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Adults with cryptococcal meningitis and cryptococcal infections of other sites on the first day are usually prescribed 409 mg (8
tablets of 50 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; in cryptococcal meningitis, it usually lasts at least 6-8 weeks.
To prevent the recurrence of cryptococcal meningitis in AIDS patients, after completing the full course of primary treatment,
fluconazole prescribe a dose of 200 mg per day for a long period of time.
With candidemia, disseminated candidiasis and other invasive candidiasis infections, the dose usually amounts to 400 mg of Bi for the first day, and then for 200 mg. With insufficient clinical effectiveness, the dose of the drug can be increased to 400 mg per day. The duration of therapy depends on clinical efficacy.
With oropharyngeal candidiasis, the drug is usually prescribed 50-100 mg 1 time / day; duration of treatment - 7 - 14 days.If necessary, patients with a marked decrease in immunity treatment may be longer.
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.
. For other candidiasis localizations (with the exception of genital candidiasis), for example, with esophagitis, noninvasive bronchopulmonary disease, candiduria, candidiasis of the skin and mucous membranes, etc., the effective dose is usually 50-100 mg / day with a treatment duration of 14 to 30 days. 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 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. Some patients may need more frequent use.
With balanitis caused by Candida,
fluconazole appoint a single dose of 150 mg orally.
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 severe 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 another 7 days.
With mycosis of the skin, including mycosis of the feet, skin of the inguinal area, and skin candidiasis, the recommended dose is 150 mg once a week or 50 mg 1 time / day. Duration of therapy in usual cases is 2-4 weeks, however, with foot mycoses, longer therapy (up to 6 weeks) may be required. .
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 it is sufficient to receive 300-400 mg once; an alternative treatment regimen is to apply 50 mg once a day for 2 to 4 weeks.
In case of onychosis, the recommended dose is 150 mg once a week.Treatment should continue until the replacement of the infected nail (growth of uninfected nail). For the repeated growth of the nails on the fingers and toes normally takes 3-6 months. and 6 - 12 months. respectively.
With deep endemic mycoses, it may be necessary to use the drug at a dose of 200 mg to 400 mg per day for up to 2 years. The duration of therapy is determined individually; she can make up. 11 - 24 months with coccidiomycosis; 2-17 months. with paracoccidiomycosis;
1 - 1b 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 that would exceed that in adults, i.e. not more than 400 mg per day. The drug is used daily 1 time / day.
When candidiasis of mucous membranes is recommended, the dose of fluconazole. is 3 mg / kg / day. On the first day, a shock dose of 6 mg / kg may be prescribed in order to more quickly achieve permanent. equilibrium concentrations. -
For treatment of generalized candidiasis or cryptococcal infection, the recommended dose is 6-12 mg / kg / day, depending on the severity of the disease.
For the prevention of fungal infections in children with reduced immunity, where the risk of infection is associated with neutropenia, resulting from cytotoxic chemotherapy or radiotherapy, the drug is prescribed at 3-12 mg / kg / day, depending on the severity and duration of preservation of induced neutropenia.
In children with impaired renal function, the daily dose of the drug should be reduced (in the same proportional relationship as in adults), according to the degree of renal insufficiency.
Application of Fluconazole 50 mg tablets v children from 4 to 15 years
| Diseases | Weight and weight of the child |
|
| 4-6 years the average weight of the child is 15-20 kg | 7-9 years old child's average weight 21-29 kg | 10-12 years the average weight of the child is 30-40 kg | 12-15 years old the average child weight is 40-50 kg |
| 'Candidiasis of the esophagus (Zmg / kg / day) | 1 tablet 50 mg per day | 1-2 tablets 50 mg per day | 2 tablets of 50 mg once | 2-3 tablets 50 mg each once |
| Treatment period | For at least 3 weeks and within 2 weeks after regression of symptoms |
| Candidiasis mucous shells (Zmg / kg / day) | In the 1st day: 2-3 tablets Further: 1 tablet per day | In the 1st day: 2-4 tablets Next: 1-2 tablets per day | In the 1st laziness: 4- 5 tablets Next: 2 tablets per day once | In the first laziness: 5- 6 tablets Next: 2-3 tablets per day once |
| Treatment period | On the first day, a shock dose is given to achieve a more rapid steady-state equilibrium concentration, then treatment is continued for at least 3 weeks |
| Generalized candidiasis and cryptococcal infection (incl. meningitis) (6-12 mg / kg / day) | 2-5 tablets per day- | 2-6 tablets per day | 4-7 tablets per day | 5-8 tablets per day |
| Treatment period | Within 10-12 of absence; | weeks (before laboratory confirmation of the sturgeon in the cerebrospinal fluid) |
| Prevention of fungal infections in children with reduced immunity, whose risk of infection is associated with neutropenia, resulting from cytotoxic chemotherapy or radiation therapy (3-12 mg / kg / day) | 1-5 tablets per day | 1-6 tablets in. day | 2-7 tablets per day | 2-8 tablets per day |
| Treatment period | The drug is given in doses, depending on the severity and duration of preservation of induced neutropenia. |
In elderly patients, in the absence of impaired renal function, the usual dosage regimen should be followed.
Patients with renal insufficiency (creatinine clearance less than 50 ml / min) dosage regimen should be adjusted as indicated 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. When re-administering the drug, patients with impaired renal function should first introduce a shock dose of 50 mg to 400 mg. If creatinine clearance (CC) is greater than 50 ml / myn applied normal dose (100% of the recommended dose). 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 hemodialysis session ..