Diflucan

Adult Dosing .

Dosage forms:  TAB: 50 mg, 100 mg, 150 mg, 200 mg; SUSP: 10 mg per mL, 40 mg per mL

Dosage Forms Discontinued in US

[IV not avail. as brand; see generic]

candidiasis, oropharyngeal

[100-200 mg PO/IV qd x7-14 days]

Info: for mod-severe disease; cont. for >2wk to prevent relapse

candidiasis, esophageal

[200-400 mg PO/IV qd x14-21 days]

Info: for mod-severe disease

candidiasis, vulvovaginal

[uncomplicated]

Dose: 150 mg PO x1

[severe]

Dose: 150 mg PO q72h x2 doses

[recurrence, 100 mg-dose regimen]

Dose: 100 mg PO q72h x3 doses

[recurrence, 150 mg-dose regimen]

Dose: 150 mg PO q72h x3 doses; Info: may follow w/ oteseconazole

[recurrence, 200 mg-dose regimen]

Dose: 200 mg PO q72h x3 doses

[suppression]

Dose: 100-200 mg PO qwk x6mo; Start: after recurrence regimen

candidiasis, systemic

[400 mg PO/IV qd]

Start: 800 mg PO/IV x1; Info: dose, duration vary by indication

meningitis, cryptococcal

[treatment regimen]

Dose: 200 mg PO/IV q24h; Start: 400 mg PO x1; Info: may incr. to 400 mg PO/IV; cont. x10-12wk after culture negative, then begin suppression regimen if AIDS

[suppression regimen]

Dose: 200 mg PO qd; Info: cont. for lifetime if AIDS; may consider D/C if CD4+ >100-200 cells/mm^3 after >6mo HAART

fungal prophylaxis, BMT

[400 mg PO/IV qd]

Info: begin several days before anticipated onset of neutropenia, cont. x7 days after PMN >1000

cystitis, candidal (off-label)

[200 mg PO qd x2wk]

pyelonephritis, candidal (off-label)

[200-400 mg PO qd x2wk]

coccidioidomycosis (off-label)

[400-800 mg PO/IV qd]

meningitis, coccidioidal (off-label)

[400-1200 mg PO qd]

Info: cont. for lifetime

tinea capitis (off-label)

[200 mg PO qd x6wk]

Info: may use selenium sulfide shampoo 2x/wk as adjunct

onychomycosis (off-label)

[150-450 mg PO qwk]

Info: give x3-6mo if fingernail infection; give x6-12mo if toenail infection

tinea pedis (off-label)

[150 mg PO qwk x2-6wk]

tinea corporis (off-label)

[150-200 mg PO qwk x2-4wk]

tinea cruris (off-label)

[150-200 mg PO qwk x2-4wk]

tinea barbae (off-label)

[200 mg PO qd x2-4wk]

tinea manuum (off-label)

[200 mg PO qd x2-4wk]

Majochhi granuloma (off-label)

[200 mg PO qd x2-4wk]

pityriasis versicolor (off-label)

[200-300 mg PO qwk x2wk]

sporotrichosis, cutaneous/lymphocutaneous (off-label)

[400-800 mg PO qd]

Info: continue until 2-4wk after lesions resolved

renal dosing

[candidiasis, vulvovaginal]

renal impairment: no adjustment

HD/PD: no adjustment; no supplement

[all other indications]

CrCl <50: give usual loading dose x1, then decr. usual maint. dose by 50%

HD: give usual loading dose x1, then give usual dose 3x/wk after dialysis; PD: decr. usual dose by 50%; supplement not defined

hepatic dosing

[see below]

hepatic impairment: not defined, caution advised

Peds Dosing .

