Azole: a broad spectrum antifungal developed in 1967. It was one of the first azoles to be developed. Formulations are now generic in a number of countries.
It is effective against Candida albicans and the dermatophytes. Its action is fungistatic or fungicidal, depending upon the concentration used.
This azole drug is available in a variety of dosage forms, including oral lozenges and vaginal formulations. It is also available in a variety of combinations with antibiotics and corticosteroids.
- Canesten* Bayer
- Mycelex* Bayer
- Desenex* Novartis
- Lozenges: Clotrimazole 10 mg Mycelex*
- Topical: Cream: Clotrimazole 1% Desenex* Lotrimin*
- Lotion: Clotrimazole 1% Desenex* Lotrimin*
- Solution: Clotrimazole 1% Desenex*
- Tinea corporis
- Tinea cruris
- Tinea pedis
- Pityriasis versicolor
- Cutaneous candidiasis
- Nail and skin infections, fungal or gram positive
Clotrimazole 1% cream, solution, or lotion bid x14-28d, apply in a thin layer to the affected area and surrounding skin.
- Topical preparations should not be used in children < 2 years old
- Vaginal preparations are not recommended for children < 12 years old
- Lozenges should not be used in children < 5 years old
- Avoid applying dressings that seal the area
- Elevated liver function tests have been observed in patients using Clotrimazole lozenges.
Local cutaneous effects may include irritation, hypersensitivity, burning, pruritus, erythema, fissuring, or swelling.
FDA Pregnancy Category C
Oral formulation shows toxicity in animal trials. Use is not recommended during pregnancy or lactation.
Mechanism of Action / Pharmacokinetics
Clotrimazole damages the fungal cell wall and alters the permeability. It also inhibits the activity of intracellular enzymes, leading to a buildup of toxic concentrations of hydrogen peroxide within the fungal cell, causing death of the cell. Systemic absorption is minimal.