Prevention of oropharyngeal candidiasis in immunocompromised patients (receiving chemotherapy or radiation for cancer or corticosteroids for cancer or transplant).
Action⬆⬇
Affects the permeability of the fungal cell wall, allowing leakage of cellular contents.
Therapeutic effects:
Decrease in or prevention of symptoms of oropharyngeal candidiasis.
Pharmacokinetics⬆⬇
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.
Time/Action Profile⬆⬇
ROUTE
ONSET
PEAK
DURATION
PO
unknown
unknown
up to 3 hr
Contraind./Precautions⬆⬇
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).
Adv. Reactions/Side Effects⬆⬇
Derm: pruritis
GI: ↑liver function tests, abnormal mouth sensations, nausea, vomiting
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.
Availability⬆⬇
(Generic available)
Troche: 10 mg
Assessment⬆⬇
Assess oropharnyngeal mucosa prior to and periodically during therapy.
Lab Test Considerations:
Monitor hepatic function prior to and periodically during therapy. May cause ↑AST.
Implementation⬆⬇
PO: Allow each troche to dissolve slowly in mouth to achieve maximum effect.
Patient/Family Teaching⬆⬇
Instruct patient to take clotrimazole as directed. Allow each troche to slowly dissolve in mouth.
Evaluation/Desired Outcomes⬆⬇
Decrease in or prevention of symptoms of oropharyngeal candidiasis.