Fluconazole

Fluconazole (DiflucanŽ) is an antifungal used orally, intravenously or vaginally to treat yeast and fungal infections. Side-effects of systemic administration include hepatotoxicity (liver damage).

For vaginal candidiasis (vaginal thrush), a once-only oral dose is often sufficient.

Fluconazole is a widely used bis-triazole antifungal agent. As with other triazoles, it has five-membered ring structures containing three nitrogen atoms. It is marketed as DiflucanŽ by Pfizer Pharmaceuticals. Both oral and intravenous formulations of fluconazole are available.

Usual Doses
For oropharyngeal candidiasis, and other forms of mucocutaneous candidiasis, fluconazole is typically dosed at 50-150 mg/day. For invasive candidiasis, the commonly applied dose is ~6 mg/kg/day, or 400 mg in the typical 70 kg adult. Doses of ~12 mg/kg are not FDA-approved, but are used with increasing frequency due to the desire to achieve higher blood levels and thus extend the range of use of the drug. Even higher doses (up to 30 mg/kg in one report!) have been used safely . Fluconazole is excreted by the kidneys, and the dose should be reduced in proportion to any reduction of kidney function .

Side-Effects
Fluconazole is generally quite well tolerated. In common with all azole antifungal agents, fluconazole may cause hepatotoxicity.