Spectrum: Local Antimicrobial Stewardship, for Providence Health Care

Fluconazole

C. diff Risk

Low

Oral Bioavailability

Excellent

Approximate Cost

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

Dosing

Renal

Adult

Loading dose for Candidemia: 800mg IV

Serious infections (Candidemia, CNS/Endophthalmitis): 400-800mg IV daily

Other indications: 100-400mg IV/PO daily

General Information

Common Usage

Common Usage

Candida infections both mucocutaneous and invasive - i.e. Candidemia

Cryptococcus and Coccidioides infections

Antifungal prophylaxis in immunocompromised

Drug Monitoring

Drug Monitoring

Consider QTc monitoring if concomitant drugs affecting the interval or elevated baseline measurement

Adverse Effects

Adverse Effects

  • Drug interactions

  •  QTc prolongation

  •  Hepatic enzyme abnormalities

  •  Rash

  •  Alopecia

  • GI upset

  • Check LFTs within a week of starting treatment

Major Interactions

Major Interactions

Many via CYP450 - suggest review specific patient medications

Fluconazole increases levels of phenytoin, cyclosporine, tacrolimus, warfarin, oral hypoglycemics

Risk when combining with other QTc prolonging medications

Pharmacology

Pharmacology

Antimicrobial class: Triazole antifungal, decreases ergosterol synthesis

Pregnancy category: C

Average serum half life: 20.0

Biliary penetration: Therapeutic

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Therapeutic