Inside. Adults at Cryptococcal meningitis and cryptococcal infections of other sites on the first day 400 mg (8 capsules to 50 mg) are usually prescribed, and then continue treatment at a dose of 200-400 mg (4-8 capsules to 50 mg) 1 time / day. The duration of treatment for cryptococcal infections depends on the clinical efficacy, 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 patients with AIDS after completion of the full course of primary treatment fluconazole prescribe a dose of 200 mg (4 capsules to 50 mg) per day for a long period of time.
When candidemia, disseminated candidiasis and other invasive candidiasis infections The dose is usually 400 mg (8 capsules to 50 mg) on the first day, and then to 200 mg (4 capsules to 50 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.
When 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.
When other localizations of candidiasis (with the exception of genital candidiasis), for example, with esophagitis, non-invasive 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. For prevention relapses of oropharyngeal candidiasis in patients with AIDS after the completion of a full course of primary therapy, the drug can be administered at 150 mg once a week.
When vaginal candidiasis fluconazole taken once inside the dose of 150 mg. For decrease in the frequency of recurrences of vaginal candidiasis the drug can be used in 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 balanitis caused by Candida, fluconazole appoint a single dose of 150 mg orally.
For prevention of candidiasis 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 (8 capsules 50 mg) 1 time / 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 is continued for another 7 days.
When mycosis of the skin, including mycosis of the feet, skin of the inguinal region and skin candidiasisthe recommended dose is 150 mg once a week. Duration of therapy in usual cases is 2-4 weeks, however, with foot mycoses, longer therapy (up to 6 weeks) may be required.
When pityriasis 300 mg (2 caps.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 to receive 300-400 mg once a day.
With onichomycosis the recommended dose is 150 mg once a week, treatment should continue until the replacement of the infected nail (nonsinfected nail growth). To completely replace the nails on the fingers and toes, it normally takes 3-6 months and 6-12 months, respectively.
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 11-24 months with coccidioidomycosis; 2-17 months with paracoccidioidomycosis; 1-16 months with sporotrichosis and 3-17 months with histoplasmosis.
Have 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 of adults. The drug is used daily 1 time / day.
When candidiasis of mucous membranes the recommended dose of fluconazole is 3 mg / kg / day. On the first day, a shock dose of 6 mg / kg can be given to achieve a faster Cssmax.
For treatment of generalized candidiasis or cryptococcal infectionthe recommended dose is 6-12 mg / kg / day, depending on the severity of the disease.
For prevention of fungal infections the children with reduced immunity, at which the risk of infection is associated with neutropenia, resulting from cytotoxic chemotherapy or radiation therapy, the drug is prescribed at 3-12 mg / kg / day, depending on the severity and duration of preservation of induced neutropenia.
Have children with impaired renal function the daily dose of the drug should be reduced (in the same proportional relationship as in adults), in accordance with the degree of renal insufficiency.
Have elderly patients in the absence of violations of kidney function should follow the usual dosage regimen. Patients with renal insufficiency (CC <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 by the kidneys 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 inject a shock dose of up to 400 mg. 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, 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.