Application

Treatment of fungal diseases - it is always a problem, just as it did not look all advertising antifungals (took and forgot about thrush). The fact is that almost all of antifungal drugs have a lot of side effects, so they must appoint a doctor with all the indications and contraindications.

What is fluconazole and its mechanism of action

Fluconazole - is an antifungal agent that acts directly on the pathogenic fungi by inhibiting the activity of enzymes, thereby increasing the permeability of the cell membrane and disturbing the growth and reproduction of fungi.

Indications for receiving fluconazole

Fluconazole is active at a candidiasis such as thrush (oral mucosa lesions and genital) candidiasis light Candidiasis light: why it is so difficult to diagnose? Disseminated forms of candidiasis in the background immunity disorders, in some intracranial infections caused by fungi, Microsporum and Trichophyton (fungal skin disease), fungal diseases of the feet, nails, body, groin and other diseases caused by fungi.

Apply fluconazole for prophylaxis of fungal infections in cancer patients on chemotherapy Chemotherapy - it always falls the hair?   or radiation therapy. Fluconazole is also the best preparation for the prevention of common Candida infections after bone marrow transplantation. Introduction fluconazole orally for 75 days after bone marrow transplantation effectively reduces the risk of surface (skin and mucosa) and invasive (internal organs) candidal infection and death from candidiasis. Thereby increasing the survival rate of patients after bone marrow transplantation.

As used fluconazole

Fluconazole administered orally and intravenously. Dosage and duration of treatment depends on the type and severity of fungal disease. For example, when meningitis fluconazole take at least 6-8 weeks in stomatitis Stomatitis - to breath fresh   Sometimes it 7-10 days, vaginal candidiasis Thrush - vaginal candidiasis: when to go to the doctor?   it is used only once.

With care prescribe fluconazole patients with renal and hepatic impairment.

Treatment is carried out under the mandatory laboratory control (detection of pathogenic fungi laboratory methods), otherwise there may be recurrent infection. During treatment, checked blood counts, kidney and liver function.

Contraindications Fluconazole

Contraindications Fluconazole is, above all, increased sensitivity to the drug. C care should be given fluconazole for severe kidney disease (eg, in infectious and allergic diseases of the kidney) and liver (hepatitis, cirrhosis). Contraindications Fluconazole is pregnancy, lactation and age (for children up to 6 months, it is not indicated).

Since fluconazole adversely affects the liver, should not be receiving during his take other substances that have a similar effect on the liver: alcohol, some drugs (the doctor knows what medication it).

What can happen when drug overdose

At fluconazole overdose may appear hallucinations (seeing, hearing what is actually there), paranoid (delusional, with obsessions, when it seems that someone is following or to kill, and so on) behavior.

When the first symptoms of overdose have to call an ambulance. Treatment of such patients is carried out in the hospital, they washed the stomach is carried out forced diuresis (plenty of fluids are administered in combination with diuretics). If this does not help, hemodialysis (cleansing of the blood).

What happens if I take fluconazole with other medications

Fluconazole enhances the effectiveness of certain drugs such as coumarin anticoagulants (medicines are taken for the prevention of thrombus formation), as well as some other drugs. For this reason, fluconazole should be administered only by a physician, and all treatment should take place under its control.

Fluconazole - highly effective anti-fungal drug, so it has a lot of contraindications and restrictions for use. To understand all this and to monitor the healing process the patient alone can not.

The dosage regimen of fluconazole

Adult patients

Vaginal candidiasis:

• 150 mg orally - a single dose.

Thrush of the mouth:

• 200 mg on the first day followed by 100 mg orally or intravenously once per day.
• Therapy should last for at least two weeks, to reduce the likelihood of recurrence.
• Oral fluconazole 100-200 mg per day is recommended for long-term suppressive or maintenance therapy, the aim of which is to prevent relapse of oropharyngeal candidiasis in HIV-infected patients who had previously been frequent or severe recurrences of the disease.

Candidemia (candida septicemia):

• Systemic candidiasis: 400 mg on the first day followed by 200 mg intravenously or orally administered once a day.
• For systemic candidiasis (including candidemia, disseminated candidiasis and pneumonia) is not determined the optimal therapeutic dose and duration of treatment. Typically prescribed doses up to 400 mg per day.
• Treatment should be continued for at least four weeks, and at least two weeks after the disappearance of symptoms.

Fungal pneumonia:

• 400 mg on the first day followed by 200 mg intravenously or orally administered once a day.
• Therapy should last at least four weeks, and at least two weeks after the symptoms disappear completely.

Disseminated fungal infection:

• 400 mg on the first day followed by 200 mg intravenously or orally administered once a day.
• Treatment should be continued for at least four weeks, and at least two weeks after the disappearance of symptoms.

