Clotrimazole cream belongs to antifungal agents. Designed for the treatment of skin diseases. The drug has several forms of release - cream, ointment, tablets, suppositories, douching solution. Each of them has its own peculiarities of application. The drug has a detrimental effect on pathological microorganisms, prevents the spread of infection.
The active component of Clotrimazole cream is a substance of the same name - clotrimazole. The action depends on the concentration. Either it slows down and stops the growth of pathological microorganisms, or leads to their death. The substance is characterized by a wide spectrum of action.
- Fungi;
- Bacteria;
- The simplest;
- Dermatophytes;
- Yeast.
Pathogenic microorganisms do not show resistance to the active ingredient. The action of the drug always causes their death.
The main advantage of clotrimazole is its concentration in skin tissues. The substance practically does not penetrate into the bloodstream, concentrates on problem areas. This reduces the risk of side effects.
Auxiliary components of the drug:
- Benzyl, cetostearyl alcohol;
- Polysorbate;
- Octyldodecanol;
- Sorbitan Stearate;
- Water;
- Synthetic spermaceti.
The cream has a lightweight texture, is well applied, absorbs quickly, and is practically odorless. Metabolism occurs in the liver, is excreted from the body by the kidneys, through the intestines.
What does the cream help from - indications for use
An antifungal drug with a wide spectrum of action has found application in dermatology, gynecology, and some other areas. An external drug is prescribed for:
Clotrimazole can be used by women and men. The course of therapy is prescribed by the doctor, regulates the concentration of the active ingredient with various forms of the drug.
Application features
Clotrimazole cream is recommended to be applied in a thin layer to previously cleansed, dried skin. The procedure is carried out 2-3 times a day. The duration of therapy depends on the extent of the lesion, localization. On average, the treatment lasts 1 month. It is not recommended to stop therapy immediately after the painful symptoms disappear. In order to consolidate the effect, the drug is used for another 1-2 weeks.
The use of Clotrimazole for men
One of the indications is thrush. Fungi of the genus Candida are often detected in women, although the main carrier of the disease is a man. Their thrush is asymptomatic or has mild symptoms:
Clotrimazole is considered one of the most effective remedies for male thrush. The drug is applied in a thin layer to the head of the penis twice a day after water procedures. Duration of therapy is 2 weeks. For consolidating the result, it is recommended to extend the course by 7 days.
Another disease that is more typical for men is foot fungus. The main symptoms are:
- Itching, burning;
- Peeling of the skin;
- Redness;
- Wet between toes;
- Erosion at the site of previous cracks;
- Loosening of the skin.
The disease is dangerous by a decrease in local immunity, the addition of a secondary infection.
Clotrimazole is used after preliminary cleansing of the skin of the foot. Apply in a thin layer twice a day. The drug quickly relieves symptoms, destroys the source of the disease.
Contraindications
Since the active ingredient does not enter the bloodstream, the cream does not affect the functioning of internal organs and systems. The only contraindication is individual intolerance to the components. A test is recommended before active treatment. A small amount of cream is applied to the elbow bend, the condition of the skin is monitored for 1 hour.
Side effects occur in the presence of individual intolerance. Manifested in the form of rashes, redness on the skin. They pass on their own without special treatment.
In the course of laboratory studies, they did not find a negative effect of Clotrimazole cream on the body of a pregnant woman, fetal development. However, use during pregnancy, breastfeeding should be done under 
careful supervision of specialists.
Drug price
The cream is produced by several manufacturers, including Russia, under license from a UK company. Therefore, prices are different. The budget version of the drug is produced by Cedeate Healthcare. For a tube of cream with a capacity of 20 ml, you will have to pay 39 rubles. The most expensive drug is presented by GlaxoSmithKline Pharmaceuticals S.A .. The cost of a cream with the same capacity is 170 rubles. The drug can be bought at a pharmacy or ordered online. The shelf life is 3 years from the date of manufacture.
What is the difference between clotrimazole cream and ointment
The concentration of the active ingredient is similar to that of the cream. This means that the ointment works in the same way. The composition of the excipients differs insignificantly. Due to this, the ointment has a denser consistency. In case of complex fungal lesions of the skin, mucous membranes, it is recommended to initially treat with an ointment, then switch to a cream.
Analogues of Clotrimazole cream
Antifungal agents are one of the most numerous pharmaceutical groups. Clotrimazole has analogues in composition and action.
Generics of the cream, that is, drugs with an identical active ingredient, practically do not differ in price, composition, and action. The pharmacy can offer:
Antifungal drugs with a similar effect:
- Pimafucin;
- Nystatin ointment;
- Ketozoral;
- Miconazole;
- Dactanol;
- Ketoconazole.
