Antifungals, Azole (Systemic)

Proper Use of This Medicine

Ketoconazole and the capsule form of itraconazole should be taken with a fullmeal. The oral solution form of itraconazole should be taken on an empty stomach. If you have any questions about the antifungal medicine you are taking, check with your health care professional.

For patients taking the oral liquid form of fluconazole, itraconazole, or ketoconazole :

• Use a specially marked measuring spoon or other device to measure each dose accurately. The average household teaspoon may not hold the right amount of liquid.

If you have achlorhydria (absence of stomach acid) or hypochlorhydria (decreased amount of stomach acid), and you are taking itraconazole or ketoconazole , your doctor may want you to take your medicine with an acidic drink. You may dissolve your medicine in cola or seltzer water and drink the solution, or your may take your medicine with a glass of cola or seltzer water. Your doctor may suggest that you dissolve each capsule or tablet in a teaspoonful of weak hydrochloric acid solution to help you absorb the medicine better. Your health care professional can prepare the solution for you. After you dissolve the tablet in the acid solution, add this mixture to a small amount (1 or 2 teaspoonfuls) of water in a glass. Drink the mixture through a plastic or glass drinking straw. Place the straw behind your teeth, as far back in your mouth as you can. This will keep the acid from harming your teeth. Be sure to drink all the liquid to get the full dose of medicine. Next, swish around in your mouth about one-half glass of water and then swallow it. This will help wash away any acid that may remain in your mouth or on your teeth.

To help clear up your infection completely, it is very important that you keep taking this medicine for the full time of treatment , even if your symptoms begin to clear up or you begin to feel better after a few days. Since fungus infections may be very slow to clear up, you may have to continue taking this medicine every day for as long as 6 months to a year or more. Some fungus infections never clear up completely and require continuous treatment. If you stop taking this medicine too soon, your symptoms may return.

This medicine works best when there is a constant amount in the blood. To help keep the amount constant, do not miss any doses . Also, it is best to take each dose at the same time every day . If you need help in planning the best time to take your medicine, check with your health care professional.

Dosing - The dose of azole antifungals may be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of azole antifungals. Your dose of fluconazole may be different if you have kidney disease. If your dose is different, do not change it unless your doctor tells you to do so.

The number of capsules or tablets, or the amount of oral suspension or injection that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking azole antifungals .

For fluconazole
• For fungus infections:
  • For capsule dosage form:
    • Adults - 150 milligrams (mg) as a single dose to treat vaginal yeast infections.
    • Children up to 18 years of age - Dose must be determined by your doctor.
  • For oral suspension and tablet dosage forms:
    • Adults and teenagers - 200 to 400 mg on the first day, then 100 to 400 mg once a day for weeks or months, depending on the medical problem being treated. A vaginal yeast infection is treated with a single dose of 150 mg.
    • Children 6 months of age and older - 6 to 12 mg per kilogram (mg/kg) (2.7 to 5.4 mg per pound) of body weight on the first day, then 3 to 12 mg/kg (1.35 to 5.4 mg per pound) of body weight once a day for weeks or months, depending on the medical problem being treated.
    • Infants and children up to 6 months of age - Dose must be determined by your doctor.
  • For injection dosage form:
    • Adults and teenagers - 200 to 400 mg on the first day, then 100 to 400 mg once a day, injected into a vein, for weeks or months, depending on the medical problem being treated.
    • Children 6 months of age and older - 6 to 12 mg per kilogram (mg/kg) (2.7 to 5.4 mg per pound) of body weight on the first day, then 3 to 12 mg/kg (1.35 to 5.4 mg per pound) of body weight once a day, injected into a vein, for weeks or months, depending on the medical problem being treated.
    • Infants and children up to 6 months of age - Dose must be determined by your doctor.

For itraconazole
• For fungus infections:
  • For capsule dosage form:
    • Adults and teenagers - 200 milligrams (mg) once a day, which may be increased up to 400 mg once a day for weeks or months, depending on the medical problem being treated. Fingernail and toenail infections are treated with 200 mg one or two times a day for weeks or months.
    • Children up to 16 years of age - Dose must be determined by your doctor.
  • For injection dosage form:
    • Adults - 200 milligrams (mg) twice a day for 4 doses, then 200 mg once a day.
    • Children - Dose must be determined by your doctor.
  • For oral solution dosage form:
    • Adults and teenagers - 100 to 200 mg once a day for days or weeks, depending on the medical problem being treated.
    • Children up to 12 years of age - Dose must be determined by your doctor.

For ketoconazole
• For fungus infections:
  • For oral dosage form (oral suspension and tablets):
    • Adults and teenagers - 200 to 400 milligrams (mg) once a day for days or weeks, depending on the medical problem being treated.
    • Children over 2 years of age - 3.3 to 6.6 mg per kilogram (1.5 to 3 mg per pound) of body weight once a day for days or weeks, depending on the medical problem being treated.
    • Infants and children up to 2 years of age - Dose must be determined by your doctor.

Missed dose - If you miss a dose of this medicine, take it as soon as possible. This will help to keep a constant amount of medicine in the blood. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage - To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store the capsule or tablet form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the oral liquid form of this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.