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Fluconazole

Sex

CrCl
(ml/min)

>50

≤50

Intermittent HD

CRRT

CAPD

Fluconazole

200-400 mg IV/PO post HD
alt: 200-400 mgx1 then 100-200 mg IV/PO q 24 h

100-200 mg IV/PO q 24 h

200-400 mg IV/PO q 24 h

Load 800 mgx1 then
400 mg IV/PO q 24 h

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Conditions
Dose
CrCl ≥ 50 ml/min
200 - 400 mg IV/PO Q24H
CrCl < 50 ml/min
100 - 200 mg IV/PO Q24H
Hemodialysis
200 - 400 mg IV/PO post-HD
alt: 200 - 400 mg x 1, then 100 - 200mg IV/PO Q24H
CAPD
50 - 200 mg q24h
CRRT
Load 800 mg x 1 dose, then 400mg IV/PO Q24H
SLED
800 mg initial dose, then 400 mg q12h (or pre/post SLED)
Give initial dose at start of an 8-hr dialysis sesstion, or 16-hr before the next session.
Conditions
Dose
CrCl ≥ 50 ml/min
Load 800 mg x 1 dose, then 400 - 800 mg IV/PO Q24H
CrCl < 50 ml/min
Load 800 mg x 1 dose, then 200 - 400 mg IV/PO Q24H
Hemodialysis
Load 800 mg x 1 dose, then 400 - 800 mg post-HD
alt: 200 - 400 mg IV/PO Q24H
CAPD
50 - 200 mg q24h
CRRT
Load 800 mg x 1 dose, then 400 - 800 mg IV/PO Q24H
SLED
800 mg initial dose, then 400 mg q12h (or pre/post SLED)
Give initial dose at start of an 8-hr dialysis sesstion, or 16-hr before the next session.
Conditions
Dose
CrCl ≥ 50 ml/min
800 mg IV/PO Q24H
CrCl < 50 ml/min
Load 800 mg x 1 dose, then 400 mg IV/PO Q24H
Hemodialysis
800 mg post-HD
alt: 800 mg x 1, then 400 mg IV/PO Q24H
CAPD
50 - 200 mg q24h
CRRT
800 mg IV/PO Q24H
SLED
800 mg initial dose, then 400 mg q12h (or pre/post SLED)
Give initial dose at start of an 8-hr dialysis sesstion, or 16-hr before the next session.

The Cockcroft-Gault equation may yield inaccurate estimates based on a patient's body weight and BMI. By including additional height information, we can calculate BMI and provide a modified estimate and range. 

 

- Underweight: For a BMI of 18.5 or lower, use the actual body weight for calculations.

- Normal Weight: Use the ideal body weight for calculations.

- Overweight/Obese: For a BMI of 25 or higher, use the adjusted body weight for calculations.

Calculation Steps

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how it work

©2023 BY Piti Niyomsirivanich, MD. (Personal website)

 

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