【缺藥訊息】 公告日期：2023/6/12。 缺藥品項：Diflucan 膠囊 50mg。 缺藥原因：因製造廠排程問題缺藥。 替代藥品：國內有同成份規格替代品。 配套措施：採購替代品，庫存量用罄關檔停用，替代品預計於2023/6/15到貨 (依照實際到貨日為準)。

黴菌感染
1. Candidiasis (esophageal, oropharyngeal, peritoneal, urinary tract, vaginal); Systemic candida infections (candidemia, disseminated candidiasis, pneumonia)
2. Cryptococcal meningitis
3. Antifungal prophylaxis in allogeneic hematopoietic cell transplant recipients
#仿單變更2021

Antifungal Agent, Azole Derivative
Interferes with fungal cytochrome P450 activity (lanosterol 14-α-demethylase), decreasing ergosterol synthesis (principal sterol in fungal cell membrane) and inhibiting cell membrane formation

Absorption:
1. Well absorbed; food does not affect extent of absorption
2. Bioavailability: >90%
3. Time to peak, serum: 1 to 2 hours
Distribution:
1. Vd: (children age 5 to 15 years) 0.722 to 1.069 L/kg
2. Protein binding: 11% to 12%
Excretion:
1. Renal: approximately 80% unchanged, 11% as metabolite
2. Dialyzable: yes (hemodialysis), 50% removed in 3 hours

1. Hypersensitivity to fluconazole or any component of the formulation (cross-reaction with other azole antifungal agents may occur; use caution)
2. Coadministration with CYP3A4 substrates, which may lead to QTc prolongation (eg, erythromycin, pimozide, quinidine)

D [FDA.AUS]

Infant risk is minimal

Nausea, vomiting, elevation in liver function tests, hypokalemia

Candidemia:
1. For initial therapy: Loading dose of 800 mg (or 12 mg/kg) on day 1, then 400 mg (or 6 mg/kg) once daily; if fluconazole-susceptible Candida glabrata isolated, transition to 800 mg (or 12 mg/kg) once daily
2. For step-down therapy: 400 mg (or 6 mg/kg) once daily
Cardiac device infection (eg, implantable cardiac defibrillator, pacemaker, ventricular assist device), CNS infection, endocarditis:
400 to 800 mg (or 6 to 12 mg/kg) once daily for 4 to 6 weeks
Esophageal infection:
1. For treatment: 400 mg (or 6 mg/kg) on day 1, then 200 to 400 mg (or 3 to 6 mg/kg) once daily for 14 to 21 days
2. For chronic suppression for recurrent infection: 100 to 200 mg once daily
Intra-abdominal infection:
800 mg (or 12 mg/kg) on day 1, then 400 mg (or 6 mg/kg) once daily; Total antifungal duration is ≥14 days based on source control and clinical response
Oropharyngeal:
200 mg on day 1, then 100 to 200 mg once daily for 7 to 14 days
Peritonitis:
200 mg on day 1, then 100 to 200 mg once daily for 2 to 4 weeks
Urinary tract infection:
200 to 400 mg (or 3 to 6 mg/kg) once daily for 2 weeks
Cryptococcal meningitis:
1. For HIV patients, consolidation: 400 mg once daily for ≥8 weeks following induction with the preferred regimen of amphotericin B and flucytosine
2. For HIV patients, maintenance: 200 mg once daily for ≥12 months; may discontinue if completed induction, consolidation, and 12 months of maintenance therapy, patient remains asymptomatic, and CD4 count has been 100 cells/mm3 for 3 months and HIV RNA is suppressed in response to effective antiretroviral therapy
3. For HIV-uninfected patients, consolidation: 400 to 800 mg once daily for 8 weeks (800 mg once daily preferred for patients who receive a 2-week induction course)
4. For HIV-uninfected patients, maintenance: 200 to 400 mg once daily for 6 to 12 months

Not recommended in children <18 years of age

1. ClCr >50ml/min: No dosage adjustment necessary
2. ClCr< 50ml/min: 50% of usual daily dose

There are no dosage adjustments provided in the manufacturer's labeling; use with caution.