neutropenia and continue for 7 days after neutrophil
count in desirable range, dose given according to
extent and duration of neutropenia
Prevention of fungal infections in immunocompromised
patients (for patients with high risk of systemic
infections e.g. following bone-marrow transplantation)
▶BY MOUTH, OR BY INTRAVENOUS INFUSION
▶Child: 12 mg/kg daily (max. per dose 400 mg),
commence treatment before anticipated onset of
neutropenia and continue for 7 days after neutrophil
count in desirable range
Prevention of relapse of cryptococcal meningitis in HIV-
infected patients after completion of primary therapy
▶BY MOUTH, OR BY INTRAVENOUS INFUSION
▶Child: 6 mg/kg daily (max. per dose 200 mg)lUNLICENSED USENot licensed for tinea infections in
children, or for vaginal candidiasis in girls under 16 years,
or for prevention of relapse of cryptococcal meningitis
after completion of primary therapy in children with AIDS.
lCONTRA-INDICATIONSAcute porphyrias p. 603
lCAUTIONSSusceptibility to QT interval prolongation
lINTERACTIONS→Appendix 1 : antifungals, azoles
lSIDE-EFFECTS
GENERAL SIDE-EFFECTS
▶Common or very commonDiarrhoea.gastrointestinal
discomfort.headache.nausea.skin reactions.vomiting
▶UncommonDizziness.flatulence.hepatic disorders.
seizure.taste altered
▶Rare or very rareAgranulocytosis.alopecia.dyslipidaemia
.hypokalaemia.leucopenia.neutropenia.QT interval
prolongation.severe cutaneous adverse reactions (SCARs)
.thrombocytopenia.torsade de pointes
SPECIFIC SIDE-EFFECTS
▶Uncommon
▶With parenteral useAnaemia.appetite decreased.asthenia.
constipation.drowsiness.dry mouth.fever.
hyperhidrosis.insomnia.malaise.myalgia.paraesthesia.
vertigo
▶Rare or very rare
▶With parenteral useAngioedema.face oedema.tremor
▶Frequency not known
▶With oral useCardio-respiratory distress.oedema
SIDE-EFFECTS, FURTHER INFORMATIONIf rash occurs,
discontinue treatment (or monitor closely if infection
invasive or systemic); severe cutaneous reactions are more
likely in patients with AIDS.lPREGNANCYManufacturer advises avoid—multiple
congenital abnormalities reported with long-term high
doses.
lBREAST FEEDINGPresent in milk but amount probably too
small to be harmful.
lHEPATIC IMPAIRMENTToxicity with related drugs.
lRENAL IMPAIRMENT
Dose adjustmentsUsual initial dose then halve subsequent
doses if estimated glomerularfiltration rate less than
50 mL/minute/ 1. 73 m^2.
lMONITORING REQUIREMENTSMonitor liver function with
high doses or extended courses—discontinue if signs or
symptoms of hepatic disease (risk of hepatic necrosis).
lDIRECTIONS FOR ADMINISTRATIONForintravenous
infusion, give over 10 – 30 minutes; do not exceed an
infusion rate of 5 – 10 mL/minute.
lPRESCRIBING AND DISPENSING INFORMATIONFlavours of
oral liquid formulations may include orange.
lPROFESSION SPECIFIC INFORMATION
Dental practitioners’formulary
Fluconazole Capsules 50 mg may be prescribed.
Fluconazole Oral Suspension 50 mg/ 5 mL may be
prescribed.
lEXCEPTIONS TO LEGAL CATEGORYFluconazole capsules
can be sold to the public for vaginal candidiasis and
associated candidal balanitis in those aged 16 – 60 years, in
a container or packaging containing not more than 150 mg
and labelled to show a max. dose of 150 mg.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Infusion
▶Fluconazole (Non-proprietary)
Fluconazole 2 mg per 1 mlFluconazole 200 mg/ 100 ml infusion bags
| 5 bagP£ 19. 45
Fluconazole 400 mg/ 200 ml infusion bags| 5 bagP£ 72. 50
Solution for infusion
ELECTROLYTES:May contain Sodium
▶Fluconazole (Non-proprietary)
Fluconazole 2 mg per 1 mlFluconazole 200 mg/ 100 ml solution for
infusion vials| 1 vialP£ 3. 00 – £ 29. 28
Fluconazole 50 mg/ 25 ml solution for infusion vials| 1 vialP
£ 7. 31 – £ 7. 32
Fluconazole 200 mg/ 100 ml solution for infusion bottles|
5 bottleP£ 274. 50
▶Diflucan(Pfizer Ltd)
Fluconazole 2 mg per 1 mlDiflucan 200 mg/ 100 ml solution for
infusion vials| 1 vialP£ 29. 28 (Hospital only)
Oral suspension
CAUTIONARY AND ADVISORY LABELS 9
▶Fluconazole (Non-proprietary)
Fluconazole 10 mg per 1 mlFluconazole 50 mg/ 5 ml oral suspension
| 35 mlP£ 20. 51 DT = £ 20. 51
▶Diflucan(Pfizer Ltd)
Fluconazole 10 mg per 1 mlDiflucan 50 mg/ 5 ml oral suspension|
35 mlP£ 16. 61 DT = £ 20. 51
Fluconazole 40 mg per 1 mlDiflucan 200 mg/ 5 ml oral suspension|
35 mlP£ 66. 42 DT = £ 66. 42
Capsule
CAUTIONARY AND ADVISORY LABELS 9 ( 50 mg and 200 mg strengths
only)
▶Fluconazole (Non-proprietary)
Fluconazole 50 mgFluconazole 50 mg capsules| 7 capsuleP
£ 5. 00 DT = £ 0. 45
Fluconazole 150 mgFluconazole 150 mg capsules| 1 capsuleP
£ 8. 50 DT = £ 0. 39
Fluconazole 200 mgFluconazole 200 mg capsules| 7 capsuleP
£ 6. 02 DT = £ 5. 30
▶Diflucan(Pfizer Ltd)
Fluconazole 50 mgDiflucan 50 mg capsules| 7 capsuleP
£ 16. 61 DT = £ 0. 45
Fluconazole 150 mgDiflucan 150 mg capsules| 1 capsuleP
£ 7. 12 DT = £ 0. 39
Fluconazole 200 mgDiflucan 200 mg capsules| 7 capsuleP
£ 66. 42 DT = £ 5. 30Itraconazole
lINDICATIONS AND DOSE
Oropharyngeal candidiasis
▶BY MOUTH
▶Child 1 month–11 years: 3 – 5 mg/kg once daily for
15 days; maximum 100 mg per day
▶Child 12–17 years: 100 mg once daily for 15 days
Oropharyngeal candidiasis in patients with AIDS or
neutropenia
▶BY MOUTH
▶Child 1 month–11 years: 3 – 5 mg/kg once daily for
15 days; maximum 200 mg per day
▶Child 12–17 years: 200 mg once daily for
15 days continued→BNFC 2018 – 2019 Fungal infection 375
Infection5