II. Indications
- Onychomycosis
- Yeast Vaginitis (Single dose)
III. Dosing
-
Tinea Capitis
- Daily: 6 mg/kg/day (up to 150 mg to 300 mg) daily for 3 to 6 weeks
- Weekly: 6 mg/kg/day (up to 150 mg to 300 mg) weekly for 8 to 12 weeks
-
Onychomycosis
- Adult: 150 to 300 mg (up to 450 mg) orally once per week
- Child: 3 to 6 mg/kg once weekly
- Course
- Fingernail: 3-6 months
- Toenail: 6-12 months
-
Yeast Vaginitis
- Adult dose: 150 mg PO for 1 dose
IV. Monitoring
-
Onychomycosis or Yeast Vaginitis
- No routine lab tests recommended
- Some guidelines have recommended baseline labs
- Complete Blood Count (CBC)
- Liver transaminases (AST, ALT)
- Serum Creatinine
V. Adverse effects (5% of patients)
- Nausea
- Headache
- Pruritus
- Liver Function Test abnormalities
VI. Drug Interactions
- Absorption not affected by gastric pH
- Significant sedation with Benzodiazepines
- Cimetidine decreases Fluconazole levels
- Hydrochlorothiazide increases Fluconazole levels
- Rifampin decreases Fluconazole levels
-
Oral Hypoglycemics (e.g. Sulfonylureas)
- Risk of Hypoglycemia
- Fluconazole increases Theophylline levels
- Increased bleeding risk with Warfarin
VII. Precautions
- As of 2016, evidence of Miscarriage risk, with even 1-2 doses
- Previously thought safe in pregnancy if limited to occassional single dose
- Mølgaard-Nielsen (2016) JAMA 315(1):58-67 +PMID:26746458 [PubMed]
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Related Studies
| fluconazole (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| FLUCONAZOLE 10 MG/ML SUSP | Generic | $0.27 per ml |
| FLUCONAZOLE 100 MG TABLET | Generic | $0.28 each |
| FLUCONAZOLE 150 MG TABLET | Generic | $0.55 each |
| FLUCONAZOLE 200 MG TABLET | Generic | $0.46 each |
| FLUCONAZOLE 40 MG/ML SUSP | Generic | $0.49 per ml |
| FLUCONAZOLE 50 MG TABLET | Generic | $0.29 each |