| name | Fluconazole (Systemic) |
| classification | Azole antifungal, broad-spectrum |
| pharmacokinetics | | absorption | Well absorbed orally, with peak plasma concentrations typically achieved within 1-4 hours. | | distribution | Distributed throughout the body, including the central nervous system and the kidneys. High concentrations in the lungs, kidneys, and skin. | | metabolism | Primarily metabolized in the liver. About 80% of the dose is metabolized through the cytochrome P450 enzyme system, particularly CYP2C9 and CYP3A4. | | excretion | Excreted primarily in the urine, with some excretion in the bile. Elimination half-life is relatively long, which is important in terms of dosing. Renal impairment may require dosage adjustments. |
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| suggested dosage | | general | Dosage depends on the specific condition being treated. Consult a physician for specific recommendations. | | example oral dosage | | type | oral | | common dosage | 50 mg orally daily or 150mg every 72 hours depending on the medical condition. | | max dosage | Maximum recommended daily dose is 400 mg, depending on clinical presentation. |
| | notes | Dosage must be tailored to the individual patient's needs and specific clinical presentation. Always follow your physician's prescribed instructions. |
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| indications | | 1 | Candidiasis (oral, esophageal, vaginal, or disseminated) | | 2 | Cryptococcal infections | | 3 | Coccidioidomycosis | | 4 | Histoplasmosis | | 5 | Other fungal infections (depending on resistance patterns) |
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| safety in pregnancy | Fluconazole is considered to be relatively safe during pregnancy, but potential risks to the fetus exist. Consult with a physician for a risk-benefit assessment. |
| safety in breastfeeding | Fluconazole is excreted in breast milk. However, it is generally considered to be safe in moderate doses at the time of breastfeeding, though low doses are preferred. Consult with a physician on specific dosing requirements. |
| side effects | | 1 | Gastrointestinal upset (nausea, vomiting, diarrhea) | | 2 | Headache | | 3 | Skin rash | | 4 | Hypersensitivity reactions (e.g., urticaria, angioedema, anaphylaxis) | | 5 | Liver dysfunction | | 6 | Changes in blood counts | | 7 | Increased blood pressure |
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| alternatives | |
| contraindications | | 1 | Known hypersensitivity to fluconazole or other azole antifungals | | 2 | Severe liver disease |
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| interactions | | 1 | Many interactions are possible with Fluconazole. Key drug interactions often involve CYP450 enzymes. Use a comprehensive drug interaction checking tool in clinical practice. | | 2 | Important: Instruct patients to inform all medical providers of all other medications, including OTC medications, herbal remedies, and supplements. |
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| warnings and precautions | | 1 | Renal impairment may necessitate dosage adjustment. | | 2 | Monitor liver function tests (LFTs) during therapy. | | 3 | Monitor for signs of hypersensitivity reactions, particularly in individuals with a history of allergic reactions. | | 4 | Possible interactions with other medications, including warfarin, and other CYP3A4 substrates. | | 5 | Use caution in patients with pre-existing cardiac conditions or conditions that may cause electrolyte imbalances. |
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| additional informations | Fluconazole's long half-life requires cautious consideration when discontinuing therapy. For severe or extensive fungal infections, treatment may be prolonged or require combination therapy. |
| patient specific considerations | | age | Dosage adjustments may not be necessary for a 25-year-old patient based on age alone; however, underlying health conditions must be considered. | | weight | Weight (70 kg) will not dictate dosage alone. Baseline renal and hepatic function should be factored into prescribing. |
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