When choosing a medicine, it is necessary to be guided by the recommendations of the attending physician. The drugs are dispensed without a prescription.
Due to poor absorption through the skin and mucous membranes of systemic action and associated side effects, the drug does not.
Clotrimazole is available in several dosage forms: vaginal cream, suppositories and tablets, cream and ointment for external use. In domestic pharmacies, the drug with the trade name "Clotrimazole" in the form of branded generics and generic generics can be found at once from several manufacturers, including Russian (Atoll, Avexima, GlaxoSmithKline Trading, ZiO-Zdorovye, Sintez, Ozone, Akrikhin) and foreign pharmaceutical companies: Esparma (Germany), Hyperion (Romania), Pharmaprim (Moldova), Sedeit Helcar (India), Medana Pharma (Poland), Teva (Israel), Shreya (India). Given the lack of absorption through the skin and, therefore, systemic (not only locally, but also on distant organs and tissues) action, the use of Clotrimazole in high doses is not associated with life-threatening reactions. Poisoning with the drug is possible only with inappropriate (in this case, oral) use. The symptoms of toxicosis caused by Clotrimazole are nausea, vomiting, epigatric pain, anorexia, liver dysfunction, dermatological reactions, polyuria. In such a situation, the intake of activated carbon is indicated.
Pharmacology
Antifungal agent of the group of imidazole derivatives for topical use. It acts by disrupting the synthesis of ergosterol, which is an integral part of the cell membrane of fungi. Possesses a wide spectrum of action.
Active against dermatophytes, molds, fungi of the genus Candida, Malassezia furfur.
Clotrimazole is also active against Corynebacterium minutissimum, Streptococcus spp., Staphylococcus spp., Trichomonas vaginalis.
Pharmacokinetics
When applied externally, clotrimazole penetrates well into various layers of the skin, reaching therapeutic concentrations. When applied topically, a small amount of clotrimazole is absorbed into the bloodstream.Release form
3 pcs. - contour cell packaging (1) - cardboard packs.
6 pcs. - contour cell packaging (1) - cardboard packs.
Dosage
When applied externally, it is applied to the affected skin 2-3 times / day for 2-4 weeks.
When treating the oral cavity, apply 1-2 times / day for no more than 7 days.
Intravaginally - 100-500 mg for 1-6 days.
Interaction
With simultaneous use with amphotericin B, nystatin, the activity of clotrimazole decreases.
Side effects
Local reactions: contact allergic dermatitis, redness, burning sensation.
Indications
Fungal lesions of the skin and mucous membranes caused by dermatophytes, mold and yeast-like fungi, versicolor versicolor, erythrasma, vulvovaginal candidiasis, trichomoniasis, mycoses complicated by secondary pyoderma.
Contraindications
Hypersensitivity to clotrimazole, I trimester of pregnancy.
Application features
Application during pregnancy and lactation
Contraindicated in the first trimester of pregnancy.
In experimental studies, it was found that when used in high doses, clotrimazole has an embryotoxic effect.
It is not known whether clotrimazole is excreted in breast milk. Although clotrimazole is not contraindicated during pregnancy and lactation, the potential risk should be considered when choosing antifungal therapy.
special instructions
Dosage forms intended for intravaginal use are not used during menstruation.
To prevent reinfection, simultaneous treatment of sexual partners is necessary. Clotrimazole is not recommended for use in ophthalmology.
Clotrimazole is a drug (cream) that belongs to the pharmacological group of antifungal drugs for the treatment of skin diseases. The instructions for use highlight the following features:
- During pregnancy: with caution
- When breastfeeding: with caution
Package
Compound
Gel 1% contains clotrimazole at a concentration of 10 mg / g, propylene glycol, macrogol 400, carbomer, ethyl alcohol rectified from food raw materials 96%, glycerol, sage ether extract.
Cream composition 1%: clotrimazole at a concentration of 10 mg / g, cetostearyl and benzyl alcohols, polysorbate 60, synthetic spermaceti, octyldodecanol, sorbitan stearate, water.
The composition of the ointment is 1%: clotrimazole at a concentration of 10 mg / g, polyethylene oxides 400 and 1500, propylene glycol, methylparaben, nipagin.
The composition of the solution is 1%: clotrimazole at a concentration of 10 mg / ml (in terms of dry matter), polyethylene glycol 400, propylene glycol, ethanol 96%.
Composition of suppositories: one suppository contains 100 mg of active substance and a base in the amount necessary to obtain a suppository weighing 2 g. As a base, suppositories with Clotrimazole contain semisynthetic glycerides.
Composition of tablets: 100, 200 or 500 mg of clotrimazole, lactose in the form of monohydrate, potato starch, adipic acid, sodium bicarbonate, silicon dioxide in colloidal form, sodium lauryl sulfate.
Release form
- gel 1% (packs 20 and 40 g);
- cream 1% (tubes 15, 20, 30 and 50 g);
- ointment 1% (tubes 15, 20, 30 and 40 g);
- solution 1% (vials 15 ml);
- vaginal suppositories 0.1 g (pack No. 6);
- vaginal tablets 0.1, 0.2 or 0.5 g (packs No. 1, No. 3, No. 6; tablets are completed with an applicator).
Clotrimazole tablets and vaginal suppositories have a different ATX code from other dosage forms of the drug - G01AF02.
Clotrimazole can also be produced in the form of granules, powder for external use, spray.
The drug is intended for local (including intravaginal) and external use, tablets for oral administration are not available.
pharmachologic effect
Antimycotic.
Pharmacodynamics and pharmacokinetics
Clotrimazole is an imidazole derivative.
In vitro is highly active against the most pathogenic fungi that can cause serious infectious complications, namely:
- dermatophytes (Microsporum sp., Epidermophyton floccosum, Trichophyton sp.);
- yeast-like fungi (Cryptococcus neoformans, Candida sp.);
- dimorphic fungi (Histoplasma capsulatum, Paracoccidicides brasiliensis, Coccidiodes immitis).
The mechanism of action of clotrimazole is based on its ability to block the synthesis of proteins, nucleic acids and ergosterol, which is necessary for the construction of cell membranes of fungi. As a result, the cell walls of the fungi are damaged, and the cells die.
In low concentrations, clotrimazole acts fungistatically. If the dose exceeds 20 μg / ml, the drug has a fungicidal effect, and not only on proliferating cells.
When used in high doses, it helps to increase the concentration of hydrogen peroxide in the fungal cell to a toxic value and, as a result, to the destruction of fungal cells.
When applied topically, the drug is absorbed by the epidermis. The highest concentration of the substance is found in the reticuloderm. It is also able to penetrate the keratin of the nails.
Clotrimazole enters the systemic circulation in very small quantities. It is metabolized in the liver to inactive substances, which are excreted from the body with feces and urine.
With intravaginal use, from 5 to 10% of clotrimazole is absorbed. The absorbed substance is metabolized in the liver. Metabolic products are excreted with bile.
Indications for use: what is Clotrimazole ointment, cream, gel, suppositories and tablets for?
What does Clotrimazole ointment, gel, cream and solution help with?
The drug is prescribed for the treatment of fungal infections of the skin, which are caused by mold and yeast fungi, dermatophytes and other pathogens sensitive to clotrimazole.
They are also used as a remedy for Malassezia furfur lichen and erythrasma (caused by Corynebacterium minutissimum).
Ointment, cream, gel and Clotrimazole solution help: from nail fungus (onychomycosis, fungal paronychia), trichophytosis, dermatophytosis, fungal erosion and diaper rash, candidiasis, microsporia, epidermophytosis, dermatomycosis, complicated by secondary pyoderma mycoses.
Indications for the use of ointments, gel, cream and solution include infectious diseases, pathogens that are resistant to nystatin and a number of other antifungal agents.
For the treatment of pink lichen, the drug is not suitable, since this disease is most likely of a viral or infectious-allergic origin, and may also be the body's response to a severe shock or nervous breakdown. Clotrimazole is also effective for fungal infections.
The use of Clotrimazole ointment, gel and cream with clotrimazole in gynecology is shown:
- for the treatment and prevention of thrush;
- for the prevention of repeated fungal infections of the female reproductive system, which develop with prolonged antibiotic treatment or against the background of immunodeficiency conditions.
Also, a solution, gel, cream and ointment in gynecology is used to sanitize the genital tract before delivery.
Candles - what are they from?
Indications for the use of vaginal suppositories are vaginal candidiasis and genital superinfections provoked by microorganisms sensitive to clotrimazole. The drug is prescribed for women and - after the onset of sexual activity - for adolescent girls.
What are clotrimazole tablets from?
Clotrimazole tablets are used to treat blastomycotic infections of the vulva and vagina. In particular, the drug is prescribed for vaginitis caused by fungi of the genus Candida (including diseases caused by strains resistant to nystatin), caused by other genital superinfections sensitive to clotrimazole, to sanitize the genital tract before delivery.
Contraindications
Contraindication: hypersensitivity.
Side effects
Allergic reactions.
When applied to the skin, the following side effects are possible:
- burning;
- edema;
- the appearance of blisters;
- erythema;
- skin irritation;
- tingling sensation
- peeling.
Local application for urogenital mycoses may be accompanied by burning, itching, swelling and hyperemia of the mucous membrane, intercurrent cystitis, vaginal discharge, increased urination, pain during intercourse.
When applied topically with mycoses of the oral cavity, redness of the mucous membrane, a tingling and burning sensation at the site of application of the drug, and irritation may occur.
Instructions for use of Clotrimazole: Clotrimazole for women and for men
Clotrimazole ointment: instructions for use. How to apply Clotrimazole ointment for men?
Before applying Clotrimazole ointment (Acri or other manufacturers), the affected areas of the body are pre-washed with soapy water and dried thoroughly.
The drug is applied to the affected areas (capturing small areas of healthy skin around the lesion) in a thin layer from 1 to 3 times / day. and rub in lightly.
For 1 treatment of a palm-sized area, a 5-millimeter strip of ointment is sufficient.
Regardless of what pathogens caused the disease, it is recommended to continue treatment for another 2 weeks after the subjective symptoms have subsided.
With dermatomycosis, the course of treatment lasts from 3 to 4, with erythrasma - from 2 to 4, with multi-colored lichen - from 1 to 3 weeks.
If there is no clinical improvement after 4 weeks of regular use of the drug, the patient is sent for a second microbiological examination and the treatment regimen is reviewed.
The use of an ointment for thrush in women allows you to block the proliferation of fungal cells and - when prescribing higher doses - ensures their complete destruction. For therapeutic purposes, Clotrimazole from thrush is used 2 r. / Day, rubbing the ointment into the affected perineum.
For men, the method of application for thrush and other fungal infections of the genital organs (candidal balanoposthitis, urogenital candidiasis) is the same as for women.
The ointment is applied to the foreskin and glans of the penis and gently rubbed into the skin and mucous membrane. Frequency rate of applications - 2 rubles / day.
The drug is poorly absorbed into the skin, and its active substance is characterized by the ability to gradually accumulate in the upper layer of the skin. Thanks to these properties, the high efficiency of Clotrimazole ointment for thrush in men and women is ensured.
Clotrimazole cream: instructions for use
The cream is intended for topical use. With thrush and other fungal diseases, it is applied to the affected area twice or three times during the day and rubbed lightly.
The duration of the course depends on the indications for use and ranges from 1-2 (with candidal balanitis / vulvitis) to 3-4 weeks (with dermatomycosis).
For the prevention of recurrence of the disease, it is very important not to stop treatment for another 2 weeks after the subjective symptoms of infection disappear. If there is no improvement after 4 weeks of therapy, the patient should consult a doctor.
Vaginal cream Clotrimazole is injected into the vagina in portions of 5 grams 1 r. / Day. within 3 days.
Solution instruction
Before applying Clotrimazole, the skin should be washed with warm soapy water (especially the areas between the fingers) and dried well. Treatment of the affected areas is carried out 2-3 times / day. The amount of solution should be sufficient to evenly apply to the entire affected area.
In case of lesions of the skin of the feet, liquid Clotrimazole solution must be applied after each wash.
The solution is the most preferred dosage form for onychomycosis. This is due to the fact that it has the best penetrating properties.
In case of fungal infections of the oral cavity, the affected areas of the mucous membrane are treated with a cotton swab or a tampon, on which drops are pre-applied (10 to 20 drops are enough to treat each ear). The frequency of procedures is 3-4 rubles / day.
After applying Clotrimazole, you should refrain from eating and drinking for an hour.
Clotrimazole drops are also effective for onomycosis caused by yeast fungi. Drops are injected into the ear using turundochek: a twisted cotton flagellum is moistened in a solution and 3-4 r. / Day. put in the ear canal for 5-10 minutes. The treatment lasts 3 to 4 weeks.
Gel instruction
A feature of this dosage form is that the gel is well distributed on the skin and is just as well absorbed into it. This allows you to use the drug, including for the treatment of hard-to-reach areas of the body.
Intravaginally, the gel is applied in the same way as the clotrimazole cream: 1 r. / Day. 5 grams each. The course of treatment is 3 days.
Clotrimazole vaginal tablets: instructions for use
In the absence of other prescriptions, Clotrimazole Acri tablets and their synonymous drugs for thrush and other fungal infections of the genital organs are used:
- within 3 days, 1 tablet 2 r. / day;
- within 6 days, 1 tablet 1 r. / day.
