Treatment of a variety of cutaneous fungal infections, including tinea pedis (athlete’s foot), tinea cruris (jock itch), tinea corporis (ringworm), and tinea versicolor.
Action⬆⬇
Affects the synthesis of the fungal cell wall.
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: Hepatic via hydroxylation.
Half-Life: 35 hr.
Time/Action Profile⬆⬇
ROUTE
ONSET
PEAK
DURATION
Top
unknown
up to 4 wk
unknown
Contraind./Precautions⬆⬇
Contraindicated in:
Hypersensitivity to active ingredients, additives, preservatives, or bases;
Some products contain alcohol or bisulfites and should be avoided in patients with known intolerance.
Use Cautiously in:
Nail and scalp infections (may require additional systemic therapy);
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Children <12 yr (safety and effectiveness not established).
Adv. Reactions/Side Effects⬆⬇
Local: burning, itching, local hypersensitivity reactions, redness, stinging
Interactions⬆⬇
Drug-drug:
None significant.
Route/Dosage⬆⬇
(Adults and Children ≥12 yr): Apply once daily for 2 wk for patients with tinea corporis, tinea cruris, or tinea versicolor. Apply once daily for 4 wk or twice daily for 7 days for patients with tinea pedis.
Availability⬆⬇
(Generic available)
Cream: 1% Rx, OTC
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.
Topical 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 or vaginal area.
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.
Early relief of symptoms may be seen in 2–3 days. For 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.
