Low
Excellent (90 to 100%)
$4.04 (PO)
$124.00 (IV)
Mild to moderate (Child-Pugh A/B)Standard loading dose then reduce maintenance by 50%
Severe impairment (Child-Pugh C)Should only be used if benefit outweighs risk
IV Administration
6mg/kg IV q12h x 2 doses then 4mg/kg IV q12h
PO Administration
400mg PO q12h x 2 doses then 200mg PO q12h
Dose reduction may be required if low body weight (i.e. less than 40 kg = 100 mg PO BID)
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).
Check with chemistry lab as specimen may need to be referred out of province.
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.
IV Administration
Dilute in 100 -250 mL D5W or NS and administer over 1-2 hrs.
Max concentration 5 mg/mL. Max rate 3 mg/kg/min
EH Prescribing Restrictions
None
Community IV Formulary (Metro)
NO
NLPDP Status
Requires Special Authorization
Note
Costs for PO are based on Eastern Health Contract Pricing. Costs are MARKEDLY higher in Community Setting
Antimicrobial class: Triazole antifungal, Second generation
Pregnancy category: D
CSF penetration: Therapeutic
Lung penetration: Therapeutic
Urine penetration: Poor
