Fluconazole
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Manufacturer
and trade name: Pfizer and many other companies, therefore several trade
names, such as Diflucan®, Fluconazole CT®/Stada,
or Flucobeta®.
Indications: Candida infection,
cryptococcal meningitis and some rare mycoses.
§ Fluconazole® capsules,
50 mg, 100 mg, 200 mg.
§ Fluconazole® suspension,
50 mg per 10 ml.
§ Fluconazole® IV
for injections, 100, 200 and 400 mg.
Dose: for
oral candidiasis, 100 mg QD orally; for candida esophagitis 200 mg
QD for 7-10 days. Double the dose on the first day. An attempt with a higher
dose (up to 800 mg daily) may be made if there is persistent candidiasis
after 10 days.
Cryptococcal meningitis:
Initially, 400-800 mg daily, combined with flucytosine and amphotericin B
if possible. After completion of acute therapy – usually after 6 weeks –
maintenance therapy with 200 mg fluconazole daily.
Renal insufficiency: half the dose with creatinine clearance of 10 to 50 ml/min; reduce to 25% below 10 ml/min.
Side
effects: overall good tolerability, rarely gastrointestinal complaints
and elevated transaminases. Reversible alopecia in approximately 10% of cases
with more than 400 mg daily.
Interactions,
warnings: long-term treatment may lead to development of candida-resistant strains. Fluconazole is not effective
against C. krusei or aspergillus. In cases of C. glabrata infection higher doses are required
(sensitivity is dose-dependent). Fluconazole levels are reduced with concurrent
administration of rifabutin/rifampin. Fluconazole increases the serum levels of
rifabutin, atovaquone, clarithromycin, theophylline, opiates, coumarin
derivatives, benzodiazepines, cyclosporine, tacrolimus, phenytoin and
anti-convulsive drugs as well as AZT.
Comments: Fluconazole
is the first choice for HIV-associated candidiasis and for the secondary
prophylaxis of cryptococcosis (also as component of acute therapy). The tablets
have good absorption. Infusions (more expensive) are only required in cases of
non-adherence, severe mucositis, and/or problems with absorption.
We, at Darleys Surgical Company strive to be a leading global manufacturer and exporters of a broad range of quality-surgical-instruments.
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