CLINICAL TRIALS PROFILE FOR FLUCONAZOLE IN DEXTROSE 5% IN PLASTIC CONTAINER

505(b)(2) Clinical Trials for FLUCONAZOLE IN DEXTROSE 5% IN PLASTIC CONTAINER

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials

Trial Type	Trial ID	Title	Status	Sponsor	Phase	Start Date	Summary
New Dosage	NCT02372357 ↗	A New Dosing Regimen for Posaconazole Prophylaxis in Children Based on Body Surface Area	Completed	Institutul Clinic Fundeni	Phase 4	2012-02-01	A new prophylactic posaconazole dosing regimen of 120mg/m² tid is evaluated pharmacologically in children 13 years and younger, suffering from a hematologic malignancy.
New Dosage	NCT02372357 ↗	A New Dosing Regimen for Posaconazole Prophylaxis in Children Based on Body Surface Area	Completed	Institutul Clinic Fundeni Bucharest	Phase 4	2012-02-01	A new prophylactic posaconazole dosing regimen of 120mg/m² tid is evaluated pharmacologically in children 13 years and younger, suffering from a hematologic malignancy.
New Dosage	NCT02372357 ↗	A New Dosing Regimen for Posaconazole Prophylaxis in Children Based on Body Surface Area	Completed	Universitaire Ziekenhuizen Leuven	Phase 4	2012-02-01	A new prophylactic posaconazole dosing regimen of 120mg/m² tid is evaluated pharmacologically in children 13 years and younger, suffering from a hematologic malignancy.
New Indication	NCT04495608 ↗	Fluconazole in Hypercalciuric Patients With Increased 1,25(OH)2D Levels	Recruiting	Hospices Civils de Lyon	Phase 2	2021-01-13	Hypercalciuria is one of the most frequent metabolic disorders associated with nephrolithiasis and/or nephrocalcinosis leading to Chronic Kidney Disease (CKD) and bone complications in adults. Hypercalciuria can be secondary to increased intestinal absorption and/or increased renal distal tubular reabsorption of calcium due to increased active vitamin D, i.e. 1,25(OH)2D, levels. The management of hypercalciuria is challenging. Classic management based on hyperhydration and dietary advice has low impact on calciuria and therefore on CKD progression. Other strategies such as hydrochlorothiazide can be proposed, however with an uncertain medical benefit in view of side effects (hypokalemia, asthenia, potential cutaneous long-term side effects). Azoles are known to inhibit the 1α-hydroxylase and therefore decrease 1,25(OH)2D levels. These antifungal drugs are commonly used in neonates, infants and adults; pharmacokinetic data are well described. Recently, to improve azoles tolerance, fluconazole has been successfully reported to reduce calciuria in patients with CYP24A1 mutation (1 adult) or NPTIIc mutations (1 child), while maintaining a stable renal function. Based on these observations, the investigators hypothesize that fluconazole is effective to decrease and normalize calciuria in patients with hypercalciuria and increased 1,25(OH)2D levels. The primary objective is to demonstrate that fluconazole normalizes or decreases calciuria after 4 months of treatment in patients with hypercalciuria and increased 1,25(OH)2D levels. The secondary objectives aim to describe: - the effects of fluconazole on the evolution over time of the calcium/phosphate metabolism, - the evolution of renal function, - the cohort at Baseline and after 4 months of treatment period, - the safety of fluconazole, - the onset of potential mycological resistances, - and the treatment compliance. This is a prospective, interventional, national, randomized in 2 parallel groups (1:1), controlled versus placebo, double blind trial. This study will involve patients between 10 and 50 years of age suffering from nephrolithiasis and/or nephrocalcinosis with hypercalciuria (> 0.1 mmol/kg/d) and increased 1,25 (OH)2D levels (≥ 150 pmol/l) and 25-OH-D levels (≥50 nmol/L). FLUCOLITH study is a unique opportunity to develop a new indication of a well-known and not expensive drug (e.g. fluconazole) in rare renal diseases, the ultimate objective being the secondary prevention of CKD worsening in these patients. If the results of this proof-of-concept randomized controlled trial are positive, the investigators will propose an extension phase to evaluate the long term efficacy and safety of fluconazole on renal and bone parameters.
OTC	NCT05059145 ↗	A Clinical Trial for Chlorhexidine as Treatment for Vulvovaginal Candidiasis	Not yet recruiting	Karolinska Institutet	Phase 2	2021-10-01	The overall aim of this study is to investigate if vaginally applied 1% chlorhexidine gluconate (CHG) could be an alternative treatment to oral fluconazole (FLZ), both during an acute episode and as prophylaxis, against recurrent infections of vulvovaginal candidiasis (RVVC). RVVC is very common in fertile women. Up to six months of treatment with FLZ is recommended for RVVC. Over the last ten years, the use of FLZ has increased markedly in many countries. No major problems have been noted with resistance development, but there is concern that this will occur in the future and alternative treatments are requested. In recent years, it has emerged that flukonazol interacts with several different types of drugs that are common in the patient group; several antidepressants, pain relief at dysmenorrhea (NSAID) and oral contraceptives to name a few. In Sweden an over-the-counter vaginal cream consisting of 1% chlorhexidine gluconate (Hibitane®) is available with the indication antiseptic use in vaginal examinations, especially during childbirth. The product has been used for a long time in various gynecological and obstetric surgical procedures. Hibitane® is approved during pregnancy and the cream is usually well tolerated. Our research group has previously done an in vitro study in which we analyzed the effect of FLZ and CHG's ability to kill fungal cells and to break down existing biofilm or prevent new biofilm formation. The biofilm formation is an important stage for the fungal cells to attach to surfaces such as skin and mucosa and is considered a first step in the development of an infection. In the biofilm, the fungus can hide from the immune system and also to some extent for various treatments aimed against the fungus. The results of the study showed that CHG was better than FLZ both at killing the fungal cells and preventing new biofilm from forming and dissolving already established "old" biofilm. This effect is absolutely crucial for successful treatment with antimycotics. These encouraging results form the basis of the planned study. If CHG is at least as effective as FLZ with little impact on vaginal lactobacillus, with high tolerability and without cytotoxic effect on epithelial cells, the results of the study might lead to major benefits to the patients with reduced risk of systemic side effects such as drug interactions, development of drug resistance and reduced drug costs.

