Tolnaftate

What is Tolnaftate

Tolnaftate is a synthetic topical thiocarbamate antifungal agent. It is used primarily for the treatment of mild to moderate tinea pedis (athlete’s foot), tinea cruris (jock itch), tinea corporis (ringworm), tinea manuum, and tinea versicolor in immunocompetent patients.

The causative dermatophytes (fungi that require keratin to grow) are Trichophyton rubrumT. mentagrophytesT. tonsuransMicrosporum canisM. audouiniiMalassezia furfur or Epidermophyton floccosum. Superficial dermatophyte infections are typically treated with a topical antifungal agent alone, however, occasionally a keratolytic agent, surgical debridement, wet compresses, or an oral antifungal is needed instead of or in addition to tolnaftate.

Adjunctive oral antifungal therapy may be required if the disease is extensive, dermatophyte folliculitis is present, hyperkeratotic areas on the palms and soles are affected, the infection is chronic, frequently relapses, or does not respond to topical therapy or if the patient is immunocompromised.

Tolnaftate can also be used prophylactically for tinea pedis and is effective in the treatment of fungal otitis externa.

It is recommended to not use tolnaftate in patients with purulent discharge from skin or ears, foul smelling toe webs, or inflammation of a major portion of the foot.

Tolnaftate is not recommended for the treatment of deeper fungal infections of the skin or infections of the nail beds.

Tolnaftate is usually ineffective in the treatment of onychomycosis (tinea unguium) due to lack of drug penetration.

Tolnaftate has no activity against and therefore should not be used in the treatment of infections caused by Candida albicansCryptococcus neoformansAspergillus fumigatus, bacteria, protozoa, or viruses.

This drug was approved by the FDA in 1965.

Indications

  1. Epidermophyton floccosum
  2. Fusarium sp.
  3. Malassezia furfur
  4. Microsporum audouinii
  5. Microsporum canis
  6. Microsporum gypseum
  7. Microsporum japonicum
  8. otitis externa
  9. tinea barbae
  10. tinea capitis
  11. tinea corporis
  12. tinea cruris
  13. tinea manuum
  14. tinea pedis
  15. tinea versicolor
  16. Trichophyton mentagrophytes
  17. Trichophyton rubrum
  18. Trichophyton schoenleinii
  19. Trichophyton sp.
  20. Trichophyton tonsurans

Side Effects

  1. contact dermatitis
  2. erythema
  3. pruritus
  4. skin irritation
  5. xerosis

Allergic contact dermatitis has been reported with tolnaftate. It is recommended to discontinue use if pruritus, erythema, inflammation, or skin irritation occur or worsen during therapy.

Spray, gel, and liquid formulations preparations may also contain alcohol; which may cause mild stinging at the site of application or dry skin (xerosis).

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • breast-feeding
  • children
  • diabetes mellitus
  • immunosuppression
  • infants
  • neonates
  • occlusive dressing
  • ocular exposure
  • onychomycosis
  • paraben hypersensitivity
  • peripheral vascular disease
  • pregnancy
  • tobacco smoking
  • tolnaftate hypersensitivity

Interactions

There are no drug interactions associated with Tolnaftate products.

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