Esophageal candidiasis:

• 200 mg on the first day followed by 100 mg orally or intravenously once per day. Depending on the degree of effectiveness of therapy can be administered dose up to 400 mg per day.
• Therapy should last at least three weeks, at least two weeks after the disappearance of symptoms.
• To prevent the recurrence of esophageal candidiasis in HIV-infected patients who had previously been observed frequent or severe episodes of infection, it can be assigned to long-term use of fluconazole 100-200 mg per day orally.

Candida infections of the urinary tract:

• From 50 to 200 mg orally or intravenously once per day.

Fungal peritonitis:

• From 50 to 200 mg orally or intravenously once per day.

Cryptococcal meningitis (patients with normal immunity):

• 400 mg on the first day, then from 200 to 400 mg intravenously or orally administered once a day. The dose may be increased or decreased depending on how the patient responds to the treatment.
• Treatment should be continued for 10-12 weeks after assays cryptococcal meningitis Cryptococcal meningitis - a serious illness   give negative results. In addition, within one year, the patient must undergo regular medical examinations, since at this time is stored an increased risk of relapse.

Cryptococcal meningitis (immunocompromised patients):

• The treatment takes place as well as in patients with normal immunity Immunity - types and characteristics in children in adults . However, AIDS patients after standard treatment may be assigned to long-term use of fluconazole 200 mg per day for the prevention of recurrence.

Prevention of fungal infection:

• Prevention of candidiasis in patients who underwent bone marrow transplantation: 400 mg orally or intravenously once per day.
• If there is a possibility of severe granulocytopenia can also be assigned to treatment with fluconazole, which should continue for seven days after a patient's blood tests will bounce.

Coccidiosis meningitis Meningitis - an inflammation of the meninges :

• From 200 to 800 mg intravenously or orally administered once a day.
• AIDS may be assigned to reception from 400 mg to 800 mg per day of fluconazole.
• To prevent recurrence of therapy should be continued for one year after the results of tests have come back to normal. Many experts believe that the most effective administration of fluconazole prophylaxis should be continued until the end of life.

Coccidioidomycosis:

• 400 mg orally or intravenously once per day.
• The duration of treatment varies from a few months to several years. Many patients relapse cases. HIV-positive and AIDS patients are advised to take fluconazole for life.

Cryptococcosis:

• 400 mg orally or intravenously once per day.
• The duration of therapy is about eight weeks. In the future, patients should be screened at least once a year. To prevent a recurrence (usually in patients with HIV and AIDS) can be assigned to long-term use of fluconazole 200 mg daily.

Histoplasmosis:

• From 400 to 800 mg intravenously or orally administered once a day.
• The duration of treatment ranged from 6 to 12 months.

Chronic mucocutaneous candidiasis:

• From 100 to 200 mg orally or intravenously once per day.
• Typically, patients require long-term maintenance therapy.

Blastomycosis:

• From 400 to 800 mg orally once daily.
• Therapy should last at least six months.

Onychomycosis:

• From 150 to 300 mg orally once a week.
• Duration of therapy - from six to twelve months.

Children

The standard dose for children with candidiasis of the esophagus:

• Children under the age of two weeks from 3 to 12 mg per kilogram of body weight, orally or intravenously every 72 hours.
• Children under the age of two weeks of 6 mg per kilogram of body weight on the first day, followed by 3 mg per kilogram intravenously or orally once a day. If necessary, the dose may be increased to 12 mg / kg.
• Treatment should be continued for at least three weeks, and at least two weeks after the disappearance of symptoms.

The standard dose for children with thrush of the oral cavity:

• Children under the age of two weeks 3 mg / kg orally or intravenously every 72 hours.
• Children older than two weeks: 6 mg / kg on the first day, followed by 3 mg / kg orally or intravenously once per day.
• To reduce the likelihood of relapse, treatment should last at least two weeks.

The standard dose for children when candidemia:

• Children under the age of two weeks from 6 to 12 mg / kg intravenously or orally every 72 hours.
• Children under the age of two weeks from 6 to 12 mg / kg / day, intravenously or orally.

The standard dose for children under disseminated fungal infection Fungal infection: to prevent and defeat :

• Children under the age of two weeks from 6 to 12 mg / kg intravenously or orally every 72 hours.
• Children under the age of two weeks from 6 to 12 mg / kg / day, intravenously or orally.

The standard dose for children in cryptococcal meningitis:

• Children under the age of two weeks from 6 to 12 mg / kg intravenously or orally, every 72 hours.
• Children older than two weeks, 12 mg / kg on the first day, then from 6 to 12 mg / kg intravenously, or orally once a day.
• Treatment should continue for 10-12 weeks after the child's condition normalized.
• To prevent cryptococcal menangita children suffering from AIDS, can be assigned to receive 6 mg / kg of fluconazole per day.