Clotrimazole (Topical)
Indications
- All dermatomycoses due to dermatophytes (e.g.Trichophyton species).
- All dermatomycoses due to yeasts (Candida species).
- Dermatomycoses due to moulds and other fungi.
- Skin diseases showing superinfections with these fungi.
Some examples of skin infections included in above points are interdigital mycoses (e.g. athlete's foot), paronychias (associated with nail mycoses), mycoses in skin folds, Candida vulvitis, Candida balanitis, Pityriasis versicolor, erythrasma.
Pharmacology
Clotrimazole acts primarily by damaging the permeability barrier in the cell membrane of fungi. Clotrimazole causes inhibition of ergosterol biosynthesis, an essential constituent of fungal cell membranes. If ergosterol synthesis is either completely or partially inhibited, the cell is no longer able to construct an intact and functional cell membrane. Because ergosterol directly promotes the growth of fungal cells in a hormone‐like fashion, rapid onset of the above events leads to dose-dependent inhibition of fungal growth.
Though decreased ergosterol, due to the inhibition of lanosterol 14-demethylase (also known as CYP51) is accepted to be primarily responsible for the antimycotic properties of clotrimazole, this drug also shows other pharmacological effects. These include the inhibition of sarcoplasmic reticulum Ca2+ ATPase, depletion of intracellular calcium, and blocking of calcium‐dependent potassium channels and voltage‐dependent calcium channels. The action of clotrimazole on these targets accounts for other effects of this drug that are separate from its antimycotic activities.
Dosage And Administration
Clotrimazole Cream: This should be thinly applied 2-3 times daily to the infected sites and rubbed in. On account of the excellent efficacy, a small amount of cream is usually sufficient for an area about the size of the palm. For the treatment to become a complete success, reliable and sufficiently long-time application of Clotrimazole Cream is important. The duration of treatment varies; it depends among other factors on the extent and localization of the disease.
Recommended duration of treatment-
- Dermatomycoses: 3-4 weeks
- Candida vulvitis and Candida balanitis: 1-2 weeks
- Erythrasma and Pityriasis Versicolor: 3 weeks (approximately)
In fungal infection of the feet, to prevent relapse, treatment should be continued for about 2 weeks beyond the disappearance of all signs of disease. After washing, the feet should be thoroughly dried (particularly spaces between the toes). Clotrimazole Cream is odorless, can be washed off and does not stain clothing.
Clotrimazole topical solution: Apply this sparingly to the affected areas and rub in gently, two or three times daily.
Interaction
No information is available.
Contraindications
Hypersensitivity to Clotrimazole.
Side Effects
When applied topically, Clotrimazole is well tolerated.With external application, systemic effects are not observed. Local irritation or burning sensation may occur in a very few cases but these symptoms are not considered harmful.
Pregnancy And Lactation
It is recommended that Clotrimazole should be used in pregnancy only when considered necessary by the physician.
Therapeutic Class
Drugs for subcutaneous and mycoses, Topical Antifungal preparations
Storage Conditions
Keep below 25°C temperature, away from light & moisture. Keep out of the reach of children.