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Palliative cancer care - oral problems - Management
What dose of fluconazole should I use?
- For the treatment of oral candidiasis:
- Adults with mild oral candidiasis not responding to topical therapy: fluconazole 50 mg daily for 7 days.
- Adults who have severe oral candidiasis: fluconazole 100 mg daily for 7 to 14 days depending on response.
- Oral suspension is the preferred formulation because this can be swirled in the mouth before swallowing, producing both topical and systemic effects.
- As fluconazole is predominately excreted by the kidneys, the dose needs to be adjusted for those with renal impairment:
- For people with impaired renal function, the normal recommended dose should be given on the first day, followed by a daily dose based on [ABPI Medicines Compendium, 2005a]:
- Creatinine clearance greater than 50 mL/min: dose remains as the standard recommended dose.
- Creatinine clearance less than 50 mL/min (no dialysis): reduce the dose by 50%.
- Regular dialysis: give 100% of recommended dose after each dialysis.
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