Adults with Cryptococcal meningitis and cryptococcal infections of other sites on the first day, 400 mg are usually prescribed, and then continue treatment at a dose of 200-400 mg once / ct. 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 appoint a dose of 200 mg / day. for a long period of time.
When candidemia, disseminated candidiasis and other invasive candidiasis infections The dose is usually 400 mg on the first day, and then 200 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 at 50-100 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
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 local antiseptic agents for the treatment of the prosthesis.
For 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 50-100 mg / day. with a treatment duration of 14-30 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.
When
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.
When
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 persistent neutropenia, the recommended dose is 400 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 / mm
3 treatment is continued for another 7 days.
When mycosis of the skin, including mycosis of the feet, skin of the inguinal region, and candidiasis of the skin the recommended dose is 150 mg once a week or 50 mg 1 time / day.The 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 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 2-4 weeks.
When onychomycosis the recommended dose is 150 mg once a week. Treatment should continue until the replacement of the infected nail (the growth of the uninfected nail). For the repeated growth of the nails on the fingers and toes normally takes 3-6 months. and 6-12 months. respectively.
When deep endemic mycoses may require the use of the drug in 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 coccidiomycosis; 2-17 months. with paracoccidiosis; 1-16 months. with sporotrichosis and 3-17 months. with histoplasmosis.
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 may be prescribed to achieve a more rapid equilibrium equilibrium concentration.
For treatment generalized candidiasis or cryptococcal infection the recommended dose is 6-12 mg / kg / day. depending on the severity of the disease.
For prevention of fungal infections in children with reduced immunity, at which the risk of infection is associated with neutropenia, which develops as a result of 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.
In 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.
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.) Regimendosage should be adjusted as indicated below.
The 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 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 of 50% is recommended. Patients regularly on dialysis, one dose of the drug is used after each session of hemodialysis.