Low
Excellent
Severe impairment (Child-Pugh C)
Should only be used if benefit outweighs risk
Mild to moderate (Child-Pugh A/B)
Standard loading dose then reduce maintenance by 50%
PO DosingWeight less than 40kg - 100mg q12h
Weight greater than/equal to 40kg - 200mg q12h
IV Dosing6mg/kg IV q12h x 2 doses then 4mg/kg IV q12h
This medication is currently not on hospital formulary - please contact pharmacy if it is needed.
Candida infections both mucocutaneous and invasive - i.e. Candidemia.
Antifungal prophylaxis in immunocompromised patients.
Therapeutic drug monitoring may be helpful to ensure adequate concentrations and exclude toxicity (Discuss with ID).
QTc interval in patients at elevated risk.
Monitor hepatic profile.
Drug interactions
QTc prolongation
Hepatic enzyme abnormalities
Rash - up to 20%
Visual disturbance
Fluorosis
GI upset
CYP450 interactions ++.
Other QTc prolonging agents.
Recommend review of pt medications due to high frequency of significant interactions.
Antimicrobial class: Triazole antifungal, Second generation
Pregnancy category: D
Urine penetration: Poor
Lung penetration: Therapeutic
CSF penetration: Therapeutic
