To prevent the recurrence of cryptococcal meningitis in AIDS patients, after completion of the full course of primary therapy,
fluconazole prescribe a dose of 200 mg (4 capsules of 50 mg) per day for a long period of time.
When candidemia, disseminated candidiasis and other invasive candidiasis infections on the first day of the dose is 400 mg (8 capsules of 50 mg), and then - 200 mg (4 capsules of 50 mg) per day. With insufficient clinical effectiveness, the dose of the drug can be increased to 400 mg (8 capsules 50 mg) per day. The duration of therapy depends on clinical effectiveness.
With oropharyngeal candidiasis, the drug is usually prescribed for 150 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 - 150 mg once a week.
With atrophic oral candidiasis associated with the wearing of dentures, 50 mg once a day for 14 days in combination with local antiseptic medicines to treat the prosthesis.
In other localizations of candidiasis (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 150 mg / day with a treatment duration of 14-30 days.
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. Duration of therapy from 4 to 12 months. Some patients may need more frequent use.
With balanitis caused by Candida, fluconazole is administered intravenously at a dose of 150 mg / day.
For the prevention of candidiasis, the recommended dose is 50-400 mg once a day, depending on the degree of risk of fungal infection. For the prevention of candidiasis in patients with malignant neoplasms the recommended dose of fluconazole is 150-400 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 persistent neutropenia, the recommended dose is 400 mg / day.
Fluconazole appoint a few days before the expected appearance of neutropenia. After increasing the number of neutrophils more than 1 thousand / μl treatment is continued for another 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 dosage regimen depends on the clinical mycological effect. 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 lichen - 300 mg (2 capsules of 150 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 One-time intake of 300-400 mg; an alternative treatment regimen is to apply 50 mg once a day for 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 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 (4 capsules of 50 mg) - 400 mg (8 capsules 50 mg) per day for up to 2 years. The duration of therapy is determined individually: it can be
11-24 months. with coccidioidomycosis and 3-17 months. with histoplasmosis.
In elderly patients in the absence of violations of kidney function should follow the usual dosage regimen. Patients with renal insufficiency (creatinine clearance less than 50 ml / min) dosage regimen should be adjusted as indicated below.
Fluconazole is excreted mainly with urine in unchanged form. In chronic renal failure, a "shock" dose of 50-400 mg is initially administered. If the creatinine clearance (CK) 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 50% of the recommended dose or usual dose is applied once in 2 days.
Patients with impaired renal function
fluconazole is introduced according to the following scheme: