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Adults with cryptococcal meningitis and cryptococcal infections of other localizations the first day is usually prescribed 400 mg, and then continue treatment at a dose of 200 mg - 400 mg 1 time / day. The duration of treatment for cryptococcal infections depends on the clinical efficacy, confirmed by mycological examination; with cryptococcal meningitis, it usually lasts a minimum of 6-8 weeks.
For the prevention of recurrence cryptococcal meningitis in AIDS patients, after completing the full course of primary treatment, fluconazole prescribe at a dose of 200 mg / day for a long period of time.
With candidemia, disseminated candidiasis and other invasive candidiasis infections The dose is usually 400 mg on the first day, and then 200 mg. With insufficient clinical effectiveness, the dose of the drug can be increased to 400 mg / day. The duration of therapy depends on the clinical effectiveness.
With oropharyngeal candidiasis the drug is usually prescribed 50-100 mg once a day; the duration of treatment is 7-14 days. When necessity, in patients with a pronounced decrease in immunity treatment can be longer. To prevent the recurrence of oropharyngeal candidiasis in AIDS patients after completing a full course of primary therapy the drug can be prescribed 150 mg once a week.
When atrophic candidiasis of the oral cavity, associated with the wearing of dentures, fluconazole usually appoint 50 mg once a day for 14 days in combination with local antiseptic
means for processing the prosthesis. When other localizations of candidiasis (with the exception of genital candidiasis), for example, with esophagitis, nonsynvaginal bronchopulmonary
defeat, candiduria, skin candidiasis and mucous membranes, etc., the effective dose is usually 50-100 mg / day with a treatment duration of 14-30 days.
When vaginal candidiasis fluconazole is taken single-handedly at a dose of 150 mg. To reduce the frequency of recurrences of vaginal candidiasis, the drug can be used at a dose of 150 mg once a month. The duration of therapy is determined individually; it varies from 4 to 12 months. Some patients may need more frequent use.
When balaity caused by Candida spp., fluconazole is prescribed once in a dose of 150 mg orally.
For the prevention of candidiasis recommended dose of fluconazole is 50-400 mg once a day in depending on the degree of risk development of fungal infection. When high risk generalized infection, for example in patients with the expected expressed or prolonged persistent neutropenia, the recommended dose is 400 mg once a day. Fluconazole appoint a few days before the expected appearance of neutropenia; after an increase in the number of neutrophils more than 1000 / mm3 treatment continues for another 7 days.
When mycoses of rut, including mycosis Stop, groin groove, and kaididosis of rut the recommended the dose is 150 mg once a week or 50 mg once a day. Duration therapy in ordinary cases is 2-4 weeks, but with mycoses stop may be required longer therapy (up to 6 weeks).
When pityriasis 300 mg
Once a week for 2 weeks, some patients require a third dose of 300 mg per week, while in some cases it is sufficient to take a single dose of 300 mg to 400 mg; An alternative treatment regimen is to administer 50 mg once daily for 4 weeks.
When onychomycosis the recommended dose is 150 mg once a week. Treatment should continue until the replacement of the infected nail (growth of uninfected nail). To re-grow the nails on the fingers and toes is required 6 months and 6-12 months, respectively. However, the growth rate can vary widely among different people, and also depending on age.
When deep endemic mycoses may require the use of the drug at a dose of 200 - 400 mg / day for up to 2 years. The duration of therapy is determined individually; it can be 1 1-24 months with coccidiomycosis; 2-17 months with paracoccidiosis; 1-16 months with sporotrichosis and 3-17 months with histoplasmosis.
In children, as with similar infections in adults, the duration of treatment depends on the clinical and mycological effect. Have children the drug should not be used in a daily dose that would exceed that of adults, that is, not more than 400 mg per day. The drug is used daily 1 time / day.
When esophageal candidiasis in children fluconazole is prescribed once in a daily dose of 3 mg / kg, in the following average doses: at the age of 3-6 years (body weight 15-20 kg) - 50 mg; at the age of 7-9 years (body weight 21-29 kg) - 50-100 mg; at the age of 10-12 years (body weight 30-40 kg) - 100-150 mg; at the age of 12-15 years (body weight 40-50 kg) - 100-150 mg. The duration of therapy is at least 3 weeks and 2 weeks after regression of the symptoms.
When candidiasis of mucous membranes in children fluconazole is given once in a daily dose of 3 mg / kg, in following average doses: at the age of
3-6 years (body weight 15-20 kg) - in the first day 100-150 mg, then - 50 mg; at the age of 7-9 years (body weight 21-29 kg) - on the first day 100-200 mg, then - 100 mg; at the age of 10-12 years (body weight 30-40 kg) - on the first day 100-150 mg, then - 50-100 mg; at the age of 12-15 years (body weight 40-50 kg) - on the first day 250-300 mg, then - for 100-150 mg. The duration of therapy is at least 3 weeks.
When generalized candidiasis and cryptococcal infection (including meningitis) in children fluconazole is prescribed once in a daily dose of 6-12 mg / kg, in the following medium doses: at the age of 3-6 years (body weight 15-20 kg) - 100-250 mg; at the age of 7-9 years (body weight 21-29 kg) - 100-300 mg; at the age of 10-12 years (body weight 30-40 kg) - 200-350 mg; at the age of 12-15 years (body weight 40-50 kg) - 250-400 mg. Duration of therapy - within 10-12 weeks (before laboratory confirmation
absence of pathogens in CSF). For prevention of fungal infections in children with reduced immunity, in which the risk of infection is associated with neutropenia, developing in result of cytotoxic chemotherapy or radiotherapy, fluconazole is prescribed according to 3-12 mg / kg / day depending on the severity and duration conservation of induced neutropenia, in the following mean doses: at the age of 3-6 years (body weight 15-20 kg) - 50-250 mg; aged 7-9 years (body weight 21-29 kg) - 50-300 mg; at the age of 10-12 bed (weight
body 30-40 kg) - 100-350 mg; at age 12-15 years (body weight 40- 50 kg) - 100-400 mg. Duration therapy - to eliminate induced neutropenia.
In children with impaired function nights daily dose of the drug should be reduced (in the same proportional to the dependence that and in adults), in accordance with degree of renal function insufficiency.
Have elderly patients at There are no violations of kidney function the usual dosage regimen of the drug. Patients with renal insufficiency (clearance
creatinine less than 50 ml / min) dosing regimens should be
correct, as indicated below. Use of the drug in patients with impaired renal function. Fluconazole is excreted mainly with urine in an unchanged form. With a single admission, a dose change ns is required. When re-administering the drug, patients with impaired renal function should first introduce a "shock" dose of 50 mg to 400 mg. If the clearance of creatinine (CC) is 50 ml / min, the usual dose of the drug (100% recommended dose) once a day. When KK from 11 to 50 ml / min a dose of 50% recommended. Patients regularly on dialysis, one dose of the drug is used after each session of hemodialysis.