Clotrimazole

Administration

  • Type: Antifungal, azole
  • Dosage Forms
    • Topical:1% cream
    • Vaginal: 100mg supp, 200mg supp; 1% cream, 2% cream
    • Oropharyngeal: 10mg troche
  • Routes of Administration: topical, oropharyngeal, vaginal
  • Common Trade Names
    • Topical: Anti-Fungal Liquid, Desenex AF Prescription Strength, FungiCURE Pump Spray, Lotrimin AF Cream, Lotrimin AF For Her, Lotrimin AF Jock Itch, Lotrimin AF Solution, Lotrimin Jock Itch Powder, MPM Anti-Fungal, Prescription Strength Cruex
    • Vulvovaginal: Clotrimazole-3, Clotrimazole-7, Femcare, Gyne-Lotrimin, Gyne-Lotrimin 3 Day, Gyne-Lotrimin Combo Pack
    • Oropharyngeal: Mycelex Troche

Adult Dosing

  • Topical
    • Candidiasis, cutaneous
      • Apply bid
    • Tinea
      • Apply bid
      • 2-4 wks for best results with corporis, cruris, pedis, versicolor
  • Vulvovaginal
    • candidiasis, vulvovaginal
      • 200mg PV qhs x3 days
      • Alt: 100mg PV qhs x7 days
      • Alt: 1 applicatorful 2% PV qhs x3 days
      • Alt: 1 applicatorful 1% PV qhs x7-14 days
  • Oropharyngeal
    • candidiasis treatment, oropharyngeal
      • 10mg PO 5x/day x14 days
        • slowly dissolve in mouth; do not chew or swallow whole
    • candidiasis prophylaxis, oropharyngeal
      • 10mg PO tid
        • continue for duration of chemo or high-dose steroid; slowly dissolve in mouth; do not chew or swallow whole

Pediatric Dosing

Same as adult

Special Populations

Renal Dosing

  • Adult:
  • Pediatric:

Hepatic Dosing

  • Adult: Precaution with troches. Monitor LFTs.
  • Pediatric:

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

may occur but none reported

Common

  • Topical
    • irritation
    • burning/stinging
    • pruritus
    • erythema
    • localized edema
    • urticaria
    • peeling
    • blistering
  • Vulvovaginal
    • vulvovaginal burning
    • vulvovaginal pruritus
    • vulvovaginal soreness
    • vulvovaginal swelling
    • pelvic pain
    • pelvic cramps
    • abdominal pain
  • Oropharyngeal
    • vomiting
    • nausea
    • abdominal cramps
    • abnormal LFTs

Pharmacology

  • Half-life: Unknown
  • Metabolism: liver; CYP450: unknown; Info: minimal systemic absorption
  • Excretion: bile/feces primarily, urine

Mechanism of Action

  • Exact mechanism of action unknown
  • Azole antifungal
    • Inhibits 14-alpha demethylase, reducing fungal cell membrane ergosterol synthesis and increasing cellular permeability

Comments

See Also

References