How to give Clotrimazole vaginal tablets? Before the introduction, the tablet is taken out of the package and moistened with chilled boiled water. The drug should be administered in the supine position with legs bent at the knees.
In order for the tablet to completely dissolve and clotrimazole to work, a moist environment is required (otherwise, undissolved particles may spill out). Therefore, the pill is inserted into the vagina as deep as possible. It is optimal to carry out the procedure before bedtime.
Treatment must be discontinued before the onset of menstruation. The menstrual flow will wash out the drug and will not have the desired effect. During the period of treatment with vaginal tablets, tampons, spermicides, intravaginal douching and any other vaginal products should not be used.
To sanitize the genital tract before delivery, a woman is injected with 200 mg of clotrimazole once.
During pregnancy, the drug is contraindicated in the 1st trimester. At a later date, clotrimazole does not have an adverse effect on the development of the fetus, but the use of the applicator may be associated with certain risks.
Candle manual
Suppositories from thrush are used intravaginally. The drug should be injected deep into the vagina, one at a time daily for 6 days. A second course is possible after consulting a doctor.
Suppositories Clotrimazole for thrush and other urogenital mycoses are not used during menstrual bleeding. Treatment must be completed before starting.
During pregnancy, the drug in this dosage form is used from the 2nd trimester and in situations where the expected benefit to the mother outweighs the possible risks to the fetus.
Reviews suggest that the drug quickly destroys fungal colonies and eliminates the unpleasant symptoms of mycoses. Its other advantages include a low price and a large selection of dosage forms.
Overdose
When applied to the skin and intravaginal use, there is no risk of acute intoxication, since clotrimazole enters the systemic circulation in very small quantities.
In case of accidental intake of Clotrimazole inside, nausea, anorexia, vomiting, gastralgia, liver dysfunction are possible. In rare cases, pollakiuria, hallucinations, drowsiness, and allergic skin reactions are noted.
In this case, the patient is prescribed enterosorbents and symptomatic treatment. Gastric lavage is performed in situations where a life-threatening dose was taken within the previous hour, as well as in the presence of visible symptoms of an overdose (nausea, dizziness, vomiting).
Interaction
When used simultaneously with polyene antibiotics (amphotericin B, natamycin, nystatin), the drugs mutually suppress each other's activity.
Terms of sale
Without recipe.
Storage conditions
Protect from moisture and light. Storage temperature should not exceed 25 ° C. Freezing of cream, gel, ointment or solution is not allowed.
Best before date
Suppositories, cream, solution, gel and vaginal tablets are usable for 3 years after the date of issue. The shelf life for the ointment is 2 years.
special instructions
Avoid swallowing and contact with eyes.
With mycoses, all affected areas of the body should be treated simultaneously.
The use of vaginal tablets, unless the doctor has given other recommendations, is contraindicated in the presence of any of the following symptoms:
- acyclic vaginal bleeding;
- bloody discharge or pathological bleeding from the vagina, uterine hemorrhages;
- dysuria;
- lower abdominal pain;
- open sores, blisters, or sores in your vagina or vulva;
- any unpleasant symptoms associated with the use of Clotrimazole (irritation, redness, burning, swelling, etc.);
- chills or fever with a rise in temperature above 38 ° C;
- nausea and / or vomiting;
- foul-smelling vaginal discharge;
- diarrhea;
- pain in the shoulder or back.
To prevent reinfection, treatment is prescribed simultaneously to both partners. The optimal dosage form for men is a cream.
In trichomoniasis, in addition to the drug, chemotherapeutic agents are prescribed for systemic treatment (oral metronidazole).
What is better clotrimazole ointment or cream?
The choice in favor of one or another dosage form is made depending on the indications. Clotrimazole ointment for women and men is prescribed for diseases that are accompanied by increased dryness and flaking of the skin.
As a rule, these are skin mycoses caused by dermatophytes (trichophytosis, microsporia), epidermophytosis groin, erythrasma, pityriasis versicolor, isolated cases of smooth skin candidiasis, mixed bacterial and fungal infections.
With weeping inflammatory processes, it is more advisable to use a cream that has a drying effect.
Clotrimazole's analogs
Synonyms for dosage forms for external use: Clotrimazole-Acri, Amiklon, Imidil, Kandibene, Kandizol, Candide, Kanesten, Kanizon, Funginal, Funugcip.
Analogs of vag. tab .: Candide, Imidil, Kandizol, Kandibene, Funginal, Candid-B6, Kanizon, Fungitsip.
Which is better: Candide or Clotrimazole?
