Spectrum: Local Antimicrobial Stewardship, for IWK Health Centre

Fluconazole

C. diff Risk

Low

Oral Bioavailability

Excellent

Approximate Cost

IV-$15/d PO-$3/d

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

Dosing

General Pediatric

Neonatal

Other

Daily dose of fluconazole is the same for oral and IV administration unless otherwise specified

Renal

Renally cleared, requires dosage adjustment with changes in renal function. Consult a pharmacist for renal dosing

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

  • QTc prolongation

  • Hepatic enzyme abnormalities

  • Rash

  • GI upset

Major Interactions

Major Interactions

Many via CYP450 - suggest review interactions with pharmacist.
Risk when combining with other QTc prolonging medications

Oral Liquids

Oral Liquids

Concentration: 10 mg/mL
Taste: palatable
Not all strengths of oral liquids are listed nor are available on IWK formulary

Tablet/Capsule Strengths

Tablet/Capsule Strengths

50 mg tablet
100 mg tablet
Tablets and capsules are preferred especially over an unpleasant tasting liquid.
Not all strengths of oral tablets/capsules are listed and they are not all available on the IWK formulary.

Pharmacology

Pharmacology

Antimicrobial class: Triazole antifungal

Average serum half life:

  • Premature neonates: 47-73.6 hours.

  • Pediatrics (9 months to 15 years): oral 19.5-25 hours

  • 5- 15 years: IV 15-18 hours

  • Adults: Normal renal function: ~30 hours

Route of Elimination: 80% unchanged in urine; 11% metabolites in urine.