[.
]
Action/Kinetics:
Depending on concentration, may be fungistatic or fungicidal. Acts by inhibiting the biosynthesis of sterols, resulting in damage to the cell wall and subsequent loss of essential intracellular elements due to altered permeability. May also inhibit oxidative and peroxidative enzyme activity and inhibit the biosynthesis of triglycerides and phospholipids by fungi. When used for
Candida albicans the drug inhibits transformation of blastophores into the invasive mycelial form. Poorly absorbed from the GI tract and metabolized in the liver to inactive compounds that are excreted through the feces.
Duration: up to 3 hr.
Uses:
Broad-spectrum antifungal effective against
Malassezia furfur, Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, Microsporum canis, C. albicans.
Oral troche: Oropharyngeal candidiasis. Reduce incidence of oropharyngeal candidiasis in clients who are immunocompromised due to chemotherapy, radiotherapy, or steroid therapy used for leukemia, solid tumors, or kidney transplant.
Topical OTC products: Topically to treat tinea pedis, tinea cruris, and tinea corporis.
Topical prescription products: Same as OTC plus candidiasis and tinea versicolor.
Vaginal products: Vulvovaginal candidiasis.
Contraindications:
Hypersensitivity. First trimester of pregnancy.
Special Concerns:
Use with caution during lactation. Safety and effectiveness for PO use in children less than 3 years of age has not been determined.
Side Effects:
Skin: Irritation including rash, stinging, pruritus, urticaria, erythema, peeling, blistering, edema.
Vaginal: Lower abdominal cramps; urinary frequency; bloating; vaginal irritation, itching or burning; dyspareunia.
Hepatic: Abnormal liver function tests.
GI: N&V; following use of troche.
How Supplied:
Kit;
Lotion: 1%;
Lozenge/Troche: 10 mg;
Solution: 1%;
Topical
cream: 1%;
Vaginal
cream: 1%;
Vaginal tablet: 100 mg, 500 mg
Dosage
?Troche
Treatment of oropharyngeal candidiasis.
One troche (10 mg) 5 times/day for 14 consecutive days.
Prophylaxis of oropharyngeal candidiasis.
One troche t.i.d. for duration of chemotherapy or until maintenance doses of steroids are instituted.
?Topical Cream, Lotion, Solution (each 1%)
Massage into affected skin and surrounding areas b.i.d. in morning and evening for 7 consecutive days. Diagnosis should be reevaluated if no improvement occurs in 4 weeks.
?Vaginal Tablets
One 100-mg tablet/day at bedtime for 7 days. One 500-mg tablet can be inserted once at bedtime.
?Vaginal Cream (1%)
5 g (one full applicator)/day at bedtime for 7 consecutive days.
?Vaginal Inserts and Clotrimazole, 1%
Vaginal yeast infections.
Insert daily for 3 consecutive days.