Candide is synonymous with Clotrimazole. Both drugs are based on the same substance, so there are no fundamental differences between them.
Clotrimazole or Pimafucin - which is better?
The main component of Pimafucin is an antibiotic with antimycotic action, nitamycin. Mold and yeast fungi (including the genera Penicillium, Candida, Cephalosporium, Aspergillus and Fusarium) are mainly susceptible to the drug.
Pseudoallescheria boydii and dermatophytes are less sensitive to Pimafucin. That is, in situations where the cause of the disease is fungi of the genus Epidermophyton, Trichophyton or Microsporum, the choice should be made in favor of the drug Clotrimazole.
The use of Clotrimazole is less often accompanied by hypersensitivity reactions. In addition, it provokes imbalances in the microflora of the genital organs less often than Pimafucin.
Clotrimazole for children
The experience of using the solution, ointment, gel and cream 1% in children is absent.
Tablets are used from 12 years old, subject to the onset of menarche in the patient.
Candles are not prescribed for children.
Clotrimazole during pregnancy and lactation
Cream, gel, ointment, solution, suppositories and vag. tablets during pregnancy can be used from the 2nd trimester.
Strictly controlled studies regarding the safety of use during pregnancy, therefore, Clotrimazole is not prescribed in the 1st trimester.
Clinical studies on the effect of the drug on fertility in women have not been carried out; in experiments on animals, no adverse effects have been identified.
Clotrimazole tablets and suppositories during pregnancy (in the 2nd and 3rd trimesters) do not have a negative effect on the fetus, but the use of the applicator can be dangerous.
When breastfeeding, the drug is used with caution, since it is not known whether it passes into milk.
Producer: Glaxo Operetaions UK Limited (Glaxo Operations UK Limited) UK
ATC code: D01AC01
Pharm group:
Release form: Soft dosage forms. Cream.
General characteristics. Compound:
Cream for external use 1% in the form of a homogeneous white mass.
Active ingredient: clotrimazole 1 g
Excipients: benzyl alcohol - 1 g, cetostearyl alcohol - 11.5 g, octyldodecanol - 10 g, polysorbate 60 - 1.5 g, sorbitan stearate - 2 g, synthetic spermaceti - 3 g, water - 71 g.
Pharmacological properties:
Clotrimazole inhibits the growth and division of microorganisms and, depending on the concentration, can have a fungistatic (inhibiting and stopping the growth of fungal cells) or fungicidal (leading to the death of fungi) action. Clotrimazole inhibits the synthesis of ergosterol and binds to phospholipids of the cell membrane of the fungus, which leads to a change in the permeability of the cell membranes.
At higher concentrations, clotrimazole causes damage to cell membranes by mechanisms independent of sterol synthesis.
Clotrimazole also disrupts vital processes in the fungal cell, suppressing the formation of components necessary for the construction of vital cellular structures (proteins, fats, DNA, polysaccharides), damages nucleic acids and increases the excretion of potassium.
Ultimately, the effect of clotrimazole on fungal cells leads to their death.
Clotrimazole is characterized by a wide range of antifungal and antibacterial activity: dermatophytes (Epidermophyton floccosum, Microsporum canis, Trichophyton mentagrophytes, Trichophyton rubrum), yeast (Candida spp., Cryptococcus neoformans), dimorphic prostate fungi (Coccidio sisoimides), dimorphic prostate fungi (Coccidioides vaginalis).
It is also active against some gram-positive bacteria.
When studying the effectiveness of clotrimazole in laboratory conditions outside the human body (in vitro), a wide range of its fungistatic and fungicidal activity was revealed. It acts on the mycelium of dermatophytes (Trichophyton, Microsporum, Epidermophyton) similarly to griseofulvin, and its effect on budding fungi (Candida) is similar to that of polyenes (amphotericin B and nystatin).
At concentrations less than 1 μg / ml, clotrimazole inhibits the development of most strains of pathogenic fungi related to Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, Microsporum canis.
At a concentration of 3 μg / ml, clotrimazole inhibits the development of most other bacteria: Pityrosporum orbiculare, Aspergillus fumigatus, genus Candida, incl. Candida albicans, some strains of Staphylococcus aureus, Streptococcus pyogenes, as well as some strains of Proteus vulgaris and Salmonella. Clotrimazole is active against Sporothrix, Cryptococcus, Cephalosporium, Fusarium.
At concentrations above 100 μg / ml, it is effective against Trichomonas vaginalis.
Fungi resistant to clotrimazole are extremely rare; there is data only for certain strains of Candida guilliermondii.
