Fulminant hepatitis, hepatitis, increased serum alkaline phosphatase, increased serum aspartate aminotransferase, increased serum transaminases, jaundice. © 1998-2020 Mayo Foundation for Medical Education and Research (MFMER). Econazole topical is used to treat infections caused by a fungus or yeast. Brand name is Diflucan. 400 mg to 1.2 g once daily, depending on severity; some experts favor a starting dose of ≥800 mg once daily. Endophthalmitis, endogenous (with or without vitritis) (fluconazole-susceptible isolates): Based on the IDSA clinical practice guideline for the management of candidiasis, fluconazole may be considered for prophylaxis against invasive candidiasis in high-risk patients in adult ICUs with a high rate of invasive candidiasis (>5%).Candidiasis, prophylaxis in hematologic malignancy patients: Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below.
In patients with ruptured cavities, the duration may be shorter, but depends upon the postoperative course.Soft tissue infection (not associated with bone infection): Additionally, maximum doses have been established off-label (see Dosage: Pediatric).Dosage adjustment is required for patients with renal impairment.
Because 7 18% at a dosage of cium, magnesium, and liver function tests, urinalysis, and tive, the lr for culture- marmura mj et al. Autologous hematopoietic stem cell transplant with neutropenia anticipated longer than 7 days in children 1 month to 18 years of age: After the first 2 weeks of life, these children should be dosed once daily.Coccidioidomycosis, treatment in HIV-infected patients (off-label): Fluconazole may be used for the treatment of cryptococcosis or coccidioidomycosis after the first trimester if otherwise appropriate (IDSA [Galgiani 2016]; IDSA [Perfect 2010]; Pastick 2020). HIV-infected patients (adolescents) (off-label): Cardiac device infection (eg, implantable cardiac defibrillator, pacemaker, ventricular assist device): Side Effects: Nausea, vomiting, diarrhea, stomach upset/pain, headache, dizziness, or hair loss may occur. Fluconazole inhibits in vitro minimum inhibitory concentrations (MIC values) of 8 mcg/mL or less against most (90% or more) strains of the following microorganisms, however, the safety and effectiveness of fluconazole in treating clinical infections due to these microorganisms have not been established in adequate and well-controlled trials. US Brand Name. Based on the American Society of Health-System Pharmacists (ASHP), IDSA, Surgical Infection Society (SIS), and Society for Healthcare Epidemiology of America (SHEA) guidelines for antimicrobial prophylaxis in surgery and the American Society of Transplantation Infectious Diseases Community of Practice guidelines for Candida infections in solid organ transplantation, fluconazole is recommended for surgical prophylaxis (perioperative) in select high-risk solid organ transplant patients.Based on the IDSA guideline for the treatment of coccidioidomycosis and the US Department of Health and Human Services (HHS) guidelines for prevention and treatment of opportunistic infections in adults and adolescents with HIV, fluconazole is an effective and recommended agent for the treatment of coccidioidomycosis, as well as in the prophylaxis (initial or chronic suppressive therapy) of coccidioidomycosis in patients with HIV and solid organ transplant recipients undergoing transplantation in endemic areas and/or from infected donors.Based on the IDSA clinical practice guidelines for management of cryptococcal disease, fluconazole is effective and recommended for the treatment of cryptococcal pneumonia.Primary antifungal prophylaxis in pediatric oncology patients: Protect from freezing.Interferes with fungal cytochrome P450 activity (lanosterol 14-α-demethylase), decreasing ergosterol synthesis (principal sterol in fungal cell membrane) and inhibiting cell membrane formationOral: Well absorbed; food does not affect extent of absorption Relative diffusion blood into CSF: Adequate with or without inflammation (exceeds usual MICs)CSF:blood level ratio: Normal meninges: 50% to 90%; Inflamed meninges: ~80%Pharmacokinetics are markedly affected; there is an inverse relationship between half-life and creatinine clearance.Normal renal function: ~30 hours (range: 20 to 50 hours); Elderly: 46.2 hours; Neonates (gestational age 26 to 29 weeks): 73.6 to 46.6 hours (decreases with increasing postnatal age); Pediatric patients 9 months to 15 years: 19.5 to 25 hoursFluconazole has been shown to be active against most strains of the following microorganisms both in vitro and in clinical infections: The following in vitro data are available, but their clinical significance is unknown.
The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.No adjustment for vaginal candidiasis single-dose therapy.For multiple dosing, administer 100% of the indication-specific loading/initial dose recommended in the adult dosing section, then adjust daily doses as follows:Hemodialysis, intermittent (thrice weekly): Continue lifelong as there is a high relapse rate when the dose is decreased or treatment is discontinued.400 mg once daily; IDSA guidelines state that some experts recommend 800 mg once daily. Hypersensitivity to fluconazole or any component of the formulation (cross-reaction with other azole antifungal agents may occur, but has not been established; use caution); coadministration of terfenadine in adult patients receiving multiple doses of 400 mg or higher or with CYP3A4 substrates which may lead to QT prolongation (eg, astemizole, cisapride, erythromycin, pimozide, quinidine).Serious (and sometimes fatal) hepatic toxicity (eg, hepatitis, cholestasis, fulminant hepatic failure) has been observed. It works by stopping the growth of the fungus.. Ketoconazole should not be used to treat fungal infections on the skin and nails due to the risk of serious side effects and drug interactions.