration have not been established. Use: For systemic Candida infections including candidemia, disseminated candidiasis, and pneumonia IDSA Recommendations: Candidemia in nonneutropenic or neutropenic patients: 800 mg IV or orally on the first day followed by 400 mg IV or orally once a day Duration of therapy: -Nonneutropenic patients: 14 days after first negative blood culture and candidemia signs/symptoms resolve -Neutropenic patients: 2 weeks after Candida cleared from bloodstream (documented) and candidemia symptoms and neutropenia resolve Chronic disseminated candidiasis in stable patients: 400 mg IV or orally once a day Duration of therapy: Until lesions have resolved (usually months) and through periods of immunosuppression Candida osteoarticular infection: 400 mg IV or orally once a day Duration of therapy: -Osteomyelitis: 6 to 12 months -Septic arthritis: At least 6 weeks CNS candidiasis (after initial regimen of IV amphotericin B): 400 to 800 mg IV or orally once a day Duration of therapy: Until all signs/symptoms and CSF and radiologic abnormalities resolve Candida cardiovascular system infection: 400 to 800 mg IV or orally once a day Duration of therapy: -Endocarditis: Lifelong suppressive therapy may be indicated. -Pericarditis or myocarditis: Often several months -Suppurative thrombophlebitis: At least 2 weeks after candidemia cleared -Infected pacemaker, implantable cardioverter defibrillator (ICD), or ventricular assist device (VAD): 4 to 6 weeks after device removed; chronic suppressive therapy if VAD not removed Comments: -Candidemia in nonneutropenic patients: Recommended as primary therapy; an echinocandin is recommended for moderately severe to severe illness or recent azole exposure; switching to this drug after initial echinocandin is often appropriate. -Candidemia in neutropenic patients: Recommended as alternative therapy; an echinocandin or IV amphotericin B preferred for most patients; this drug recommended for patients without recent azole exposure and who are not critically ill. -Recommended as primary therapy for chronic disseminated candidiasis in stable patients, Candida osteoarticular infection, CNS candidiasis, pericarditis/myocarditis, and suppurative thrombophlebitis -Recommended as alternative therapy for endocarditis and infected pacemaker, ICD, or VAD Doses up to 400 mg/day have been used. Comments: -Optimal therapeutic dose and therapy duration have not been established. • Vaginal candidiasis, acute or recurrent; when local therapy is not appropriate. • Chronic oral atrophic candidiasis (denture sore mouth) if dental hygiene or topical treatment are insufficient. • Mucosal candidiasis including oropharyngeal, oesophageal candidiasis, candiduria and chronic mucocutaneous candidiasis. • Candidal balanitis when local therapy is not appropriate. • Dermatomycosis including tinea pedis, tinea corporis, tinea cruris, tinea versicolor and dermal candida infections when systemic therapy is indicated. • Tinea unguinium (onychomycosis) when other agents are not considered appropriate. • Relapse of cryptococcal meningitis in patients with high risk of recurrence.
Uncomplicated vaginitis 150 mg orally as a single dose. antifungals, most often fluconazole or itraconazole; clinical trials used 400 mg/day;. In conclusion, single dose 400 mg oral fluconazole provided the best clinical as well as mycological cure rate with no relapse during twelve months of follow-up.