Dosage forms:  TAB: 50 mg, 100 mg, 150 mg, 200 mg; SUSP: 10 mg per mL, 40 mg per mL

Dosage Forms Discontinued in US

[IV not avail. as brand; see generic]

candidiasis, systemic

[<30 wk gestation, <3 mo]

Dose: 9 mg/kg/dose PO/IV q24h for >3wk; Start: 25 mg/kg/dose PO/IV x1; Info: start 35 mg/kg/dose PO/IV x1 if receiving extracorporeal membrane oxygenation

[30 wk gestation and older, <3 mo]

Dose: 12 mg/kg/dose PO/IV q24h for >3wk; Start: 25 mg/kg/dose PO/IV x1; Info: start 35 mg/kg/dose PO/IV x1 if receiving extracorporeal membrane oxygenation

[3 mo and older]

Dose: 12 mg/kg/dose PO/IV q24h for >3wk; Start: 25 mg/kg/dose PO/IV x1, max 800 mg/dose; Max: 400 mg/dose; Info: start 35 mg/kg/dose PO/IV x1 if receiving extracorporeal membrane oxygenation, max 800 mg/dose

candidiasis, oropharyngeal

[>14 days old]

Dose: 6 mg/kg/dose PO/IV x1, then 3 mg/kg/dose PO/IV q24h x7-14 days; Max: 100 mg/day; Info: cont. >2wk to prevent relapse

candidiasis, esophageal

[>14 days old]

Dose: 6 mg/kg/dose PO/IV x1, then 3 mg/kg/dose PO/IV q24h; Max: 400 mg/day; Info: may incr. to 12 mg/kg/dose; cont. for >3wk total and for >2wk after sx resolution

candidiasis, vulvovaginal

[uncomplicated, adolescents]

Dose: 150 mg PO x1

[severe, adolescents]

Dose: 150 mg PO q72h x2 doses

[recurrence, adolescents, 100 mg-dose regimen]

Dose: 100 mg PO q72h x3 doses

[recurrence, adolescents, 150 mg-dose regimen]

Dose: 150 mg PO q72h x3 doses; Info: may follow w/ oteseconazole

[recurrence, adolescents, 200 mg-dose regimen]

Dose: 200 mg PO q72h x3 doses

[suppression, adolescents]

Dose: 100-200 mg PO qwk x6mo; Start: after recurrence regimen

meningitis, cryptococcal

[treatment regimen, >14 days old]

Dose: 6 mg/kg/dose PO/IV q24h; Start: 12 mg/kg/dose PO/IV x1; Max: 600 mg/day; Info: may incr. to 12 mg/kg/dose; cont. x10-12wk after culture negative, then begin suppression regimen if AIDS

[suppression regimen, >14 days old]

Dose: 6 mg/kg/dose PO q24h; Info: cont. for lifetime if AIDS; may consider D/C if CD4+ >100-200 cells/mm^3 after >6mo on HAART

fungal prophylaxis, BMT

[10-12 mg/kg/dose PO/IV q24h]

Max: 400 mg/day; Info: begin several days before anticipated onset of neutropenia, cont. x7 days after PMN >1000

fungal colonization prophylaxis (off-label)

[premature neonates, <1000 g, <5 days old]

Dose: 3 mg/kg/dose IV q72h x14 days, then q48h x14 days, then q24h x14 days

tinea capitis (off-label)

[>14 days old]

Dose: 3-6 mg/kg/dose PO/IV q24h x6wk; Max: 400 mg/day; Alt: 6 mg/kg/dose PO/IV qwk x8-12wk; Info: may use selenium sulfide shampoo 2x/wk as adjunct

onychomycosis (off-label)

[2 yo and older]

Dose: 3-6 mg/kg/dose PO qwk; Info: give x12-16wk if fingernail infection; give x18-26wk if toenail infection

coccidioidomycosis (off-label)

[neonates]

Dose: 6-12 mg/kg/dose IV q24h

renal dosing

[candidiasis, vulvovaginal]

renal impairment: no adjustment

HD/PD: no adjustment; no supplement

[all other indications]

CrCl 10-50: give usual loading dose x1, then decr. usual maint. dose by 50%; CrCl <10: give usual loading dose x1, then decr. usual maint. dose by 50% and consider decr. usual frequency

HD: give usual loading dose x1, then give usual dose 3x/wk after dialysis; PD: decr. usual dose by 50%, supplement not defined

hepatic dosing

[see below]

hepatic impairment: not defined, caution advised