Fluconazole

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Antifungal (triazole).

Indication
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Infections with dermatophytes and yeasts, especially in cases of immunodeficiency ( HIV infection).

Limited indication
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Pregnancy, lactation, children and adolescents < 16 years (only if there is no therapeutic alternative). The use of Fluconazole is justified in the literature in the treatment of oropharyngial, vaginal and systemic candidosis and on prophylactic therapy in children with HIV infection and malignant diseases.

Dosage and method of use
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  • Candida vulvovaginitis (Candida spp. except C. glabrata and C. krusei): 150 mg p.o. as ED.
  • Dermatomycoses and pityriasis versicolor: 50 mg/day p.o. over 2-7 weeks.
  • System mycoses and cryptococcal meningitis: initial 800 mg p.o. or i.v., then 400 mg/day until the end of therapy. For prophylaxis 100 mg/day p.o. if necessary.
  • For oropharyngial, vaginal and systemic candidoses in children: initial 6 mg/kg bw, then reduction to 3 mg/kg bw. In children the maximum dose is 400 mg/day p.o.

Undesirable effects
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When driving a vehicle, it should be noted that occasional dizziness, rarely epileptic seizures, can occur.

Allergic reactions up to toxic epidermal necrolysis, headaches, abdominal pain, diarrhoea, nausea, liver dysfunction up to fatal liver necrosis. Renal, hepatic changes and disorders of the hematopoietic system are extremely rare.

Interactions
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Contraindication
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Children < 12 months (cap or infusion solution); severe liver or kidney dysfunction; azole hypersensitivity.

Preparations
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Diflucan®, Fluconazole Derm 50®

Note(s)
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Approved for invasive and mucosal candidoses in premature and newborns and children under 1 year of age (only Diflucan juice or dry juice) in the absence of a therapeutic alternative.

Literature
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  1. Seebacher C et al (2007) Tinea of the free skin. J Dtsch Dermatol Ges 11: 921-926
  2. Yu DT et al (2006) Fluconazole for empiric antifungal therapy in cancer patients with fever and neutropenia. BMC Infect Dis 6: 173

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Last updated on: 29.10.2020