kloe-TRIM-a-zole

Therapeutic Classification: antifungals (oral, nonabsorbed)

• Treatment of oropharyngeal candidiasis.
• Prevention of oropharyngeal candidiasis in immunocompromised patients (receiving chemotherapy or radiation for cancer or corticosteroids for cancer or transplant).

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

• Decrease in or prevention of symptoms of oropharyngeal candidiasis.

Absorption: Minimal systemic absorption.

Distribution: Inhibitory concentrations remain in saliva for up to 3 hr after troche dissolves.

Metabolism/Excretion: Metabolized by liver; <1% excreted unchanged in urine.

Half-life: 24 hr.

Contraindicated in:

• Hypersensitivity to clotrimazole or other components of formulation
• Systemic candidiasis.

Use Cautiously in:

• Hepatic impairment
• OB: Use only if potential benefit justifies potential risk to fetus
• Pedi: Children <3 yr (safety and effectiveness not established).

Derm: pruritis.

GI: ↑liver function tests, abnormal mouth sensations, nausea, vomiting.

Drug-Drug:

• May ↓ metabolism and ↑ risk of toxicity from CYP3A4 substrates, includingcyclosporine, HMG-CoA reductase inhibitors, some benzodiazepines (alprazolam, midazolam, triazolam), calcium channel blockers, colchicine, fentanyl, tacrolimus, and warfarin.
• .

• PO (Adults and Children 3 yr): Treatment: One troche 5 times daily for 14 days; Prophylaxis: One troche 3 times daily for the duration of chemotherapy or until steroid doses are reduced to maintenance levels.

(Generic available)

• Troche: 10 mg;

• Assess oropharnyngeal mucosa prior to and periodically during therapy.

• Monitor hepatic function prior to and periodically during therapy. May cause ↑AST.

• PO: Allow each troche to dissolve slowly in mouth to achieve maximum effect.

• Instruct patient to take clotrimazole as directed. Allow each troche to slowly dissolve in mouth.

• Decrease in or prevention of symptoms of oropharyngeal candidiasis.

Mycelex