All Clinical Trials for FLUCONAZOLE IN DEXTROSE 5% IN PLASTIC CONTAINER

Trial ID	Title	Status	Sponsor	Phase	Start Date	Summary
NCT00000627 ↗	Pilot Study to Determine the Feasibility of Fluconazole for Induction Treatment and Suppression of Relapse of Histoplasmosis in Patients With the Acquired Immunodeficiency Syndrome	Completed	Pfizer	N/A	1969-12-31	To evaluate the use of fluconazole as (1) induction therapy in histoplasmosis, (2) maintenance therapy to prevent relapse of histoplasmosis. Histoplasmosis is a serious opportunistic infection in patients with AIDS. Fluconazole is a triazole antifungal agent that has been used successfully in the treatment of experimental histoplasmosis in animals, but has not been completely evaluated in patients for this use. It has been approved by the Food and Drug Administration for certain other fungal infections. Nevertheless, physicians are prescribing it to their patients with histoplasmosis. This is a pilot study to examine the role of fluconazole for treating histoplasmosis in AIDS patients.
NCT00000627 ↗	Pilot Study to Determine the Feasibility of Fluconazole for Induction Treatment and Suppression of Relapse of Histoplasmosis in Patients With the Acquired Immunodeficiency Syndrome	Completed	National Institute of Allergy and Infectious Diseases (NIAID)	N/A	1969-12-31	To evaluate the use of fluconazole as (1) induction therapy in histoplasmosis, (2) maintenance therapy to prevent relapse of histoplasmosis. Histoplasmosis is a serious opportunistic infection in patients with AIDS. Fluconazole is a triazole antifungal agent that has been used successfully in the treatment of experimental histoplasmosis in animals, but has not been completely evaluated in patients for this use. It has been approved by the Food and Drug Administration for certain other fungal infections. Nevertheless, physicians are prescribing it to their patients with histoplasmosis. This is a pilot study to examine the role of fluconazole for treating histoplasmosis in AIDS patients.
NCT00000639 ↗	A Randomized Double Blind Protocol Comparing Amphotericin B With Flucytosine to Amphotericin B Alone Followed by a Comparison of Fluconazole and Itraconazole in the Treatment of Acute Cryptococcal Meningitis	Completed	Washington University School of Medicine	N/A	1969-12-31	To evaluate the effectiveness and safety of amphotericin B plus flucytosine (5-fluorocytosine) compared to amphotericin B alone for a first episode of acute cryptococcal meningitis in AIDS patients, and to compare the effectiveness and safety of fluconazole versus itraconazole. At least 10 percent of patients with a low CD4 count and HIV infection will develop meningitis due to Cryptococcus neoformans. More effective treatments than the standard therapy need to be explored.
NCT00000639 ↗	A Randomized Double Blind Protocol Comparing Amphotericin B With Flucytosine to Amphotericin B Alone Followed by a Comparison of Fluconazole and Itraconazole in the Treatment of Acute Cryptococcal Meningitis	Completed	National Institute of Allergy and Infectious Diseases (NIAID)	N/A	1969-12-31	To evaluate the effectiveness and safety of amphotericin B plus flucytosine (5-fluorocytosine) compared to amphotericin B alone for a first episode of acute cryptococcal meningitis in AIDS patients, and to compare the effectiveness and safety of fluconazole versus itraconazole. At least 10 percent of patients with a low CD4 count and HIV infection will develop meningitis due to Cryptococcus neoformans. More effective treatments than the standard therapy need to be explored.
