Intravenously drip at a speed of no more than 200 mg / h. The daily dose of fluconazole depends on the nature and severity of the fungal infection. When transferring from intravenous administration to taking pills and vice versa, there is no need to change the daily dose. Treatment can begin before the results of sowing and other laboratory
research. However, therapy needs to be changed accordingly when the results of these studies become known.
Adults
When cryptococcal meningitis and krshpokkovyh infections of other locations on the first day, an average of 400 mg flukonavola, and then continue treatment at a dose of 200-400 mg once a 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.
To prevent the recurrence of cryptococcal meningitis in AIDS patients after completion of the full course of primary treatment. Therapy with fluconazole at a dose of 200 mg / day can be continued for a very long period (transition to an oral form is possible).
With candidemia, disseminated candidiasis and other invasive candidiasis infections, the average dose is 400 mg on the first day, then 200 mg per day. With insufficient clinical efficacy, the dose of fluconazole can be increased to 400 mg / day. The duration of therapy depends on clinical effectiveness.
For the prevention of candidiasis in the presence of a high risk of generalized infection, for example in patients with severe or persistent neutropenia, the recommended dose is 400 mg once a day.
Fluconazole prescribe a few days before the expected appearance of neutrons and after increasing the number of neutrophils more than 1000 / μl, treatment is continued for another 7 days.
With deep endemic mycoses, it may be necessary to use the drug at a dose of 200-400 mg / day for 2 years. The duration of therapy is determined individually; it is 11 - 24 months with coccidioidomycosis, with histoplasmosis - 3-17 months (transition to an oral form is possible).
Children
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 of adults, that is, not more than 400 mg per day. The drug is used daily 1 time per day. If it is necessary to carry out long-term therapy, it is possible to switch to the oral form of fluconazole.
In cryptococcal meningitis and cryptococcal infections of other proofs, as well as generalized candidiasis in children, the recommended dose is 6-12 mg / kg / day, depending on the severity of the disease. Duration of therapy - for 10-12 weeks (before laboratory confirmation of the absence of pathogens in the cerebrospinal fluid).
To prevent the recurrence of cryptococcal meningitis in children with AIDS, after the completion of the full course of primary treatment, fluconazole therapy at a dose of 6 mg / kg / day can be continued for a long time.
With oropharyngeal candidiasis in children, the recommended dose is 6 mg / kg on the first day, then daily at 3 mg / kg / day, once. Duration of therapy - for at least 2 weeks.
When candidiasis of the mucous membranes in children, the recommended dose of flavonazole is 3 mg / kg / day. On the first day, a shock dose of 6 mg / kg may be prescribed to achieve a more rapid equilibrium equilibrium concentration. The duration of therapy is at least 3 weeks.
When Candidiasis of the esophagus in children, the fl ucopase is administered once in a daily dose of 3 mg / kg. On the first day, a shock dose of 6 mg / kg / day can be prescribed. Depending on the severity of the disease, the dose can be increased to 6-12 mg / kg / day. Duration of therapy
at least 3 weeks and 2 weeks after the regression of the symptoms.
For the prevention of fungal infections in children with reduced immunity, the risk of infection is associated with neutropenia, which develops as a result of cytotoxic chemotherapy or radiation therapy, the flipopalone is administered once in a daily dose of 3-12 mg / kg / day. The duration of therapy is until elimination of induced neutropenia.
When the drug is used in children aged from the period of ivorocity up to 4 weeks
it should be borne in mind that in newborns
fluconazole output slowly.In the first 2 weeks of life, the drug is administered at the same dose (in mg / kg) as for older children, but at an interval of 72 hours. Children up to 4 weeks of age are given the same dose at intervals of 48 hours.
Application in the elderly.
In the absence of violations of the kidneys should follow the usual dosage regimen. Patients with renal impairment (creatinine clearance less than 50 mL / min) dosing regimen should be adjusted as indicated below.
Use of the drug in patients with impaired renal function.
At K K less than 50 ml / min, correction of the dosing regimen is required.
Fluconazole is excreted mainly with urine in unchanged form. With a single administration, a dose change is not required. In patients with impaired renal function with repeated use of the drug, a shock dose of 50 mg to 400 mg should be initially administered, after which the daily dose (depending on the indications) is determined according to the following table.
| Creatinine clearance (ml / min) | Percent recommended dose |
| less than 50 (without dialysis) | 50% |
| more than 50 | 100% |
| Patients permanently on dialysis | 100% after each dialysis session |
Fluconazole is administered intravenously drip at a rate of no more than 200 mg / hour.J 1 with the transfer of the patient from intravenous administration to taking the drug inside or vice versa, changes in the daily dose are not required. In children with impaired function of the nights, the daily dose of the drug should be reduced (in the same proportional relationship as in adults), in accordance with the degree of renal failure The preparation contains 0.9% solution of sodium chloride; in 100 ml of the drug contains but 15 mmoles of sodium and chlorine ions, therefore, in patients who need to limit the intake of sodium or liquid, it is necessary to take into account the rate of fluid administration.