Various cutaneous fungal infections, including cutaneous candidiasis, tinea pedis (athlete’s foot), tinea cruris (jock itch), tinea corporis (ringworm), and tinea versicolor.
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: Systemic metabolism and excretion is negligible with local application.
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);
Adv. Reactions/Side Effects⬆⬇
Local: burning, itching, local hypersensitivity reactions, redness, stinging
Interactions⬆⬇
Drug-drug:
None reported.
Route/Dosage⬆⬇
(Adults and Children >3 yr): Apply cream or solution twice daily for 1–4 wk.
Availability⬆⬇
(Generic available)
Cream: 1%OTC
Lotion: 1%OTC
Ointment: 1%OTC
Solution: 1%OTC
In combination with: betamethasone.
Assessment⬆⬇
Inspect involved areas of skin and mucous membranes before and frequently during therapy. Increased skin irritation may indicate need to discontinue medication.
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.
Inform patient that early relief of symptoms may be seen in 2–3 days. For Candida, tinea cruris, and tinea corporis, 2 wk are needed, and for tinea pedis, therapeutic response may take 3–4 wk. Recurrent fungal infections may be a sign of systemic illness.