The development of resistance in clotrimazole-sensitive fungi after passage of Candida albicans and Trichophyton mentagrophytes has not been reported. Cases of development of resistance to clotrimazole in Candida albicans strains resistant to polyene antibiotics due to chemical mutation have not been described.
Pharmacokinetics. Absorption and distribution
Pharmacokinetic studies have shown that clotrimazole is practically not absorbed into the systemic circulation when the drug is applied to intact or inflamed skin areas. Serum concentrations of clotrimazole were below the detection limit (0.001 μg / ml), confirming that clotrimazole, when applied topically, does not lead to clinically significant systemic effects or side effects.
Metabolism and excretion
Clotrimazole breaks down in the liver to inactive substances, which are excreted from the body through the kidneys and intestines.
Indications for use:
For external treatment of fungal skin diseases caused by dermatophytes, yeast-like fungi, mold fungi, as well as pathogens sensitive to clotrimazole:
- mycoses of feet, hands, trunk, skin folds;
- fungal infections of the outer ear.
Important! Check out the treatment
Method of administration and dosage:
For external use. The cream should be applied to the affected skin 2-3
To prevent relapse, treatment should be continued for at least two weeks after all symptoms of infection have disappeared.
The cream should be applied to clean, dry areas of the affected skin (washed with neutral pH soap), the cream should be applied to the feet between the toes.
The duration of treatment depends on the severity of the disease, its location, and the effectiveness of treatment.
Duration of treatment: dermatomycosis - 3-4 weeks; erythrasma - 2-4 weeks; versicolor versicolor - 1-3 weeks; vulvitis candidiasis and balanitis - 1-2 weeks.
The duration of treatment may vary according to individual characteristics, but a duration of treatment less than 3 weeks is not recommended. To prevent recurrence of infection, you should continue to use the drug for 1-2 weeks after the disappearance of all symptoms of the disease. If symptoms do not improve after 7 days of treatment, you should consult your doctor.
Application features:
Avoid getting the cream on the mucous membrane of the eyes. Do not swallow.
All infected areas should be treated at the same time.
Clotrimazole contains cetostearyl alcohol, which can cause local skin reactions (for example).
If symptoms of hypersensitivity or irritation appear, treatment is discontinued.
Laboratory data indicate that the use of contraceptives containing latex can cause damage when used together with clotrimazole. Consequently, the effectiveness of such contraceptives may decrease. Patients should be advised to use alternative methods of contraception for at least 5 days after using clotrimazole.
Influence on the ability to drive vehicles and use mechanisms
The effect of clotrimazole on the ability to drive vehicles and mechanisms was not reported.
Side effects:
The adverse events presented below are listed in accordance with the damage to organs and organ systems and the frequency of occurrence. The frequency of occurrence is defined as follows: very often (≥1 / 10), often (≥1 / 100 and< 1/10), нечасто (≥1/1000 и < 1/100), редко (≥1/10 000 и < 1/1 000), очень редко (< 1/10 000, включая отдельные случаи), неизвестно (частота не может быть оценена по имеющимся на настоящий момент данным). Категории частоты были сформированы на основании пострегистрационного наблюдения.
From the immune system: unknown - an allergic reaction (manifested by urticaria, fainting, arterial hypotension, shortness of breath).
Skin and subcutaneous tissue disorders: unknown - rash, itching, blistering rash, peeling, pain or discomfort, edema, burning sensation, irritation.
Interaction with other medicinal products:
Has not been studied.
Contraindications:
- hypersensitivity to clotrimazole or other components of the drug.
Application of the drug CLOTRIMAZOL cream during pregnancy and breastfeeding
The use of the drug Clotrimazole during pregnancy is allowed only if, in the opinion of the doctor, the potential benefit of using the cream for the mother outweighs the possible risk of the fetus.
In the conducted epidemiological studies, there were no adverse events in relation to pregnancy or fetal health when using the drug Clotrimazole.
The use of the drug Clotrimazole in women during breastfeeding is allowed only if, in the opinion of the doctor, the potential benefit of using the cream for the mother outweighs the possible risk to the child.
Fertility
No data available.
Overdose:
Symptoms: if you accidentally take the drug inside, it may appear.
Treatment: in case of accidental ingestion of the cream, symptomatic treatment should be carried out. With external use of the drug, an overdose is unlikely.
Storage conditions:
The drug should be out of the reach of children at a temperature not exceeding 25 ° C. Do not freeze. Shelf life is 3 years.
Vacation conditions:
On prescription
Package:
20 g - aluminum (1) - cardboard packs.
For fungal diseases, antifungal pills or external agents are prescribed. To treat such problems, you can use Clotrimazole in the form of an ointment.
