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.
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
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.
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Administration
Exposure Risk: low
• Handling/administration PPE Requirements: via Mouth- Single pair of CX approved gloves via Tube- double CX gloves and gown 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: Standard
• Special Manipulation for Administration:
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin Trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
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: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
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
(Brand)
• Indications
Comments
(Diflucan©)
CrCl > 50: No adjustment necessary
CrCl ≤ 50: 50% of usual dose q24h
HD: same loading dose, then 50% q24h
The following outlines must be followed.
[Packaging: Manufacturer ⇒ Dispense]
[UD ⇒ UD]
150 mg tablet
200 mg tablet (IMH)
NIOSH Table 2B↑
Receiving / Storage / Preparation
Storage / Administration
via Tube- double CX gloves and gown
Wash hands after handling
Omnicell
Trace/packaging- trash