Drug Characteristics
  • Formulation

    Capsules: 50mg, 150mg, 200mg

    Suspension: 50mg/5ml, 200mg/5ml

    Injection: 2mg/ml (25ml, 100ml)

  • Dose

    Candida treatment:

    Oropharyngeal candidiasis: 50-100mg orallt once a day for 7-14 days. Up to 200mg orally once a day can be given to patients with severe oral candida

    Oesophageal candidiasis 50–100mg orally once a day for 14–21 days.

    In severe disease, dose up to 400mg daily

    Cryptococcal meningitis:

    Second-line initial therapy (when intolerant of amphotericin or mild infection)

    400 mg orally/IV twice a day for up to 10 weeks (dose adjusted according to clinical / mycological response)

    Consolidation therapy (CNS/lung/disseminated): 400 mg orally daily 2 weeks after induction therapy and may be reduced to 200 mg daily after 10 weeks

    Therapy may be discontinued following immune restoration with cART

    Cryptococcal pneumonia:

    400 mg once a day for 10 weeks then 200 mg as maintenance dose

    Histoplasma capsulate:

    Fluconazole 800 mg orally once a day for up to 12 months. Less effective than other second-line treatment with itraconazole

  • Side Effects

    Gastrointestinal disturbances (nausea, diarrhoea, abdominal discomfort, flatulence); headache; rash

  • Interactions

    Fluconazole is metabolized by cytochrome P450 isoenzymes (although less so than other ‘azoles’)


    Concomitant use of nevirapine has been shown to result in an increased exposure of nevirapine by 100% and potentially greater risk of hepatotoxicity

    Zidovudine levels may also be increased with fluconazole

    Increased risk of uveitis with rifabutin

    Rifampicin may decrease efficacy of fluconazole (to a lesser extent than with other ‘azoles’)

    Warfarin effect enhanced

    Plasma concentrations of sulphonylureas increased by fluconazole

    Phenytoin effect enhanced by fluconazole

    Terfenadine and astemizole contraindicated due to risk of arrhythmias        

  • Renal

    GFR 11–50: Day 1: dose as normal followed by 50% of normal dose

    Alternative dosing (Renal Handbook)

    GFR 10-50: Dose as in normal renal function

    GFR <10: 50% of normal dose

  • Hepatic

    Monitor and use with caution in patients with hepatic dysfunction

    No dosage recommendations are available        

  • Pregnancy

    Human Data Suggest Risk (>400mg/day)

  • Other Information