Indications: fungal infections.

Cautions: renal impairment, pregnancy and breast- feeding; concomitant use with hepatotoxic drugs, monitor liver function with high doses or extended courses— discontinue if signs or symptoms of hepatic disease (risk of hepatic necrosis); susceptibility to QT interval prolongation.

Side Effects: nausea, abdominal discomfort, diarrhoea, flatulence, headache, rash (discontinue treatment or monitor closely if infection invasive or systemic); less frequently dyspepsia, vomiting, taste disturbance, hepatic disorders, hypersensitivity reactions, anaphylaxis, dizziness, seizures, alopecia, pruritus, toxic epidermal necrolysis, Stevens-Johnson syndrome (severe cutaneous reactions more likely in AIDS patients), hyperlipidaemia, leucopenia, thrombocytopenia, and hypokalaemia.

Dose: Vaginal candidiasis and candidal balanitis, by mouth, a single dose of 150 mg.

Mucosal candidiasis (except genital), by mouth, 50 mg daily (100 mg daily in unusually difficult infections) given for 7–14 days in oropharyngeal candidiasis (max. 14 days except in severely immunocompromised patients); for 14 days in atrophic oral candidiasis associated with dentures; for 14–30 days in other mucosal infections (e.g. oesophagitis, candiduria, non-invasive bronchopulmonary infections);

CHILD by mouth or by intravenous infusion, 3–6 mg/kg on first day then 3 mg/kg daily (every 72 hours) NEONATE up to 2 weeks old, every 48 hours in neonate 2–4 weeks old) Tinea pedis, corporis, cruris, pityriasis versicolor, and dermal candidiasis, by mouth, 50 mg daily for 2–4 weeks (for up to 6 weeks in tinea pedis); max. duration of treatment 6 weeks

Invasive candidal infections (including candidaemia and disseminated candidiasis) and cryptococcal infections (including meningitis), by mouth or intravenous infusion, 400 mg on first day then 200–400 mg daily; max. 800 mg daily in severe infections; treatment continued according to response (at least 8 weeks for cryptococcal meningitis); CHILD 6–12 mg/kg daily (every 72 hours in NEONATE up to 2 weeks old, every 48 hours in NEONATE 2–4 weeks old); max. 400 mg daily.

Prevention of relapse of cryptococcal meningitis in AIDS patients after completion of primary therapy, by mouth, 200 mg daily or by intravenous infusion, 100–200 mg daily.

Prevention of fungal infections in immunocompromised patients, by mouth or by intravenous infusion, 50–400 mg daily adjusted according to risk; 400 mg daily if high risk of systemic infections e.g. following bone-marrow transplantation; commence treatment before anticipated onset of neutropenia and continue for 7 days after neutrophil count in desirable range; CHILD according to extent and duration of neutropenia, 3–12 mg/kg daily (every 72 hours in NEONATE up to 2 weeks old, every 48 hours in NEONATE 2–4 weeks old); max. 400 mg daily.