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Tren acetate intravenous administration fluconazole is well penetrates the tissues and body fluids. Drug concentrations in saliva and sputum are similar to its level in plasma. Patients with fungal meningitis fluconazole content in cerebrospinal fluid reaches 80% of the respective levels in the plasma.
The plasma concentrations are directly proportional to the dose. Devyanostoprotsentny equilibrium concentration level is achieved in 4-5 day after multiple introductions one dose per day.
The use of a dose on the first day, two times the normal daily dose can achieve such plasma drug levels that approach the values of 90% to equilibrium concentrations the second day. Apparent volume of distribution is close to the total volume of water in the body.  Fluconazole clearance is directly proportional to the creatinine clearance. Metabolites in peripheral blood has been detected.

Indications
Fluconazole is used to treat the following diseases:

  • Cryptococcosis: cryptococcal meningitis, cryptococcal infection of the lungs and skin; prevention of relapse of cryptococcosis in patients with  organ transplant, or in other cases of immunodeficiency.
  • Generalized candidiasis: candidemia, disseminated candidiasis and other forms of invasive Candida infections (abdominal infections, endocarditis, eye, respiratory and urinary tract).
  • Candidiasis of the mucous membranes: oral cavity, pharynx, esophagus, and non-invasive bronchopulmonary infections, candiduria.
  • Vaginal candidiasis – Acute or chronic relapsing form.
  • Prevention of fungal infections in patients with malignancy who are predisposed to such infections as a result of chemotherapy, cytostatics or radiation therapy.

 

Contraindications
The use of fluconazole is contraindicated in patients with hypersensitivity to the drug or to structurally close azole compounds. Concomitant use of terfenadine, astemizole, and cisapride.

Precautions
Liver failure, rash during treatment with fluconazole in patients with superficial fungal infection and invasive / systemic fungal infections, concomitant use of terfenadine and fluconazole at a dose of less than 400 mg / day, potentially proaritmogennoe status in tren acetate patients with multiple risk factors of patients (organic heart disease , electrolyte disturbances, concomitant use of drugs that cause arrhythmias).

Pregnancy and lactation
Use of the drug is contraindicated during pregnancy, except in severe, generalized and potentially life-threatening fungal infections. If necessary, use during lactation should stop breastfeeding.

Dosage and administration
Fluconazole as a solution for infusion is administered intravenously at a rate of not more than 20mg (10ml) / minute. When translated from the intravenous administration of the capsules and on the contrary is not necessary to change the daily dose.
A solution for infusion is compatible with the following solvents: 20% glucose solution, Ringer’s solution, Hartmann’s solution, potassium tren acetate chloride, glucose solution, sodium bicarbonate 4.2% solution aminofuzin isotonic sodium chloride solution. Infusions of fluconazole can be carried out using conventional kits for transfusion, using one of the above listed fluids. Use in adults: In cryptococcal infections, the usual dose is 400 mg fluconazole once daily on the first day of treatment in the future – at 200-400 mg once per day. The duration of treatment for cryptococcal infections depends on the clinical efficacy, confirmed by mycological examination; usually 6 to 8 weeks. For the prevention of relapse of cryptococcal meningitis in  patients after completion of a full course of primary therapy, fluconazole administered to the patient at a dose of 200 mg / day over a long period. When candidemia, disseminated candidiasis and other invasive Candida infections daily dose of 400 mg on the first day and 200 mg on subsequent days.