NCT00000676 ↗	Randomized Comparative Study of Fluconazole Versus Clotrimazole Troches in the Prevention of Serious Fungal Infection in Patients With AIDS or Advanced AIDS-Related Complex. (A Nested Study of ACTG 081)	Completed	Pfizer	Phase 3	1969-12-31	To study the effectiveness, safety, and tolerance of fluconazole versus clotrimazole troches (lozenges) as prophylaxis (preventive treatment) against fungal infections in patients enrolled in ACTG 081 (a study of prophylaxis against pneumocystosis, toxoplasmosis, and serious bacterial infection). Primarily, to compare the rates of invasive infections by C. neoformans, endemic mycoses, and Candida. To compare the mortality rates due to fungal infections between two antifungal prophylactic treatments. Secondarily, to assess the effect of prophylaxis on the incidence of severe fungal infections, defined as invasive infections and esophageal candidiasis and less severe mucocutaneous infection. Serious fungal infections are significant complicating and life-threatening occurrences in patients with advanced HIV infection. Oropharyngeal candidiasis is found in almost all such patients, and causes pain, difficulty in swallowing, and loss of appetite. Similarly, esophageal candidiasis causes illness in the population. Cryptococcosis, endemic mycoses, and coccidioidomycosis also cause significant illness and death in AIDS patients. Once established, fungal infections in AIDS patients generally require continuous suppressive therapy because attempts at curing these infections are usually unsuccessful. Fluconazole has a number of characteristics that would make it a logical candidate to examine as a prophylactic agent in patients with advanced HIV infection. Animal studies have shown it to be prophylactic in models of candidiasis, cryptococcosis, histoplasmosis, and coccidioidomycosis. Initial experience in patients with active cryptococcal meningitis appears favorable, and studies of oropharyngeal candidiasis show it to be effective.
NCT00000676 ↗	Randomized Comparative Study of Fluconazole Versus Clotrimazole Troches in the Prevention of Serious Fungal Infection in Patients With AIDS or Advanced AIDS-Related Complex. (A Nested Study of ACTG 081)	Completed	National Institute of Allergy and Infectious Diseases (NIAID)	Phase 3	1969-12-31	To study the effectiveness, safety, and tolerance of fluconazole versus clotrimazole troches (lozenges) as prophylaxis (preventive treatment) against fungal infections in patients enrolled in ACTG 081 (a study of prophylaxis against pneumocystosis, toxoplasmosis, and serious bacterial infection). Primarily, to compare the rates of invasive infections by C. neoformans, endemic mycoses, and Candida. To compare the mortality rates due to fungal infections between two antifungal prophylactic treatments. Secondarily, to assess the effect of prophylaxis on the incidence of severe fungal infections, defined as invasive infections and esophageal candidiasis and less severe mucocutaneous infection. Serious fungal infections are significant complicating and life-threatening occurrences in patients with advanced HIV infection. Oropharyngeal candidiasis is found in almost all such patients, and causes pain, difficulty in swallowing, and loss of appetite. Similarly, esophageal candidiasis causes illness in the population. Cryptococcosis, endemic mycoses, and coccidioidomycosis also cause significant illness and death in AIDS patients. Once established, fungal infections in AIDS patients generally require continuous suppressive therapy because attempts at curing these infections are usually unsuccessful. Fluconazole has a number of characteristics that would make it a logical candidate to examine as a prophylactic agent in patients with advanced HIV infection. Animal studies have shown it to be prophylactic in models of candidiasis, cryptococcosis, histoplasmosis, and coccidioidomycosis. Initial experience in patients with active cryptococcal meningitis appears favorable, and studies of oropharyngeal candidiasis show it to be effective.

