*fluconazole 150 mg *
مضادللفطريات
Indications:
Superficial mucosal (oropharyngeal, esophageal,or vaginal ) candidiasis.
- Dermatomycosis, including tinea pedis, tinea corporis, tinea cruris, tinea versicolor, tinea
unguium (onychomycosis) and dermal candidal infections.
- Systemic candidal infection e.g., Urinary tract infections, peritonitis, candidemia, disseminated
- Deep mycoses, including blastomycosis, coccidioidomycosis, histoplasmosis, and sporotrichosis.
- Cryptococcosis including cryptococcal meningitis.
- Prophylaxis for fungal infections in patients with malignancy who are receiving chemotherapy or
radiation therapy.
- Prophylaxis of serious fungal infections in patients with human immunodeficiency virus
(HIV) infection.
Contra-Indictions:
Known hypersensitivity to fluconazole
- Advanced liver disease
- Co-administration with terfenadine
Adverse Effects:
Fluconazole is generally well tolerated.
Adverse effects reported with fluconazole most commonly affect the gastrointestinal tract and include abdominal pain, diarrhoea, flatulence, nausea, and vomiting.
Other adverse effects include headache, dizziness, leucopenia, thrombocytopenia, and raised liver enzyme values. Serious hepatic toxicity has been reported in patients with severe underlying disease.
Skin reactions are rare but exfoliative cutaneous reactions such as toxic epidermal necrolysis and Stevens-Johnson syndrome have occurred, more commonly in patients with AIDS.
Dosage & Administration:
1- Vaginal candidiasis
One capsule (150 mg) as a single dose.
To reduce the incidence of recurrent vaginal candidiasis, one capsule (150 mg) once monthly dose may be used. The duration of therapy should be individualized, but ranges from 4-12 months.
2-For dermal infections including tinea pedis, corporis, cruris and candida infections, the recommended dose is one capsule (150 mg) once weekly. Duration of treatment 2-4 weeks, tinea pedis may require up to 6 weeks.
Tinea versicolor: 2 capsules (300 mg) once weekly for 2-3 weeks.
Onychomycosis: One capsule (150 mg) once weekly for 3-6 months (fingernails) and 6-12 months (toenails).
3-Oropharyngeal and esophageal candidiasis
One capsule (150 mg) daily for 7-14 days (except in severely immunocompromised patients); for 14 days in atrophic oral candidiasis associated with dentures; for 14-30 days in other mucosal infections: esophagitis, non-invasive bronchopulmonary infections.
4-Systemic candidiasis, cryptococcal meningitis and other cryptococcal infections
Treated with an initial dose of 2-3 capsules (300-450 mg) on the first day, followed by 1-2 capsules (150-300 mg) daily. Duration of therapy is based on clinical & mycological response, but is usually at least 6-8 weeks in cryptococcal meningitis.
Fluconazole may also be used in daily doses of 100-200 mg to prevent relapse following a primary course of treatment for acute cryptococcal meningitis in patients with AIDS.
5-In immunocompromised patients at risk of fungal infections, fluconazole may be given prophylactically in a dose of 50-400 mg daily.
In patients with renal impairment
Since fluconazole is primarily excreted by the kidneys, fluconazole dosage must be adjusted for
renal impairment according to creatinine clearance.
Initial loading dose of 50-400 mg should be given on the first day of treatment, after the loading do
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