Mycosyst® (Mycosyst®)

Enter intravenously drip at a rate of not more than 20 mg (10 ml) per minute.

When transferring from intravenous administration to taking capsules and vice versa, there is no need to change the daily dose.

The infusion solution is compatible with the following solutions: 20% glucose solution, Ringer's solution, Hartman's solution, potassium chloride solution in glucose, sodium bicarbonate solution, 0.9% sodium chloride solution.

Infusions of fluconazole can be carried out using conventional transfusion kits using one of the liquids listed above.

Application in adults

In cryptococcal infections, the usual dose of fluconazole is 400 mg once a day on the first day of treatment, later on - 200-400 mg once a day. The duration of treatment for cryptococcal infections depends on the clinical efficacy, confirmed by mycological examination, and usually ranges from 6 to 8 weeks.

The recommended duration of treatment for cryptococcal meningitis is 10-12 weeks after a negative result of a microbiological study of a sample of cerebrospinal fluid.

To prevent the recurrence of cryptococcal meningitis in AIDS patients after completing the full course of primary therapy fluconazole appoint a patient in a dose of at least 200 mg per day for a long period.

With candidemia, disseminated candidiasis and other invasive candidiasis infections, the daily dose of fluconazole is 400 mg on the first day and 200 mg on subsequent days. If necessary, the dose of the drug can be increased to 400 mg / day. The duration of treatment depends on clinical effectiveness.

With severe systemic candidiasis - it is possible to increase the dose to 800 mg per day. The duration of therapy depends on clinical effectiveness. Should continue at least 2 weeks after receiving negative blood cultures or after the disappearance of the symptoms of the disease.

In oropharyngeal candidiasis, including patients with impaired immunity, the usual dose of fluconazole is 50-100 mg once a day for 7-14 days. To prevent the recurrence of oropharyngeal candidiasis in AIDS patients after completing the full course of primary therapy - 150 mg once a week. If necessary, the treatment can be prolonged, especially with severe immunity disorders.

With atrophic candidiasis of the oral cavity, associated with the wearing of dentures, fluconazole usually appoint 50 mg once a day for 14 days in combination with antiseptic agents to handle the prosthesis.

In other candidiasis infections, for example, with esophagitis, noninvasive bronchopulmonary infections, candiduria, candidiasis of the skin and mucous membranes, the daily dose is 50-100 mg for 14-30 days.

In severe candidiasis of the mucous membranes - 100-200 mg per day.

For the prevention of fungal infections in patients with malignant neoplasms, the dose of fluconazole should be 50 mg once a day until the patient is at a high risk because of cytotoxic or radiation therapy.

With vaginal candidiasis - 150 mg once. To reduce the frequency of relapses, once a month, 150 mg are used for 4-12 months, sometimes more frequent use may be required.

For the prevention of candidiasis, the recommended dose of fluconazole is 50-400 mg once a 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 once daily. 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 deep endemic mycoses, it may be necessary to use the drug at a dose of 200-400 mg per day for 2 years. The duration of therapy is determined individually; it can be 11-24 months with coccidioidosis; 2-17 months with paracoccidioidosis and 3-17 months with histoplasmosis.

Use in children

The duration of treatment depends on the clinical and mycological effect. In children, the drug should not be used in a daily dose exceeding that of adults.

In candidiasis of mucous membranes, the recommended dose of fluconazole is 3 mg / kg per day. On the first day, a shock dose of 6 mg / kg can be given to achieve a more rapid equilibrium concentration.

For the treatment of generalized candidiasis and cryptococcal infection, the recommended dose is 6-12 mg / kg per day, depending on the severity of the disease.

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 or radiotherapy, the drug is prescribed at 3-12 mg / kg per day, depending on the severity and duration of preservation of induced neutropenia.

In newborns fluconazole is slower, so in the first 2 weeks of life the drug is prescribed in the same dose (in mg / kg) as in older children, but at an interval of 72 hours. Children aged 3-4 weeks of life are given the same dose at intervals of 48 hours.

Application in elderly patients

In the absence of violations of the kidneys should follow the usual recommendations for dosing the drug. For patients with impaired renal function (creatinine clearance <50 mL / min), the dosage regimen should be adjusted as indicated below.

Use in patients with renal insufficiency

Fluconazole is excreted mainly by the kidneys in unchanged form. With a single application of fluconazole, no dose changes are required. If a course of treatment is necessary in patients (including children) with impaired renal function, a "shock" dose of 50 mg to 400 mg should be initially administered. In the future, the daily dose (depending on the indication) is determined according to the following table: