IV infusion at a rate not over 200mg/hr.
Adult
Bone marrow transplant – Candidiasis, Prophylaxis: 400 mg qd;
patients ?who are anticipated to have severe granulocytopenia (less
than 500 neutrophils per cubic millimeter) should start prophylaxis
several days before the anticipated onset of neutropenia, and
continue for 7 days after the neutrophil count rises above 1000
cells per cubic millimeter.
Candida endophthalmitis: 6 - 12 mg/kg daily for at least 4 to 6 wk.
Candida pyelonephritis: 200- 400 mg (3 - 6 mg/kg) daily for 2
weeks
Candidemia: loading dose, 800 mg, followed by 400 mg (6 mg/kg)
daily; continue for 14 days after first negative blood culture result
and resolution of signs and symptoms of candidemia.
Candidemia (catheter-related candidemia): 400 - 600 mg daily.
Candidiasis, systemic candidiasis: up to 400 mg qd for 4 to 6 wk.
Candidiasis, Cardiovascular infection: initial or as step-down
therapy, 400 - 800 mg (6 - 12 mg/kg) daily.
Candidiasis, Osteoarticular infection: 400 mg (6 mg/kg) daily for at
least 6 wk (septic arthritis) or for 6 to 12 months (osteomyelitis).
Candidiasis of the esophagus: 200-400 mg (3 - 6 mg/kg) daily for
14 to 21 days; or 200 mg on the first day, then 100 mg qd (Max, 400
mg/day) for at least 3 weeks; continue treatment for at least 2
weeks following resolution of symptoms.
Candidiasis of the esophagus, Recurrent: 100 to 200 mg three
times weekly.
Candidiasis of urogenital site (asymptomatic cystitis (undergoing
?urologic procedures) and urinary fungus balls): 200 -400 mg (3 –
6 mg/kg) daily.
Candidiasis of urogenital site (symptomatic cystitis): 200 mg (3
mg/kg) daily for 2 weeks.
Candidiasis of urogenital site: 50- 200 mg daily .
Central nervous system candidiasis: initial or as step-down therapy,
400 – 800 mg (6- 12 mg/kg) daily until resolution of clinical and
laboratory parameters.
Coccidioidomycosis: 400- 800 mg/day; up to 2000 mg daily has
been used for disseminated infection.
Cryptococcal meningitis, consolidation: 400 mg daily for at least 10
weeks following induction therapy.
Cryptococcal meningitis: 400 mg on day 1, then 200 mg once daily
(Max. 400 mg qd); treat for 10 to 12 weeks after the cerebrospinal
fluid becomes culture negative.
Cryptococcal meningitis - HIV infection, induction: 400 mg daily
with amphotericin B 0.7 mg/kg IV daily or lipid formulation
amphotericin B 4 to 6 mg/kg IV daily for at least 2 weeks ; OR,
400 - 800 mg daily with flucytosine 25 mg/kg PO four times daily
for 4 to 6 weeks.
Cryptococcal meningitis - HIV infection: 400 mg on day 1, then
200 mg qd (Max. 400 mg qs); treat for 10 to 12 weeks after the
cerebrospinal fluid becomes culture negative. For suppression of
relapse of cryptococcal meningitis in patients with AIDS, the
recommended dose is 200 mg qd.
Cutaneous sporotrichosis: 400 to 800 mg daily; continue for 2 to 4
wk after ?all lesions have healed
Disseminated candidiasis, chronic: 400 mg (6 mg/kg) daily.
Disseminated candidiasis, Prophylaxis (solid-organ transplant
recipients): 200 - 400 mg (3 - 6 mg/kg) daily for 7 to 14 days.
Disseminated candidiasis, Prophylaxis (high-risk ICU patients,
stem cell transplant recipients with neutropenia,
chemotherapy-induced neutropenia): 400 mg (6 mg/kg) daily.
Empirical antifungal therapy, Suspected candidiasis: loading dose,
800 mg , followed by 400 mg (6 mg/kg) daily.
HIV infection - Oropharyngeal candidiasis, Prophylaxis:
100 mg three times weekly.
HIV infection - Pulmonary cryptococcosis (mild-to-moderate
pulmonary disease): preferred therapy, 200 - 400 mg/day, lifelong.
HIV infection - Pulmonary cryptococcosis: (mild-to-moderate
pulmonary disease) :alternative therapy, 400 mg/day with
flucytosine 100 - 150 mg/kg/day PO in divided doses for 10 weeks.
Lymphocutaneous sporotrichosis: 400 - 800 mg daily;
continue for 2 to 4 wk after all lesions have healed.
Oropharyngeal candidiasis: 200 mg on the first day, then 100 mg
qd for at least 2 weeks to decrease the likelihood of relapse.
Pulmonary cryptococcosis (asymptomatic with positive lung
culture for Cryptococcus neoformans): 200- 400 mg/day for 3 to 6
months.
Pulmonary cryptococcosis (mild-to-moderate disease): 200 - 400
mg/day for 6 to 12 months.
Pulmonary cryptococcosis (severe disease) consolidation:
400 mg daily for at least 10 weeks following induction therapy with
amphotericin B and flucytosine.
Pediatric3 6 mo:
Candidemia:6- 12 mg/kg/day.
Candidiasis, systemic candidiasis:,6 - 12 mg/kg/day.
Candidiasis of the esophagus: 6 - 12 mg/kg/day on day 1, then 3
mg/kg/day (Max. 12 mg/kg/day) qd for at least 3 weeks; continue
treatment for 2 weeks following resolution of symptoms.
Cryptococcal meningitis: 12 mg/kg on day 1, then 6 mg/kg/day
(Max. 12 mg/kg/day) for 10 to 12 weeks after the cerebrospinal
fluid becomes culture negative.
Cryptococcal meningitis - HIV infection, induction: 12 mg/kg on
day 1, then 6 - 12 mg/kg qd (Max. 800 mg/day) in combination
with flucytosine 25 mg/kg PO four times daily for minimum of 2
weeks.
Cryptococcal meningitis - HIV infection, consolidation: 12 mg/kg
on day 1, then 6 - 12 mg/kg qd (Max. 800 mg/day) for a minimum
of 8 weeks.
Cryptococcal meningitis - HIV infection: 12 mg/kg on day 1, then
6 mg/kg/day (Max. 12 mg/kg/day) for 10 to 12 weeks after the
cerebrospinal fluid becomes culture negative.
Disseminated candidiasis, Prophylaxis, (high-risk, birthweight
less than 1000 g): 3 or 6 mg/kg ?twice weekly; a 6-week course of
3 mg/kg twice weekly was used in 1 clinical trial.
Neonatal candidiasis: 12 mg/kg daily for 3 weeks.
Oropharyngeal candidiasis: 6 mg/kg/day on day 1, then 3
mg/kg/day qd for at least 2 weeks to decrease the likelihood of
relapse. |
