Biozole Dosage/Direction for Use

The daily dose of fluconazole should be based on the nature and severity of the fungal infection. Most cases of vaginal candidiasis respond to single dose therapy. Therapy for those types of infections requiring multiple dose treatment should be continued until clinical parameters or laboratory tests indicate that active fungal infection has subsided. An inadequate period of treatment may lead to recurrence of active infection. Patients with AIDS and cryptococcal meningitis or recurrent oropharyngeal candidiasis usually require maintenance therapy to prevent relapse.
Adults: For cryptococcal meningitis and cryptococcal infections at other sites: The usual dose is 400 mg on the first day followed by 200 mg once daily. Depending on the clinical response of the patient this dose may be increased to 400 mg daily. Usually, duration of treatment for cryptococcal meningitis is 6-8 weeks.
For the prevention of relapse of cryptococcal meningitis in patients with AIDS: After the patient receives a full course of primary therapy. Fluconazole may be administered indefinitely at a daily dose of at least 200 mg.
For candidemia, disseminated candidiasis and other invasive candidal infections: The usual dose is 400 mg on the first day followed by 200 mg daily. Depending on the clinical response, the dose may be increased to 400 mg daily. Duration of treatment is upon the clinical response.
For oropharyngeal candidiasis: The usual dose is 50 mg once daily for 7-14 days. If necessary, treatment can be continued for longer periods in patients with severely compromised immune function.
For atrophic oral candidiasis associated with dentures: The usual dose is 50 mg once daily for 14 days administered concurrently with local antiseptic measures to the denture.
For other candidal infections of mucosa, (except vaginal candidiasis, see the following): E.g. oesophagitis, non-invasive bronchopulmonary infections, candiduria, mucocutaneous candidiasis, etc. the usual effective dose is 50 mg daily, given for 14-30 days. In unusually difficult cases of mucosal candidal infections, the dose may be increased to 100 mg daily.
For vaginal candidiasis: Fluconazole 150 mg should be administered as a single oral dose.
For the prevention of fungal infections in patients with malignancy: The dose should be 50 mg once daily while the patients is at risk as a consequence of receiving cytotoxic chemotherapy or radiotherapy.
For dermal infections: Including tinea pedis, tinea corporis, tinea cruris and Candida infections the recommended dosage is 150 mg once weekly or 50 mg once daily. Duration of treatment is normally 2-4 weeks but tinea pedis require treatment for up to 6 weeks. For tinea versicolor, the recommended dose is 50 mg once daily for 2-4 weeks.
The recommended fluconazole dosage for the prevention of candidiasis is 50 to 400 mg once daily, based on the patients risk for developing fungal infection while receiving cytotoxic chemotherapy or radiotherapy. For patients at high risk of systemic infection, e.g., patients who are anticipated to have profound or prolonged neutropenia, the recommended daily dose is 400 mg once daily. Fluconazole administration should start several days before the anticipated onset of neutropenia and continue for 7 days after the neutrophil count rises above 1000 cells per mm³.
For tinea unguium (onychomycosis): The recommended dosage is 150-450 mg once weekly for 3-12 months or treatment should be continued until infected nail is replaced (uninfected nail grown in).
Children: Although, as stated in the precautions section, use in children below the age of 16 is not recommended, where the treating physician considers. Fluconazole therapy imperative, the following doses are proposed: For children aged >1 year with normal renal function: The recommended daily dose is 1-2 mg/kg for superficial candidal infections, and 3-6 mg/kg for systemic candidal/cryptococcal infections.
For children with impaired renal function: The daily dose should be reduced in accordance with the guidelines given for adults, dependent on the degree of renal impairment.
Use in children 4 weeks of age and younger: Neonates excrete fluconazole slowly. In the first two weeks of life, the same mg/kg dosing as in older children should be used but administered every 72 hours. After the first two weeks, these children should be dosed once daily.
Use in Elderly: Where there is no evidence of renal impairment, normal dosage recommendations should be adopted. For patients with renal impairment (creatinine clearance <40 mL/min.) the dosage schedule should be adjusted as described in the following table.
Patients with renal impairment: Fluconazole is predominantly excreted in the urine as unchanged drug. No adjustments in single-dose therapy are necessary. In multiple-dose treatment of patients with renal impairment, normal doses should be given on days 1 and 2 of treatment and thereafter the dosage intervals should be modified in accordance with creatinine clearance as described in the following table. (See table.)

Click on icon to see table/diagram/image