econazole

REMS

Cream

Treatment of a variety of cutaneous fungal infections, including cutaneous candidiasis, tinea pedis (athlete’s foot), tinea cruris (jock itch), tinea corporis (ringworm), and tinea versicolor.

Foam

Treatment of interdigital tinea pedis

Action ⬆ ⬇

Affects the permeability of the fungal cell wall, allowing leakage of cellular contents.

Therapeutic effects:

Decrease in symptoms of fungal infection.

Pharmacokinetics ⬆ ⬇

Absorption: Absorption through intact skin is minimal.

Distribution: Distribution after topical administration is primarily local.

Metabolism/Excretion: Metabolism in the liver and <1% excreted in the urine and feces.

Half-Life: Not applicable.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
Top	unknown	unknown	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity to active ingredients, additives, preservatives, or bases.

Use Cautiously in:

Nail and scalp infections (may require additional systemic therapy);
OB: Safety not established.

Adv. Reactions/Side Effects ⬆ ⬇

Local: burning, itching, local hypersensitivity reactions, redness, stinging

Interactions ⬆ ⬇

Drug-drug:

May ↑ levels of and risk of bleeding from warfarin.

Route/Dosage ⬆ ⬇

(Adults and Children ): Apply once daily in patients with tinea pedis (for 1 mo), tinea cruris (for 2 wk), tinea corporis (for 2 wk), and tinea versicolor (for 2 wk). Apply twice daily in patients with cutaneous candidiasis (for 2 wk).

Availability ⬆ ⬇

(Generic available)

Cream: 1%
Foam: 1%

Assessment ⬆ ⬇

Inspect involved areas of skin and mucous membranes before and frequently during therapy. Increased skin irritation may indicate need to discontinue medication.

Lab Test Considerations:

Monitor INR and/or prothrombin time in patients taking warfarin and applying econazole to large body surface areas, in genital area, or under occlusion.

Implementation ⬆ ⬇

Consult health care professional for proper cleansing technique before applying medication.
Apply small amount to cover affected area completely. Avoid the use of occlusive wrappings or dressings unless directed by health care professional.

Patient/Family Teaching ⬆ ⬇

Instruct patient to apply medication as directed for full course of therapy, even if feeling better. Emphasize the importance of avoiding the eyes.
Caution patient that some products may stain fabric, skin, or hair. Check label information. Fabrics stained from cream can usually be cleaned by handwashing with soap and warm water.
Patients with athlete’s foot should be taught to wear well-fitting, ventilated shoes, to wash affected areas thoroughly, and to change shoes and socks at least once a day.
Advise patient to report increased skin irritation or lack of response to therapy to health care professional.
Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
Advise patient that early relief of symptoms may be seen in 2–3 days. For Candida, tinea cruris, tinea corporis, and tinea versicolor, 2 wk are needed, and for tinea pedis, therapeutic response may take 4 wk. Recurrent fungal infections may be a sign of systemic illness.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