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The route of drug administration is determined according to the clinical condition of the patient.
Oral formulations are absorbed quickly and almost completely, so the dosage of oral formulations (capsules, dry syrup) and injection formulations is the same.
○ Adult
1. Vaginal candidiasis: As fluconazole, a single oral administration of 150 mg
2. Mucosal candidiasis
1) Oropharyngeal candidiasis: This drug is usually administered at 50 mg once a day for 7-14 days. have.
2) Chronic atrophic oral candidiasis (pain in the mouth due to dentures): This drug is usually administered at 50 mg once a day for 14 days, and local disinfection of dentures is required.
3) Other mucosal candidiasis (esophageal candidiasis except vaginal candidiasis, noninvasive bronchopulmonary infection, candidiasis, cutaneous mucosal candidiasis, etc.) may be increased to 100 mg once a day.
3. Systemic candidiasis, including candidiasis, disseminated candidiasis and other invasive candida infections (peritoneum, endocardium, lung, urinary system, etc.) mg, and depending on the patient's response, the dose can be increased to 400 mg once a day. The duration of administration is determined according to clinical response and medical judgment.
4. Cryptococcal meningitis and cryptococcus in other sites: As this drug, 400 mg is usually administered on the first day, and 200-400 mg is administered once a day from the next day. The duration of treatment is determined by clinical and fungal responses, but usually it should be administered for at least 6 to 8 weeks.
5. To prevent recurrence of cryptococcal meningitis in AIDS patients, after the patient has received all basic treatment, administer 200 mg once a day indefinitely as this drug.
6. Prevention of fungal infection in immunocompromised patients at risk of fungal infection due to neutropenia due to cytotoxic chemotherapy, radiotherapy, or bone marrow transplant -400 mg should be administered. For patients at very high risk of systemic fungal infection, i.e., patients with severe neutropenia such as bone marrow transplantation or who are expected to have a long period of neutropenia, 400 mg once a day is recommended. To these patients, 400 mg should be administered 5-6 days before the onset of neutropenia, and 400 mg should be continued for 1 week after the neutrophil count has increased to more than 1,000 cells/mm3.
7. Administer 150 mg once a week for onychomycosis, and the administration period is until the hands and toenails grow back (until new uninfected hands and toenails grow). It usually takes 3-6 months for new nails to grow, and 6-12 months for toenails, and the growth rate may vary depending on individual age. After successful treatment with long-term administration, sometimes the hands and toenails remain damaged.
Skin fungal infections including athlete's foot (tinea pedis), ringworm of the body, tinea groin (tinea groin), and skin candidiasis: This drug is usually administered at 50 mg once a day or 150 mg once a week for 2-4 weeks. However, in the case of athlete's foot, administration for 6 weeks may be necessary depending on the progress. For rhinitis, 50 mg once a day is administered for 2-4 weeks.
○ For pediatric
doses based on adult doses, the following criteria are generally applied, and the maximum dose does not exceed 400 mg. (Refer to the description of the evidence table)
However, safety and efficacy for infants under 6 months of age have not been established (refer to precautions for use).
1. Oropharyngeal candidiasis
As this drug, 6 mg/kg of body weight is administered on the first day, and 3 mg/kg of body weight is administered once a day from the next day. It should be administered for at least 2 weeks to prevent recurrence.
2. Esophageal candidiasis
As this drug, the dose is 6 mg/kg of body weight on the first day, and 3 mg/kg of body weight is administered once a day from the next day. Depending on the patient's response, the dose may be increased to 12 mg/kg body weight once a day. Administer for at least 3 weeks and at least 2 weeks after symptoms disappear.
3. Systemic candidiasis, including candidiasis, disseminated candidiasis and other invasive candidiasis (peritoneal, endocardial, pulmonary, urinary system, etc.),
6-12 mg/kg body weight once daily. The duration of administration is determined according to clinical response and medical judgment.
4. Cryptococcus meningitis
As this drug, 12 mg/kg of body weight is administered on the first day, and 6 mg/kg of body weight is administered once a day from the next day. Depending on the patient's response, the dose may be increased to 12 mg/kg body weight once a day. The treatment period is 10-12 weeks after the cerebrospinal fluid culture is negative.
5. To prevent recurrence of cryptococcal meningitis in AIDS patients, administer 6 mg per kg of body weight once a day after the patient has received all basic treatment.
6. Children with renal impairment should increase the dosing interval and decrease the dose according to the degree of renal impairment, based on the same standards as adult patients with renal impairment. When administering a dose of less than 10 mg, a syrup should be administered orally or an injection should be administered according to the clinical condition of the child in order to adjust the correct amount.
○ Elderly
In the case of normal renal function, the adult dose is usually administered. In the case of renal impairment (creatinine clearance of 50 mL/min or less), the dose should be reduced or the interval between administrations should be increased.
○ Patients with renal impairment
This drug is mainly excreted through urine unchanged. In case of single administration, there is no need to adjust the dose. However, if multiple administrations are required, the usual dose should be administered only on the first day of administration, and the dose should be adjusted as follows from the next day.
(Refer to the manual of the recommended dosage table according to the creatine clearance)
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