Clinical Trial Conditions for FLUCONAZOLE IN DEXTROSE 5% IN PLASTIC CONTAINER

Condition Name

Condition Name for FLUCONAZOLE IN DEXTROSE 5% IN PLASTIC CONTAINER
Intervention	Trials
HIV Infections	42
Candidiasis	21
Mycoses	19
Meningitis, Cryptococcal	16

Condition MeSH

Condition MeSH for FLUCONAZOLE IN DEXTROSE 5% IN PLASTIC CONTAINER
Intervention	Trials
Candidiasis	77
HIV Infections	45
Mycoses	44
Infections	31

Clinical Trial Locations for FLUCONAZOLE IN DEXTROSE 5% IN PLASTIC CONTAINER

Trials by Country

Trials by Country for FLUCONAZOLE IN DEXTROSE 5% IN PLASTIC CONTAINER
Location	Trials
United States	766
China	33
Canada	28
Spain	18
Belgium	15

Trials by US State

Trials by US State for FLUCONAZOLE IN DEXTROSE 5% IN PLASTIC CONTAINER
Location	Trials
California	57
Texas	53
Florida	46
New York	45
Pennsylvania	39

Clinical Trial Progress for FLUCONAZOLE IN DEXTROSE 5% IN PLASTIC CONTAINER

Clinical Trial Phase

Clinical Trial Phase for FLUCONAZOLE IN DEXTROSE 5% IN PLASTIC CONTAINER
Clinical Trial Phase	Trials
Phase 4	32
Phase 3	57
Phase 2/Phase 3	7

Clinical Trial Status

Clinical Trial Status for FLUCONAZOLE IN DEXTROSE 5% IN PLASTIC CONTAINER
Clinical Trial Phase	Trials
Completed	183
Unknown status	21
Recruiting	20

Clinical Trial Sponsors for FLUCONAZOLE IN DEXTROSE 5% IN PLASTIC CONTAINER

Sponsor Name

Sponsor Name for FLUCONAZOLE IN DEXTROSE 5% IN PLASTIC CONTAINER
Sponsor	Trials
Pfizer	40
National Institute of Allergy and Infectious Diseases (NIAID)	25
Merck Sharp & Dohme Corp.	7

