Fluconazole Dosing For 'Intestinal Candida'

Answer

I'm not exactly sure what you mean by an 'intestinal candida' infection. Candida species, a type of yeast, are part of your normal gastrointestinal flora. If you had a stool culture done, and a Candida species was shown to be present, that does not represent an infection and generally would not warrant any treatment.

Nevertheless, I certainly don't want to discount what some more recent studies suggest the symptoms of a suspected 'overgrowth' of Candida can cause.

Studies suggest that an 'overgrowth' of candida can occur in certain individuals with inflammatory conditions, like ulcerative colitis and Crohn's disease, which can cause worsening symptoms of diarrhea, gas, bloating, or nausea. It is theorized that Candida can delay healing and exacerbate diseases for these individuals, and thus, treating an overgrowth with an antifungal could provide beneficial effects for them.

Additionally, although not recognized as a medical diagnosis, some providers, typically on the more holistic end of things, believe that an overgrowth of Candida in the gastrointestinal tract can cause 'leaky gut syndrome', which can also cause some of the symptoms I've described above (e.g., bloating, diarrhea).

It is important to point out here too that an 'intestinal candida' infection could be a layman's way of describing the very real problem of a Candida species causing an infection following a gastrointestinal tract perforation (i.e., tear). This is typically referred to as peritonitis or an 'intra-abdominal' infection.

Dosing Considerations

Since I don't know exactly what you are treating with fluconazole, it's tough to give you what the recommended dosages are. I also don't know if you are referring to an oral dosage or an intravenous one.

However, we can start with an FDA-approved indication. Clinical studies support the following dosing an intra-abdominal infection (i.e. peritonitis) caused by Candida:

• Adults [oral tablet]: Fluconazole 800 mg by mouth once, then 400 mg by mouth once daily for at least two weeks or longer depending on when the signs and symptoms of peritonitis are resolved.
• Adults [intravenous]: Fluconazole 800 mg intravenously, then 400 mg intravenously once daily for at least two weeks or longer depending on when the signs and symptoms of peritonitis are resolved.

As I mentioned in the section above, Candida being identified as simply being present in your gastrointestinal tract generally does not warrant treatment, and there is no recommended dosing of fluconazole for gastrointestinal overgrowth or for 'leaky gut'.

However, some studies suggest that if Candida is suspected of causing significant gastrointestinal symptoms (such as nausea, diarrhea, bloating, etc...) due to overgrowth in those with pre-existing inflammatory conditions (like ulcerative colitis), or in those with 'leaky gut', dosages of fluconazole are similar to those used in the treatment of conditions like oral thrush or a urinary tract infection, which is:

• Adults [oral tablet]: Fluconazole 100 to 200 mg by mouth once daily for 7 to 14 days. No loading dose is required.

Final Words

I hope this answer helped! If you want to write back with some more details of what you are treating, and some background on why your provider is suggesting fluconazole, I can likely give a more detailed answer.

Thanks for reaching out!