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Fluconazole (fluconazole) instructions
Common name: fluconazole
Trade name: Diflucan
All names: fluconazole, irican, fluconazole, Diflucan
Indications:
Candidasis: used to treat candida infection of the oropharynx and esophagus; disseminated candidiasis, including peritonitis, pneumonia, urinary tract infection and other Candida vulvovaginitis. It can also be used to prevent candida infection in bone marrow transplant patients receiving cytotoxic drugs or radiotherapy.
Cryptococcosis: used to treat Cryptococcus neoformans outside the meninges; when treating cryptococcal meningitis, this product can be used as a maintenance treatment after initial treatment with amphotericin B combined with flucytosine.
Coccidioidomycosis.
This product can also replace itraconazole for the treatment of blastomycosis and histoplasmosis.
Usage and dosage:
Fluconazole tablets:
Oral administration. Adults (1) Disseminated candidiasis: 0.4g for the first time, 0.2g for subsequent times, once a day for at least 4 weeks, and last for at least 2 weeks after symptoms are relieved. (2) Esophageal candidiasis: The first dose is 0.2g, and then 0.1g, once a day, for at least 3 weeks, and for at least 2 weeks after symptoms are relieved. According to the treatment response, the dose can also be increased to 0.4g once a day. (3) Oropharyngeal candidiasis: 0.2g for the first time, 0.1g for subsequent times, once a day, and the course of treatment is at least 2 weeks. (4) Candida vulvovaginitis: single dose, 0.15g.
Fluconazole Capsules:
Oral. Adults (1) Disseminated candidiasis: 0.4g for the first time, 0.2g for subsequent times, once a day for at least 4 weeks, and last for at least 2 weeks after symptoms are relieved. (2) Esophageal candidiasis: The first dose is 0.2g, and then 0.1g, once a day, for at least 3 weeks, and for at least 2 weeks after symptoms are relieved. According to the treatment response, the dose can also be increased to 0.4g once a day. (3) Oropharyngeal candidiasis: 0.2g for the first time, 0.1g for subsequent times, once a day, and the course of treatment is at least 2 weeks. (4) Candida vulvovaginitis: single dose, 0.15g.
Injection:
Intravenous infusion, the maximum infusion rate is about 200mg/hour.
Adverse reactions:
Common gastrointestinal reactions include nausea, vomiting, abdominal pain or diarrhea.
Allergic reaction: may manifest as rash, and occasionally severe exfoliative dermatitis (often accompanied by liver function damage) and exudative erythema multiforme may occur.
Hepatotoxicity: Mild transient elevation of serum aminotransferase may occur during treatment, and symptoms of hepatotoxicity may occasionally occur, especially in patients with serious underlying diseases (such as AIDS and cancer).
Headache and dizziness may be seen.
Some patients, especially those with serious underlying medical conditions (such as AIDS and cancer), may develop abnormal kidney function.
Changes in hematological test indicators such as transient neutropenia and thrombocytopenia in peripheral blood may occasionally occur, especially in patients with serious underlying diseases (such as AIDS and cancer).
Contraindications:
People with a history of allergies to this drug or other imidazole drugs are prohibited from using it.
Note:
This product may cause cross-allergic reactions with other azole drugs, so this product is prohibited for those who are allergic to any azole drug.
Since this product is mainly excreted from the kidneys, patients with renal insufficiency need to regularly check their renal function during treatment.
The course of application of this product should depend on the site of infection and individual treatment response. General treatment should be continued until the clinical manifestations of fungal infection and laboratory test indicators show that the fungal infection disappears. AIDS patients with cryptococcal meningitis or recurrent oropharyngeal candidiasis require long-term maintenance treatment with this product to prevent recurrence.
If severe neutropenia has already occurred in patients who have received bone marrow transplantation, this product should be used prophylactically until 7 days after the neutrophil count rises to above 1×109/L.
For patients with renal function impairment, the dosage can be adjusted according to the above plan; hemodialysis patients can be given a daily dose of this product after each dialysis, because 3 hours of hemodialysis can reduce the blood concentration of this product by about 50%.
Storage:
Seal and store in a dry place.
Mechanism of action:
Fluconazole belongs to the azole antifungal class. Broad antifungal spectrum. This product is effective for oral administration and intravenous injection of fungal infections in humans and various animals, such as Candida infection (including systemic candidiasis in people and animals with normal or immunocompromised immunity), Cryptococcus neoformans infection (including intracranial infection), Malassezia furfur, Microsporum spp., Trichophyton spp., Epidermophyton spp., Blastomyces dermatitidis, Coccidioides immitis (including intracranial infection), Histoplasma capsulatum, Chromobacterium fischeri, Cladosporium carinii, etc. The in vitro antibacterial activity of this product is significantly lower than that of ketoconazole, but the in vivo antibacterial activity of this product is significantly higher than the in vitro effect. The main mechanism of action of this product is to highly selectively interfere with the activity of fungal cytochrome P-450, thereby inhibiting the biosynthesis of ergosterol on the fungal cell membrane.