Sponsor Type

Sponsor Type for FLUCONAZOLE IN DEXTROSE 5% IN PLASTIC CONTAINER
Sponsor	Trials
Other	212
Industry	161
NIH	46

Clinical Trials Update, Market Analysis, and Projection for Fluconazole in Dextrose 5% in Plastic Container

Last updated: October 28, 2025

Introduction

Fluconazole in Dextrose 5% (D5W) administered via plastic containers remains a critical formulation in antifungal therapy, particularly in hospital settings for treating invasive fungal infections. The formulation's evolving clinical profile, regulatory landscape, and global demand underscore the importance of meticulous market analysis and future projections. This report synthesizes current clinical trial data, market dynamics, and provides future outlooks, empowering industry stakeholders with actionable insights.

Clinical Trials Update

Current State of Clinical Evaluation

Fluconazole, a triazole antifungal agent, has long-standing approval for various invasive candidiasis and cryptococcal meningitis indications. Ongoing clinical trials focus primarily on its optimized delivery, pharmacokinetics, safety in vulnerable populations, and novel formulations.

Recent phases involve:

• Pharmacokinetic and pharmacodynamic studies: Investigations aim to determine the optimal dosing in pediatric, geriatric, and immunocompromised patients, emphasizing the importance of maintaining therapeutic levels without toxicity.
• Bioavailability and stability assessments: Trials assess stability of Fluconazole in Dextrose 5% within plastic containers, including compatibility with sterilization processes and shelf-life under various storage conditions.

Notably, ongoing studies are evaluating fluconazole's efficacy and safety in neonates and critically ill patients, addressing gaps in pediatric dosing and infusion-related adverse effects.

Regulatory and Approval Landscape

While there are no recent approvals for new formulations, regulatory agencies such as the FDA and EMA have approved numerous indications for existing fluconazole products. The focus has shifted toward generic formulations, bioequivalence studies, and new delivery mechanisms, with some companies initiating trials for long-acting or concentrated formulations which could impact future market offerings.

Emerging Research and Innovations

Recent trials are exploring liposomal and other nanoparticle-based formulations for enhanced bioavailability and reduced toxicity. However, these are in early phases and not yet commercially available in Dextrose 5% in plastic containers.

Market Analysis

Global Market Overview

The global antifungal drugs market, valued at approximately USD 13 billion in 2022, is projected to grow at a CAGR of 6% through 2030, driven by increasing incidence of invasive fungal infections, expanding ICU admissions, and growing awareness.

Fluconazole remains a cornerstone antifungal owing to its efficacy, safety profile, and regulatory approvals. The segment for intravenous formulations in Dextrose 5% in plastic containers accounts for an estimated 30% of the total fluconazole market, valued at approximately USD 1.4 billion in 2022, with steady growth prospects.

Regional Market Dynamics

• North America: Dominates due to high healthcare expenditure, robust ICU infrastructure, and widespread adoption of antifungal therapies. The U.S. accounts for over 50% of regional sales.
• Europe: Exhibits stable growth, driven by aging populations and rising hospital-acquired fungal infections.
• Asia-Pacific: Fastest-growing market, propelled by expanding healthcare infrastructure, increasing immunocompromised populations (HIV/AIDS, cancer), and rising hospital procurement.

Market Drivers

• Rising incidence of fungal infections: Particularly among immunocompromised hosts such as transplant recipients and cancer patients.
• Expanding hospital-based treatments: Increased use of parenteral antifungals in ICUs and oncology.
• Generics and biosimilars: Price competition driving adoption of cost-effective formulations.
• Regulatory approvals for pediatric and special populations: Broadening the clinical utility.

Market Challenges

• Resistance Development: Increasing fluconazole resistance in certain Candida species necessitates new antifungal agents or combination therapy.
• Supply Chain Disruptions: Global manufacturing and logistics issues, notably during COVID-19, have impacted supply consistency.
• Safety and Compatibility Concerns: Compatibility of fluconazole in Dextrose 5% with different plastic materials remains a focus for manufacturers, influencing formulation stability and shelf life.

