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fluconazole IV

fluconazole IV

Restricted Medications Indication limit

Brand names: Diflucan

Form	Strength
SOLUTION, INTRAVENOUS	100 mg/50 mL; 200 mg/100 mL; 400 mg/200 mL

Display Azoles Class: 081408

Medication comments:

Per policy, use of these medications is restricted as noted below:
generic (Brand)	Restrictions
fluconazole (Diflucan)	If patient indication is for vulvovaginal candidiasis, dose and duration will be automatically adjusted to 150 mg PO x 1. If additional doses are needed, provider will need to re-order (recommended to reorder after 3 days if symptoms persist).

Per policy, these drugs are subject to renal dosing adjustments by pharmacy.
Generic + Route (Brand) • Indications	Usual Adult Dose Comments	Renal Dosage Adjustments
fluconazole IV/PO (Diflucan^©)	100-800 mg q24h	Administer 100% of the indication-specific loading initial dose recommended and then adjust daily dose CrCl > 50: No adjustment necessary CrCl ≤ 50: 50% of usual dose q24h HD: same loading dose, then 50% q24h

Per policy, these drugs may be converted from IV to PO in patients who meet criteria.
Generic (Brand)	Population	IV Dose	PO Dose	Notes
fluconazole (Diflucan)	adult	100 mg IV q24h	100 mg PO q24h
		200 mg IV q24h	200 mg PO q24h
		400 mg IV q24h	400 mg PO q24h
	pediatric	3-12 mg/kg q24h (max: 800 mg/dose)	3-12 mg/kg q24h (max: 800 mg/dose)

USP <800> Hazardous Drug Assessment of Risk (AOR)
Per policy, these drugs are exempt from USP <800> handling requirements under normal circumstances. The following outlines must be followed.
generic (Brand) Route [Packaging: Manufacturer ⇒ Dispense]	Activities
fluconazole (Diflucan) IV [n/a]		Stock @ IDBH? N NIOSH Table 2^B↑
Pharmacy: Receiving / Storage / Preparation Exposure Risk: low	• Handling/preparation PPE Requirements: n/a
	• Receiving from Distributor: Standard
	• Pharmacy Storage Area: Carousel
	• Packaging/Reconstitution Location: n/a
	• Compounding (Non-Sterile/Sterile) Location: Positive pressure room
	• Omnicell Load: Yes
Transport	• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Administration Exposure Risk: low	• Handling/administration PPE Requirements: Single pair of CX approved gloves. Wash hands after handling
	• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer Omnicell
	• Signage on Patient Door Required: No
	• Manipulation of Dosage Form: n/a
	• Special Manipulation for Administration: n/a
Disposal / Spills	• Disposal of Drug Waste: Full- blue bin Trace/packaging- trash
	• Disposol of Used PPE: trash bin (inside plastic bag)
	• Spill management: Wear CX gloves items used to clean up spill should be placed in a sealed bag and put in blue bin
NIOSH Supplemental Information: case reports describe congenital abnormalies in infants exposed in utero to maternal fluconazole (400-800mg/d) during most or all of the 1st trimester, similar to those seen in animal studies
Reason for exemption of USP<800> Containment Requirements: Preg Category C. Risks are related to systemic absorption. For skin contact, remove contaminated clothing, flush area with large amounts of water and soap. This product does not contain any hazardous materials with occupational exposure.

Last updated: May. 22, 2025

Renal Adjustment Policy fluconazole subject to adjustments by pharmacy.
Hazard.Drug Handling(USP 800) USP<800> Hazardous Drug / Assessment of Risk
IV to PO Conversion Policy Policy

UpToDate Lexidrug

Pharmacy Contact Info:

Main Inpatient Pharmacy: ext 4599, 3503
Fax: 704-878-7283

Director of Pharmacy - Randi Raynor, PharmD: ext 4501
Clinical Coordinator - Laura Rollings, PharmD: ext 4597
Pharmacy Informaticist - Stephen Pringle, PharmD: ext 7645
Pharmacy Technician Supervisor - Amy Wingler, CPhT: ext 7385
Pharmacy Automation Coordinator (Omnicell) - Melissa Fulford, CPhT: ext 3556

This site is intended for the staff of Iredell Health System. While others may view accessible pages, Iredell Health System makes no warranty, express or implied, as to the use of this information outside of Iredell Health System. The content of this policy and procedure document serves as guidance to the delivery of quality patient care. Care providers are expected to exercise critical thinking and situational awareness skills, and in specific situations to take such action as is necessary for the delivery of quality patient care.