Clotrimazole

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Clotrimazole Brand Names

Alevazol | Antifungal | Anti-Fungal | Cruex | Desenex | Fungoid | Gyne-Lotrimin | Lotrimin | Lotrimin AF | Lotrimin AF Ringworm | Mycelex | Mycelex Troche

What is Clotrimazole

Clotrimazole is an imidazole antifungal agent. It is used for the treatment of infections caused by various species of pathogenic dermatophytes, yeasts, and Malassezia furfur.

These include ringworm (dermatophytosis), vaginal and oral candidiasis, and tinea infections.

The ability of formulations to reach subcutaneous tissues is poor, so clotrimazole is not indicated in the treatment of subcutaneous mycoses.

Clotrimazole is marketed in a variety of preparations including vaginal suppositories and cream, topical lotion and cream, topical solution, and lozenges.

Clotrimazole was approved by the FDA in 1975.

Oral forms of clotrimazole continue to be investigated for the treatment of infectious diarrhea and as a unique treatment to block sickling of erythrocytes in sickle cell disease.

Indications

  1. Candida albicans
  2. Candida krusei
  3. Candida pseudotropicalis
  4. Candida sp.
  5. candidiasis
  6. candidiasis prophylaxis
  7. Epidermophyton floccosum
  8. Malassezia furfur
  9. Microsporum canis
  10. oropharyngeal candidiasis (thrush)
  11. tinea corporis
  12. tinea cruris
  13. tinea pedis
  14. tinea versicolor
  15. Trichophyton mentagrophytes
  16. Trichophyton rubrum
  17. vulvovaginal candidiasis

Side Effects

  1. abdominal pain
  2. diarrhea
  3. edema
  4. elevated hepatic enzymes
  5. erythema
  6. nausea
  7. pruritus
  8. skin irritation
  9. urticaria
  10. vaginal irritation
  11. vaginal pain
  12. vomiting

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • abdominal pain
  • azole antifungals hypersensitivity
  • breast-feeding
  • contraceptive devices
  • diabetes mellitus
  • fever
  • human immunodeficiency virus (HIV) infection
  • immunosuppression
  • menstruation
  • ocular exposure
  • onychomycosis
  • ophthalmic administration
  • pregnancy
  • vaginal discharge

Interactions

  • Progesterone

Progesterone: (Moderate) Vaginal preparations of progesterone (e.g., Crinone, Endometrin, and Prochieve) should not be used with other intravaginal products (e.g., vaginal antifungals, such as clotrimazole, miconazole nitrate, terconazole, or tioconazole vaginal) as concurrent use may alter progesterone release and absorption from the vagina.

Separate the times of administration to avoid the interaction. The manufacturers of Crinone and Prochieve indicate that other intravaginal products can be used as long as 6 hours has lapsed either before or after vaginal administration of progesterone.

Endometrin is generally not recommended for use with other vaginal products (e.g., antifungal products) as this may alter progesterone release and absorption from the vaginal insert and the potential for interaction has not been formally assessed; use other vaginal products if medically necessary, but be aware that the response to Endometrin may be altered. 

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