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Adults with cryptococcal meningitis and kryptococcal infections of other locale-
on the first day, usually prescribed 400 mg, and then continue treatment in a dose. 200-400 mg 1 time / day. The duration of treatment for cryptococcal infections depends on the clinical-effectiveness, confirmed by mycological examination; in cryptococcal meningitis, it is usually continued for at least 6-8 weeks.
For. prevention of recurrence of cryptococcal meningitis in AIDS patients, after completion of a full course of primary treatment, -fluconazole is administered 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 on 200 mg. With insufficient clinical effectiveness, the dose of the drug can be increased to 400 mg / day.,: The duration of therapy depends on clinical effectiveness. -
With oropharyngeal candidiasis, the drug is usually prescribed at 50-100 mg 1 time / day; the duration of treatment is 7:14 days. If necessary; in patients with a marked decrease in immunity, treatment may be longer. ,
To prevent the recurrence of oropharyngeal candidiasis in AIDS patients after completing the full course of primary therapy, the drug can be prescribed 150 mg once a week.
With atrophic candidiasis of the oral cavity, associated with the wearing of dentures,
fluconazole usually prescribed 50 mg 1 time / day for 14 days in combination with local antiseptic agents for prosthesis treatment
With other localizations of candidiasis (with the exception of genital candidiasis), for example, with esophagitis, a non-invasive bronchopulmonary lesion; Candidiasis, candidiasis of the skin and mucous membranes, etc., the effective dose is usually 50-100 mg / day for a long time.
treatment for 14-30days.
, With vaginal candidiasis
fluconazole taken once inside the 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, and some patients may require more frequent use.
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With balanitis caused by Candida,
fluconazole appoint a single dose of 150 mg
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For the prevention of candidiasis. The recommended-dose of fluconazole is 50-400 mg
1 time / day, depending on the degree of risk of fungal infection.If there is a high risk of generalized infection; for example, in patients with expected significant - or long-lasting. neutropenia ,. the recommended dose is 400 mg - 1 time / day.
Fluconazole appoint a few days before the expected appearance of neutropenia; after increasing the number of neutrophils more than 1000 / mm3, treatment is continued for 7 days.
With mycosis of the skin, including mycosis of the feet, skin of the inguinal region and skin candidiasis, the recommended dose is 150 mg once a week or 50 mg once a day. The duration of therapy in usual cases is 2-4 weeks, but with foot mycoses may require longer therapy (up to 6 weeks).
With pityriasis, 300 mg once a week for 2 weeks, some patients require a third dose of 300 mg per week, while in some cases,
accurate single dose of 300-400 mg; an alternative treatment regimen is to administer 50 mg once a day for 2-4 weeks.
With onychomycosis, the recommended dose is 150 mg once a week. Treatment should continue until the replacement of the infected nail (growth of uninfected nails). For the repeated growth of nails on the fingers and toes, it normally takes 3-6 months and 6-12 months, respectively.
.In severe deep endemic mycoses, a drug of 200-400 mg / day may be required for up to 2 years. The duration of therapy is determined individually; it can be 11-24 months with coccidiomycosis; 2-17 months with paracoccidiomycosis; 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. In children, the drug should not be used in a daily dose, which would exceed that of adults. The drug is used daily 1 time / day. .
When candidiasis of mucous membranes the recommended dose, fluconazole is 3 mg / kg / day. On the first day, a shock dose of 6 mg / kg may be prescribed in order to be more viable. strictly achieving constant equilibrium concentrations. , ,
For the treatment of generalized candidiasis or cryptococcal infection (including meningitis), the recommended dose is 6-12 mg / kg / day for 10-12 weeks (before laboratory confirmation of the absence of pathogens in the CSF) . ’
'For the prevention of fungal infections in children with reduced immunity, in which the risk of developing infection is associated with neutropenia developing as a result of cytotoxic-
, chemotherapy, chemotherapy or radiotherapy, the drug is prescribed at 3-12 mg / kg / day in the
. the severity and duration of preservation of induced neutropenia.
In the case of children with impaired function of the kidneys, the daily dose of the drug should be reduced
(in the same proportional relationship as in adults), according to the degree of renal insufficiency.
In elderly patients, the usual dosing regimen should be followed in patients with no renal dysfunction Patients with renal insufficiency (creatinine clearance less than 50 mL / min) should be corrected as described below.
Use of the drug in patients with impaired renal function.
Fluconazole is excreted mainly with urine in unchanged form. With a single admission, a dose change is not required. With the repeated administration of the drug to patients with impaired renal function, a "shock" dose of 50 mg to 400 mg should be administered first.
If the clearance of creatinine (CC) is more than 50 ml / min, the usual dose of the drug (100% of the recommended dose) is used. With SC from 11 to 50 ml / min, a dose equal to 50% of the recommended dose is applied.Patients regularly on dialysis, one dose of the drug is used after each session of hemodialysis.