Clotrimazole
Clinical data | |
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Trade names | Desenex, CalmYourself, others |
AHFS/Drugs.com | Monograph |
MedlinePlus | a682753 |
Pregnancy category |
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Routes of administration | Topical, throat lozenge |
ATC code | |
Legal status | |
Legal status |
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Pharmacokinetic data | |
Bioavailability | Poor absorption by mouth (lozenge), negligible absorption through intact skin (topical) |
Protein binding | 90% |
Metabolism | Liver |
Elimination half-life | 2 hours |
Identifiers | |
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JSmol) | |
Melting point | 147 to 149 °C (297 to 300 °F) |
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Clotrimazole, sold under the brand name Lotrimin, among others, is an
Common side effects when taken by mouth include nausea and itchiness.[1] When applied to the skin, common side effects include redness and a burning sensation.[1] In pregnancy, use on the skin or in the vagina is believed to be safe.[1] There is no evidence of harm when used by mouth during pregnancy but this has been less well studied.[1] When used by mouth, greater care should be taken in those with liver problems.[1] It is in the azole class of medications and works by disrupting the fungal cell membrane.[1]
Clotrimazole was discovered in 1969.
Medical uses
It is commonly available
An effective treatment option for mixed infectious vaginitis is a combination of clotrimazole and metronidazole.[7]
Topical clotrimazole is usually not effective in treatment of fungal infections of the scalp or nails.[citation needed] When using over-the-counter drug clotrimazole products, use should be discontinued if condition does not improve after treatment for 2 weeks for jock itch or after 4 weeks for athlete's foot or ringworm.[8]
Throat lozenge preparations are used for oropharyngeal candidiasis (
Clotrimazole is usually used five times daily for 14 days for oral thrush, twice daily for 2 to 8 weeks for skin infections, and once daily for 3 or 7 days for vaginal infections.[9]
Clotrimazole may be compounded with a glucocorticoid, such as betamethasone, in a topical cream for the treatment of tinea corporis (ringworm), tinea cruris (jock itch) and tinea pedis (athlete's foot). Although FDA approved, clotrimazole–betamethasone combination cream is not the preferred treatment for dermatophyte infections due to increased side effects from the topical glucocorticoid. [citation needed]Although temporary relief and partial suppression of symptoms may be observed with the combination therapy, glucocorticoids can elicit an immunosuppressive response and rebound effect that results in more severe infection typically requiring systemic antifungal agents to treat the disease. Combination creams are best avoided in order to improve treatment outcome, reduce the possibility of skin atrophy associated with prolonged topical glucocorticoid use, and to limit the cost of treatment. It can be effective in treating chronic paronychia. The preferred treatment of tinea infections is therefore with clotrimazole monotherapy.[10]
Topical clotrimazole cream, when combined with mechanical reduction of the nail, has been demonstrated to be effective in the treatment of onychomycosis - fungal infection of the fingernails and toenails.[11]
Topical and oral clotrimazole can be used in both adults and children.[citation needed]
Additionally, clotrimazole may be used to treat the sickling of cells (related to
Pregnancy
Topical clotrimazole is categorized as
Side effects
Clotrimazole creams and suppositories contain oil which may weaken latex condoms and diaphragms.[15]
For topical formulations, should be used externally and should be discontinued if irritation or sensitivity develops at the site of administration.[17]
Interactions
There are no known significant drug interactions with topical clotrimazole. However, with oral (troche) clotrimazole, there are multiple interactions as the medication is a
Pharmacology
Pharmacodynamics
Clotrimazole is an imidazole derivative which works by inhibiting the growth of individual Candida or fungal cells by altering the permeability of the fungal cell wall.[6] The drug impairs the biosynthesis of ergosterol, a critical component of the fungal cell membrane, by inhibiting the P450 enzyme lanosterol 14-alpha demethylase.[18] Clotrimazole may slow fungal growth or result in fungal cell death.[1]
Sales volume
Clotrimazole is available as a
References
- ^ a b c d e f g h i j k l m n American Society of Health-System Pharmacists (8 February 2016). "Clotrimazole Monograph for Professionals". www.drugs.com. Archived from the original on 28 October 2016. Retrieved 28 October 2016.
- ISBN 9789400926592. Archivedfrom the original on 14 September 2016.
- hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
- ^ "The Top 300 of 2021". ClinCalc. Archived from the original on 15 January 2024. Retrieved 14 January 2024.
- ^ "Clotrimazole - Drug Usage Statistics". ClinCalc. Archived from the original on 18 January 2024. Retrieved 14 January 2024.
- ^ a b c "Clotrimazole (Oral)". Lexicomp Online. Archived from the original on 23 January 2015. Retrieved 17 April 2014.
- PMID 37773671.
- ^ a b "UpToDate". www.uptodate.com. Archived from the original on 17 October 2019. Retrieved 7 August 2019.
- ^ a b "Clotrimazole: MedlinePlus Drug Information". The American Society of Health-System Pharmacists, Inc. Archived from the original on 18 April 2014. Retrieved 17 April 2014.
- S2CID 38106083.
- ISSN 0958-2592.
- ^ Marieb EN, Hoehn K. Human Anatomy and Physiology. Toronto: Pearson. p. 643.
- ^ Rodgers G. "Hydroxyurea and other disease-modifying therapies in sickle cell disease". UpToDate. Archived from the original on 15 April 2014. Retrieved 14 April 2014.
- ^ S2CID 544751.
- ^ a b "Diseases Characterized by Vaginal Discharge". CDC. Archived from the original on 28 April 2014. Retrieved 17 April 2014.
- ^ a b "Clotrimazole". DrugBank. Archived from the original on 17 April 2014. Retrieved 17 April 2014.
- ^ "DailyMed - CLOTRIMAZOLE ANTIFUNGAL- clotrimazole cream". dailymed.nlm.nih.gov. Archived from the original on 30 July 2020. Retrieved 7 August 2019.
- from the original on 25 January 2024. Retrieved 19 October 2023.
- ^ "A breakdown of the over-the-counter medicines market in Britain in 2016". Pharmaceutical Journal. 28 April 2017. Archived from the original on 22 October 2019. Retrieved 29 May 2017.