Dosing
CrCl > 80: 200-400 mg po q 12 - 24 h.
CrCl 80-50: 200-400 mg po q 12 - 24 h.
CrCl 50-10: 200-400 mg po q 12 - 24 h.
CrCl < 10: 200-400 mg po q 12 - 24 h.
Hemodialysis: 200-400 mg po q 12 - 24 h.
Peritoneal dialysis: 200-400 mg po q 12 - 24 h.
Important side effects
Abdominal pain, anaphylaxis (rare), hepatotoxicity (rare), irritation, pruritus and stinging (cream), nausea, vomiting, pruritus, reduced testosterone (po doses of 800 mg/day or more).
Important drug interactions
Acenocoumarol, alfuzosin, alosetron, aluminum carbonate, basic, aluminum hydroxide, aluminum phosphate, amlodipine, amprenavir, anisindione, aprepitant, aripiprazole, astemizole, atorvastatin, benzodiazepines, bexarotene, budesonide, calcium, carbamazepine, cerivastatin, cilostazol, cimetidine, cinacalcet, cisapride, conjugated estrogens, cyclosporine, darifenacin, delavirdine, dicumarol, didanosine, dihydroxyaluminum aminoacetate, dihydroxyaluminum sodium carbonate, dofetilide, donepezil, dutasteride, eletriptan, ergot derivatives, erlotinib, erythromycin, esomeprazole, esterified estrogens, estradiol, estriol, estrone, estropipate, eszopiclone, famotidine, felodipine, fentanyl, gefitinib, imatinib, indinavir, irinotecan, isoniazid, isradipine, lansoprazole, levomethadyl, lovastatin, magaldrate, magnesium carbonate, magnesium hydroxide, magnesium oxide, magnesium trisilicate, methylprednisolone, nevirapine, nicardipine, nifedipine, nisoldipine, nizatidine, omeprazole, pantoprazole, phenindione, phenprocoumon, pimozide, pioglitazone, prednisolone, prednisone, quetiapine, quinidine, rabeprazole, ranitidine, reboxetine, rifampin, rifapentine, ritonavir, roxatidine, saquinavir, sildenafil, simvastatin, sirolimus, sodium bicarbonate, solifenacin, tacrolimus, tadalafil, terfenadine, tolbutamide, tolterodine, trazodone, tretinoin, trimetrexate, vardenafil, warfarin, zolpidem.
Rants and Screeds
Pearls
Acid dependent absorption.
Treatment of choice
Use for
For many of these, the indications occurred before the newer and often better agents.
Acne, Blastomyces dermatiditus, blepharitis, Candida - chronic mucocutaneous/ cutaneous/disseminated/esophageal/oral/urinary/vaginal, Chromomycosis systemic infections, Coccidiodes immitis, Cryptococcus neoformans, cutaneous dermatophyte infections, dermatitis - seborrheic, Histoplasma, Leishmaniasis, Paracoccidiodes, prostatic carcinoma, Pseudallescheria boydii, Sporothrix.
Don't use for
Class
Imidazole.
Last update 11/28/19