Dosing guidelines for fluconazole in patients with renal failure

Fluconazole is a widely used drug that inhibits the synthesis of fungal cell membranes [1,2]. Its elimination is predominantly via renal excretion with most of the dose recovered in urine as an unchanged and active drug. As a result, drug pharmacokinetics are altered in patients with renal failure and it is essential to establish guidelines on how to handle this drug in those patients. Furthermore, in dialysis patients, the removal of the drug in the dialysate has to be elucidated to determine whether fluconazole should be administered after the session or not. A review of the literature was thus performed and analysis of the retrieved data permitted to establish dosage adjustment guidelines for fluconazole in patients with renal failure.