Fluconazole (Diflucan) dosage should be adjusted in patients with which condition?

• A. Hepatic impairment
• B. Renal impairment
• C. Cardiovascular disease
• D. Diabetes

Answer: (B)

Fluconazole is primarily eliminated from the body through the renal system, meaning that renal impairment significantly affects how the drug is processed and cleared. When a patient has renal impairment, the kidneys are less effective in eliminating medications, which can lead to drug accumulation and an increased risk of toxicity. Therefore, it is essential to adjust the dosage of fluconazole in patients with renal impairment to ensure safe and effective therapy.

While hepatic impairment may also require dosage adjustments for certain medications, fluconazole's pharmacokinetics indicate that renal function is the more critical factor for determining the appropriate dosage in this scenario. Cardiovascular disease and diabetes typically do not necessitate dose adjustments for fluconazole, as they do not significantly impact the drug's metabolic pathways or elimination processes.