The pharmacokinetics of fluconazole during haemodialysis in uraemic patients
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We have studied the pharmacokinetics of fluconazole in five patients on long-term haemodialysis. The single-pass extraction rate of the dialyzer was 59 (3.5) % (n=4), and the serum concentration was reduced by haemodialysis for 3 or 4 h by 26 (3.2) % (n=5) and 39 (2.2) % (n=9) respectively. The estimated amount extracted by a dialysis of 4 h was 33 (3.2) % (n=4) of the dose. During repeated administration the serum fluconazole concentration increased, reaching a plateau at about 4 times the peak concentration after the first dose. After discontinuing administration the serum fluconazole concentration fell by 25% in every 3 h dialysis session. We conclude that fluconazole should be given in the usual dose of 100 or 200 mg at the end of every haemodialysis session.
Key wordsFluconazole haemodialysis fungal infection Uraemia pharmacokinetics
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