clotrimazole (topical)

General

Pronunciation:
kloe-trye-ma-zole


Trade Name(s)

  • CanestenCanadian Tradename
  • ClotrimadermCanadian Tradename
  • Cruex
  • Lotrimin AF

Ther. Class.
antifungals (topical)

Indications

Treatment of a variety of cutaneous fungal infections, including cutaneous candidiasis, tinea pedis (athlete's foot), tinea cruris (jock itch), tinea corporis (ringworm), and tinea versicolor.

Action

Affects the permeability of the fungal cell wall, allowing leakage of cellular contents.

Therapeutic Effect(s):

Decrease in symptoms of fungal infection.

Pharmacokinetics

Absorption: Absorption through intact skin is minimal.

Distribution: Distribution after topical administration is primarily local.

Metabolism and Excretion: Systemic metabolism and excretion is negligible with local application.

Half-life: Not applicable.

TIME/ACTION PROFILE

ROUTEONSETPEAKDURATION
Topunknownunknownunknown

Contraindication/Precautions

Contraindicated in:

  • Hypersensitivity to active ingredients, additives, preservatives, or bases.

Use Cautiously in:

  • Nail and scalp infections (may require additional systemic therapy)
  • OB: Lactation: Safety not established.

Adverse Reactions/Side Effects

Local: burning, itching, local hypersensitivity reactions, redness, stinging

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Drug-Drug

Not known.

Route/Dosage

Topical: (Adults and Children) >3 yr): Apply cream or solution twice daily for 1–4 wk.

Availability (generic available)

Cream: 1%OTC

Solution: 1%OTC

In Combination with: betamethasone (Lotrisone). See combination drugs.

Assessment

  • Inspect involved areas of skin and mucous membranes before and frequently during therapy. Increased skin irritation may indicate need to discontinue medication.

Potential Diagnoses

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.
  • 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.
  • Inform patient that early relief of symptoms may be seen in 2–3 days. For Candida, tinea cruris, and tinea corporis, 2 wk are needed, and for tinea pedis, therapeutic response may take 3–4 wk. Recurrent fungal infections may be a sign of systemic illness.

Evaluation/Desired Outcomes

  • Decrease in skin irritation and.
  • Resolution of infection.
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