Fluconazole (Diflucan) (PO, IV)

Criteria & Principles

Protected Antimicrobial Warning:

Fluconazole requires advisory guidance due to identified overuse and misuse causing negative collateral damage (e.g., adverse effects, antimicrobial resistance). Prescribing feedback will be monitored based on below guideline.

Usual Dose & Administration

Usual Adult Dose

200-400 mg q24h

Adjustment of Dose & Administration

Indication-Specific Adjustment

Single dose indications:

• Mild intertrigo: 200 mg once
• Candida vaginitis: 150 mg once

Prophylaxis:

• Hematology Oncology (HOA) Anti-infective Prophylaxis Protocol
• Adult Stem Cell Transplantation Infection Prophylaxis Guidelines

Adult Mild to Moderate Infections:

Adult Invasive/Serious Infections (ID Consult Required for Candidemia):

Renal Adjustment

See above dosing table

Drug-Specific Information

Oral bioavailability approximately 100%. Therefore, consider oral formulation unless patient unable to take oral medication, severe infections, or when concerns exist regarding absorption.

Dose conversion: 1:1 IV to PO

Cost Index

$ (1-10)

General Notes

1. Up to date cost information for select antimicrobials can be found on the Antimicrobial Cost Chart page.
2. Information about how to administer select IV antimicrobials outpatient (OPAT) is found on the Outpatient Antibiotic Administration Chart page.
3. When dosing guidance is provided it is important to note the following:

Fixed (i.e. non-weight-based) doses in adults are historically based on a 70 kg patient. Specific disease states or individual patients may warrant dosages that differ from the above recommendations. Since product-specific criteria for dose adjustment based on creatinine clearance exist, consult product information regarding specific recommendations for dosage adjustment based on estimated creatinine clearance.