Fluconazole

The dose should be based on the nature and severity of the fungal infection; treatment requiring multiple dosing should continue until clinical parameters or laboratory tests indicate the active fungal infection has subsided. Treatment and prophylaxis of RECURRENT vaginal candidiasis (4 or more episodes a year): 150 mg every third day for a total of 3 doses (days 1, 4 and 7), followed by a 150 mg once-weekly maintenance dose for 6 months. Other adult regimens in the same SPC — Cryptococcal meningitis: loading 400 mg on day 1 then 200 to 400 mg once daily, usually at least 6 to 8 weeks (daily dose may be increased to 800 mg in life-threatening infection); maintenance to prevent relapse 200 mg once daily indefinitely. Coccidioidomycosis: 200 to 400 mg once daily for 11 to 24 months or longer; 800 mg daily may be considered for some infections, especially meningeal disease. Invasive candidiasis: loading 800 mg on day 1 then 400 mg once daily (for candidaemia, generally 2 weeks after the first negative blood culture and resolution of symptoms). Oropharyngeal candidiasis: loading 200 to 400 mg day 1 then 100 to 200 mg once daily for 7 to 21 days. Oesophageal candidiasis: loading 200 to 400 mg day 1 then 100 to 200 mg once daily for 14 to 30 days. Candiduria: 200 to 400 mg once daily for 7 to 21 days. Chronic atrophic candidiasis: 50 mg once daily for 14 days. Chronic mucocutaneous candidiasis: 50 to 100 mg once daily for up to 28 days. Prevention of relapse of oropharyngeal or oesophageal candidiasis in HIV: 100 to 200 mg once daily or 200 mg three times per week, indefinitely in chronic immune suppression. Dermatomycosis (tinea pedis, corporis, cruris, candida infections): 150 mg once weekly or 50 mg once daily for 2 to 4 weeks (tinea pedis may need up to 6 weeks). Tinea versicolor: 300 to 400 mg once weekly for 1 to 3 weeks, or 50 mg once daily for 2 to 4 weeks. Tinea unguium (onychomycosis): 150 mg once weekly until the infected nail is replaced. Prophylaxis in prolonged neutropenia: 200 to 400 mg once daily, starting several days before the anticipated onset of neutropenia and continuing for 7 days after the neutrophil count rises above 1000 cells/mm3. Fluconazole should not be used for tinea capitis. Elderly: adjust dosage based on renal function. Hepatic impairment: administer with caution (limited data). Capsules should be swallowed whole, independent of food; the capsule formulation is not adapted for infants and small children. Interaction entries below are drawn from the SPC §4.3/§4.4 and from the US labelling's drug-interaction section — the UK SPC §4.5 text was not captured in this fetch. Source: eMC SPC for Fluconazole 150 mg capsules (§4.2).

Infants, toddlers and children (28 days to 11 years) — mucosal candidiasis: initial dose 6 mg/kg, then 3 mg/kg once daily (the initial dose may be used on the first day to reach steady state more rapidly). Invasive candidiasis or cryptococcal meningitis: 6 to 12 mg/kg once daily depending on severity. Maintenance to prevent relapse of cryptococcal meningitis: 6 mg/kg once daily. Prophylaxis of Candida in immunocompromised patients: 3 to 12 mg/kg once daily depending on the extent and duration of neutropenia. Term newborn infants 0 to 14 days: the same mg/kg dose as for infants/children given every 72 hours, not exceeding 12 mg/kg every 72 hours. Term newborn infants 15 to 27 days: the same mg/kg dose given every 48 hours, not exceeding 12 mg/kg every 48 hours. Adolescents 12 to 17 years: the prescriber must judge whether adult or child posology is appropriate, based on weight and pubertal development. Safety and efficacy for the GENITAL CANDIDIASIS indication have not been established in the paediatric population; if treatment for genital candidiasis is imperative in adolescents 12 to 17 years, the posology should be the same as the adult posology. Doses of 100, 200 and 400 mg in adults correspond to 3, 6 and 12 mg/kg in children for comparable systemic exposure. Oral liquid formulations are more suitable than capsules in this population. Verify all paediatric dosing against a children's formulary.