Market Projection

Future Growth Factors

• Emerging indications for fluconazole, such as prophylaxis in hematopoietic stem cell transplants, will sustain demand.
• Innovation in formulations: Long-acting, lyophilized, and compatibility-optimized formulations will expand clinical applications.
• Technological advancements: The move toward more stable, preservative-free, and flexible container systems.

Forecast (2023-2030)

• The intravenous fluconazole in Dextrose 5% in plastic containers segment is expected to grow at a CAGR of 5.5%, reaching approximately USD 2.2 billion by 2030.
• Market penetration in emerging economies will accelerate due to increased healthcare spending and infrastructure development.
• Patent expirations and the influx of generics will exert downward pressure on prices, enhancing accessibility but potentially impacting profit margins for innovators.

Competitive Landscape

Major players include Pfizer, Mylan (now part of Viatris), and Cipla, which produce generic fluconazole formulations. Companies investing in formulation improvements, stability enhancements, and regulatory filings for new indications will strengthen market positioning.

Emerging biotech firms explore nanoparticle-based delivery systems to optimize tissue penetration and reduce toxicity, although these are not yet commercialized for Dextrose 5% formulations.

Regulatory and Commercialization Outlook

The regulatory environment favors approvals of generic forms with bioequivalence data, especially as patents expire. Market entry for innovative formulations or delivery systems necessitates robust clinical trial data demonstrating safety and efficacy, especially for vulnerable populations.

Key Takeaways

• Clinical trials for fluconazole in Dextrose 5% are focusing on stability, pediatric, and critically ill patient populations, with early-phase studies indicating favorable safety profiles.
• The market is poised for steady growth driven by increasing fungal infection rates and expanding healthcare infrastructure, especially in Asia-Pacific.
• Generic competition and patent expiries will drive price reductions, increasing access but pressuring margins.
• Innovations in formulations and container compatibility will shape product development and market differentiation.
• The evolving regulatory environment, coupled with technological advancements, suggests a dynamic landscape with established players and startups vying for market share.

Conclusion

Fluconazole in Dextrose 5% in plastic containers remains a vital component of antifungal therapy, with ongoing clinical trials underpinning its safety and utility. Market growth is poised to continue at a moderate pace, influenced by increasing fungal disease burden, regulatory dynamics, and technological innovation. Industry players should focus on formulation stability, expanding indications, and cost-effective manufacturing to capitalize on emerging opportunities.

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FAQs

1. What are the main clinical indications for fluconazole in Dextrose 5%?
   It is primarily used for treating invasive candidiasis, cryptococcal meningitis, and prophylaxis in immunocompromised patients.

2. How are recent clinical trials impacting the formulation of fluconazole?
   Trials focusing on stability, pediatric safety, and compatibility with plastic containers are guiding improvements in formulation stability and safety profiles, facilitating broader clinical use.

3. What factors will influence the future market growth of this formulation?
   Rising infection rates, technological advances, generic entry, and expanding indications in vulnerable populations are key drivers.

4. Are there concerns about resistance affecting fluconazole's market?
   Yes, increasing resistance among certain Candida species threatens effectiveness, prompting the need for combination therapies and new antifungal agents.

5. What innovations could disrupt the current market?
   Development of long-acting formulations, nanoparticle delivery systems, and improved container compatibility could alter the competitive landscape.

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References

1. [1] Global Market Insights. "Antifungal Drugs Market Size & Trends." 2022.
2. [2] U.S. Food and Drug Administration. "Approved Drugs Database." 2023.
3. [3] ClinicalTrials.gov. "Fluconazole Clinical Trials." 2023.
4. [4] MarketsandMarkets. "Antifungal Market Forecast." 2022.
5. [5] European Medicines Agency. "Medicines Overview." 2023.