1 May 2026Oral drugsSource update: September 2023
Fluconazole oral
Fluconazole guidance for candidiasis, cryptococcal meningitis, and secondary prophylaxis, with renal, hepatic, and QT precautions.
Prescription under medical supervision
This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.
Therapeutic action
Antifungal.
Indications
- Oesophageal candidiasis.
- Moderate to severe oropharyngeal candidiasis.
- Secondary prophylaxis of recurrent candidiasis in immunocompromised patients.
- Cryptococcal meningitis, after treatment with amphotericin B plus flucytosine or in combination with amphotericin B or flucytosine.
- Secondary prophylaxis of cryptococcal infections.
Forms and strengths
- 50 mg and 200 mg capsules.
- 50 mg/5 ml oral suspension.
Dose and duration
Oesophageal candidiasis, oropharyngeal candidiasis, secondary prophylaxis of recurrent candidiasis
The treatment lasts 14 to 21 days for oesophageal candidiasis, 7 to 14 days for oropharyngeal candidiasis, and as long as required for secondary prophylaxis.
- Child 1 month and over: 3 to 6 mg/kg, maximum 200 mg, once daily.
- Adult: 50 to 200 mg, maximum 400 mg, once daily.
Cryptococcal meningitis after treatment with amphotericin B + flucytosine
- Child >= 1 month: 12 mg/kg once daily for 1 week, then 6 to 12 mg/kg once daily for 8 weeks, maximum 800 mg once daily.
- Adult: 1200 mg once daily for 1 week then 800 mg once daily for 8 weeks.
Cryptococcal meningitis in combination with amphotericin B or flucytosine
- Child >= 1 month: 12 mg/kg once daily for 2 weeks with amphotericin B or flucytosine, then 6 to 12 mg/kg once daily for 8 weeks, maximum 800 mg once daily.
- Adult: 1200 mg once daily for 2 weeks with amphotericin B or flucytosine, then 800 mg once daily for 8 weeks.
Secondary prophylaxis of cryptococcal infections
- Child: 6 mg/kg, maximum 200 mg, once daily as long as required.
- Adult: 200 mg once daily as long as required.
Contra-indications, adverse effects, precautions
- Administer with caution to patients with hepatic or renal impairment and cardiac disorders.
- Reduce the dose by half in patients with renal impairment.
- May cause gastrointestinal disturbances, headache, severe skin reactions, anaphylactic reactions, hepatic disorders, haematologic disorders, and QT prolongation. Stop treatment in the event of anaphylactic reaction, hepatic disorders, or severe skin reaction.
- In prolonged treatment, monitor hepatic function.
- Do not administer simultaneously with rifampicin; administer 12 hours apart.
- Avoid or monitor combination with drugs that prolong the QT interval and with warfarin, carbamazepine, phenytoin, rifabutin, benzodiazepines, calcium-channel blockers, and certain antiretrovirals because concentrations may increase.
- Pregnancy and breast-feeding: use only in severe or life-threatening infections, particularly during the first trimester.
Dosage and duration
| After treatment with amphotericin B + flucytosine | Child ≥ 1 month | 12 mg/kg once daily for 1 week then 6 to 12 mg/kg once daily for 8 weeks Max. 800 mg once daily |
|---|---|---|
| Adult | 1200 mg once daily for 1 week then 800 mg once daily for 8 weeks | |
| or | ||
| In combination with amphotericin B or flucytosine | Child ≥ 1 month | 12 mg/kg once daily for 2 weeks (with amphotericin B or flucytosine) then 6 to 12 mg/kg once daily for 8 weeks Max. 800 mg once daily |
| Adult | 1200 mg once daily for 2 weeks (with amphotericin B or flucytosine) then 800 mg once daily for 8 weeks |
Source
MSF Essential drugs practical guidelines (January 2026)
This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.
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