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Nephrol Dial Transplant (2003) 18: 2227-2231
© 2003 European Renal Association-European Dialysis and Transplant Association

Editorial Comment

Dosing guidelines for fluconazole in patients with renal failure

Lucile Cousin, Marie Le Berre, Vincent Launay-Vacher, Hassane Izzedine and Gilbert Deray

Department of Nephrology, Pitie-Salpetriere Hospital, Paris, France

Correspondence and offprint requests to: Dr Vincent Launay-Vacher, Department of Nephrology, Pitie-Salpetriere Hospital, 47–83, boulevard de l’Hopital, F-75013 Paris, France. Email: vincent.launay-vacher@psl.ap-hop-paris.fr

Keywords: CAPD; CVVH; fluconazole; haemodialysis; renal insufficiency

The first 150 words of the full text of this article appear below.

Introduction

Fluconazole is a widely used drug that inhibits the synthesis of fungal cell membranes [1,2]. Its elimination is predominantly via renal excretion with most of the dose recovered in urine as an unchanged and active drug. As a result, drug pharmacokinetics are altered in patients with renal failure and it is essential to establish guidelines on how to handle this drug in those patients. Furthermore, in dialysis patients, the removal of the drug in the dialysate has to be elucidated to determine whether fluconazole should be administered after the session or not. A review of the literature was thus performed and analysis of the retrieved data permitted to establish dosage adjustment guidelines for fluconazole in patients with renal failure.

Pharmacokinetics

The oral bioavaibility of fluconazole is >90%, which enables us to administer it with similar doses by i.v. and oral routes. Neither food nor gastric pH modifications . . . [Full Text of this Article]

Toxicity

Patients with renal failure

Haemodialysis patients

Patients on peritoneal diaysis

Patients on continuous renal replacement therapy

Conclusion


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