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Diflucan (Fluconazole):Uses, Warning, Dosages
What is Diflucan and how could it be utilized?
Diflucan is a physician recommended medication used to treat the indications of contagious diseases. Diflucan might be utilized alone or with different meds.
Diflucan has a place with a class of drugs called antifungals.
What are the symptoms of Diflucan?
Diflucan might cause genuine incidental effects including:
quick or beating heartbeat,
vacillate in your chest,
windedness,
abrupt wooziness,
fever,
chills,
body throbs,
influenza manifestations,
simple swelling or dying,
Various Dose
SINCE ORAL ABSORPTION IS RAPID AND ALMOST COMPLETE, THE DAILY DOSE OF DIFLUCAN (FLUCONAZOLE) IS THE SAME FOR ORAL (TABLETS AND SUSPENSION) AND INTRAVENOUS ADMINISTRATION. As a rule, a stacking portion of double the day by day portion is suggested on the main day of treatment to bring about plasma focuses near consistent state constantly day of treatment.
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Fluconazole
Common Brand Names: Diflucan
Therapeutic Class: A synthetic triazole-derivative antifungal agent
Common Injectable Dosage Forms:
Injection: 2 mg/mL infusions in 100 mL and 200 mL bottles and in PVC bags with NaCl or dextrose diluents
Dosage Ranges:
IV doses are identical to oral doses. For oropharyngeal and esophageal candidiasis, the initial dose is 200 mg followed by 100 mg once daily. Therapy should be continued up to two weeks to ensure eradication.
In systemic infections and meningitis, 400 mg as the initial dose is recommended with once daily doses of 200 mg continued for at least 4 weeks and as long as 19 months.
In patients with impaired renal function, start with 50-400 mg as a loading dose. For those with CCr 21-50 mL/min, use 50% of the recommended dose. For those with CCr 11-20 mL/min, use 25% of the recommended dose. For those on dialysis, give one recommended dose after each dialysis.
Administration and Stability: The solutions for infusion should be given at a rate not to exceed 200 mg in 1 hour. pH 3.5-8
Pharmacology/Pharmacokinetics: Fluconazole’s fungistatic action is due to an increase in cellular membrane permeability of the fungi leading to leakage of essential intracellular contents. The drug is widely distributed into body tissues and fluids with low protein binding and high levels in the CSF. The drug is primarily excreted in the urine with elimination half-life being approximately 30 hours.
Drug and Lab Interactions: May increase the actions of cyclosporine and warfarin and increase phenytoin serum levels which may result in phenytoin toxicity. Rifampin enhances the metabolism of fluconazole and may require increased doses. Thiazide diuretics may increase fluconazole plasma levels by reducing renal clearance. May enhance hypoglycemic action of sulfonylurea antidiabetic agents.
Contraindications/Precautions: Should be used with caution in patients with known hypersensitivity to other triazole or imidazole antifungal agents. If signs and symptoms of hepatic or renal dysfunction occur, therapy should be discontinued. Patients who develop rash during fluconazole therapy should be monitored closely as rare exfoliative disorders have occurred. Pregnancy Category C.
Monitoring Parameters: Periodic liver function tests, renal function tests, serum potassium
Adverse Effects: Adverse effects are generally minimal, with primary effects being nausea, vomiting, and elevations in liver function tests. Hypokalemia has been observed in patients with myeloid leukemia. Other reported effects include fever, edema, pleural effusion, oliguria, and arthralgia/myalgias.
Common Clinical Applications: Used to treat cryptococcal meningitis in AIDS patients. Also effective for oropharyngeal and esophageal candidiasis and serious systemic Candida infections.
Fluconazole
Brand Name: Diflucan
Generic Available
Common Dosage Forms:
Tablets: 50 mg, 100 mg, 150 mg, 200 mg
Powder for Oral Suspension: 10 mg/mL, 40 mg/mL
Injection: 2 mg/mL
FDA Indications/Dosages:
For the treatment of vaginal candidiasis: 150 mg as a single oral dose.
For the treatment of oropharyngeal candidiasis: 200 mg on the first day, followed by 100 mg once daily. Clinical evidence of oropharyngeal candidiasis generally resolves within several days, but treatment should be continued for at least 2 weeks to decrease the likelihood of relapse.
For the treatment of esophageal candidiasis: 200 mg on the first day, followed by 100 mg once daily. Doses up to 400 mg/day may be used, based on medical judgement of the patient’s response to therapy. Patients with esophageal candidiasis should be treated for a minimum of 3 weeks and for at least 2 weeks following resolution of symptoms.
For the treatment of systemic candidiasis: 400 mg on the first day, followed by 200 mg once daily. Patients should be treated for a minimum of 4 weeks and for at least 2 weeks following resolution of symptoms.
For the treatment of cryptococcal meningitis: 400 mg on the first day, followed by 200 mg once daily. A dosage of 400 mg once daily may be used, based on the patient’s response to therapy. The recommended duration of treatment for initial therapy of cryptococcal meningitis is 10-12 weeks after cerebrospinal fluid becomes culture negative. The dosage for suppression of relapse of cryptococcal meningitis in patients with AIDS is 200 mg once daily.
Dosage adjustment in renal impairment: 50% of recommended dose when CrCl=21-50 mL/min and 25% of recommended dose when CrCl=12-20 mL/min.
Patients receiving regular hemodialysis: One recommended dose after each dialysis.
Children’s equivalent dosing: 3 mg/kg for each 100 mg of an adult dose. If the adult dose is 200 mg, the child’s dose is 6 mg/kg.
Pharmacology/Pharmacokinetics: Fluconazole is a highly selective inhibitor of fungal cytochrome P-450 sterol C-14 alpha-demethylation. Mammalian cell demethylation is much less sensitive to fluconazole inhibition. The subsequent loss of normal sterols correlates with the accumulation of 14 alpha-methyl sterols in fungi and may be responsible for the fungistatic activity of fluconazole. Fluconazole is approximately 90% bioavailable after oral administration. Peak plasma concentrations occur between 1-2 hours with a terminal plasma elimination half-life of approximately 30 hours after oral administration. Plasma protein binding is low (11-12%) and approximately 80% of the dose appears unchanged in the urine.
Drug Interactions: Prothrombin time is increased after warfarin administration. Fluconazole increases plasma levels of phenytoin, midazolam, VORICONAZOLE, and of cyclosporine in renal transplant patients. Fluconazole also increases the plasma concentrations and reduces the metabolism of tolbutamide, glyburide, and glipizide. Rifampin enhances the metabolism of concurrently administered fluconazole.
Contraindications/Precautions: Contraindicated in patients who have shown hypersensitivity to fluconazole or to any of its excipients. There is no evidence of cross-hypersensitivity between fluconazole and other azole antifungal agents, although caution should be used with patients hypersensitive to other azoles. Patients who develop abnormal liver function tests should be monitored for the development of more severe hepatic injury. Rare cases of prolongation of the QT interval have been reported. Use with caution in patients with these potentially proarrhythmic conditions: Immunocompromised patients who develop rashes during treatment should be monitored closely and the drug discontinued if lesions progress. The use of fluconazole in nursing mothers is not recommended. Pregnancy Category C.
Adverse Effects: Nausea, headache, abdominal pain, diarrhea, dizziness, dyspepsia, and taste perversion.
Patient Consultation:
Suspensions should be reconstituted prior to dispensing.
May be taken with or without food.
Shake suspension well before each dose.
If a dose is missed, take it as soon as possible. If it closer to the time of your next dose than the dose you missed, skip the missed dose and return to your dosing schedule. Do not double doses.
Contact your physician If a rash develops during therapy.