Clotrimazole - description
Clotrimazole is an antimycotic (antifungal) ointment for local use in dermatology and gynecology. The product is available in different packages - 10-50 g each. Among the companies producing it are Akrikhin (the drug Clotrimazole-Acri is produced), Teva, ETS Pharma, GlaxoSmithKline, Pharmtechnology and others.
How much the drug costs will depend on the manufacturer. Russian funds are sold at a price of 20-70 rubles, among Polish, Indian, German drugs, the cost is higher than -100-250 rubles.
The active ingredient of the composition is clotrimazole in an amount of 10 mg.
The ointment (cream) can only be applied externally. It is white with a yellowish tinge, thick, but not greasy. The smell of the drug is specific. As additional components, the ointment includes:
Clotrimazole is produced not only in the form of an ointment. There are other forms on sale, for example, 1% alcohol solution, 1% gel. A vaginal form is also available - tablets for local use, which are convenient to use for gynecological diseases in women.
Drug action
Clotrimazole has a wide spectrum of action, it is effective against a large number of types of fungi. The antimycotic effect of clotrimazole, which is an imidazole derivative, is due to a violation of the most important processes in the fungal cell. The active substance negatively affects the synthesis of ergosterol, a component of cell membranes. As a result, the permeability of the membranes becomes higher, this provokes lysis and cell death.
The drug has a fungicidal and fungistatic effect depending on the amount of the applied substance.
Clotrimazole also acts according to one more mechanism, which only increases its effectiveness. When interacting with cell enzymes, the substance causes an increase in the concentration of hydrogen peroxide. The level of the latter becomes toxic, the fungal particles are destroyed.
In the form of an ointment, Clotrimazole helps against diseases caused by such mycoses:
Also, the drug helps against the causative agent of erythrasma - corynebacterium, which belongs not to mycotic, but to bacterial cells. As an antimicrobial agent, Clotrimazole can be used against staphylococci and streptococci, Trichomonas, a number of gram-negative bacteria.
The agent does not give a systemic effect, its penetrating power is low. During treatment, clotrimazole is poorly absorbed through the skin, mucous membranes, but it is able to accumulate in the stratum corneum of the nails. In the dermis, subcutaneous tissue, clotrimazole is almost not found.
Basic indications
This tool has a variety of indications related to different areas of medicine. In the form of an ointment, Clotrimazole is used for dermatitis caused by fungal pathogens, for mycotic diseases:
The drug manifests itself most actively against dermatophytes and yeasts. With its help, you can get rid of dermatomycosis, mycotic paronychia, canidomycosis, skin microsporia, trichophytosis and epidermophytosis. The medicine quickly heals fungal erosion, which most often appears on the interdigital spaces in men and women. Also, Clotrimazole ointment is effective against fungus on the feet.
Due to its ability to act on bacteria, the ointment can be applied to skin with mycosis, which has been affected by a secondary bacterial infection. This is usually observed with secondary pyoderma, accompanied by mycosis. Outwardly, the ointment is used for such pathologies:
In women, the drug can be used for thrush - vaginal candidiasis, with vulvovaginal candidiasis, with trichomoniasis (in combination therapy with systemic agents). In men, the drug is applied to the genitals with candidiasis balanitis, balanoposthitis.
Side effects, contraindications
The medicine is usually well tolerated. Due to the lack of systemic absorption, only local side effects are possible, which manifest themselves in the form of itching, red spots, rash, tingling, burning. Most often, burning and itching are observed with intravaginal use. Usually, the refusal of therapy is not required, the unpleasant phenomena quickly pass. In rare cases, the development of a local form of urticaria is possible. Also among the unpleasant reactions are rarely observed:
When treating candidiasis, women sometimes experience frequent urination. In case of an overdose during intravaginal application, there is a risk of abdominal pain, diarrhea, headaches (in isolated cases).
During pregnancy in the 1st trimester, it is better not to use any medications, only if urgently needed. But according to indications, treatment in pregnant women is possible, since in experiments clotrimazole did not have a negative effect on the fetus. During lactation, it is forbidden to smear the skin of the mammary gland, therapy on other parts of the body is allowed. Children under 2 years of age are not treated with ointment, as with liver diseases in the terminal stage. It makes no sense to treat herpes with this remedy - with viral pathologies, the ointment does not help.
Instructions for use
The medicine can be used exclusively externally and intravaginally. In case of mycotic lesions of the feet, open areas of the skin, the procedure for therapy is as follows:
A single dosage should not exceed 5 cm of the ointment column, this rate is indicated for an area the size of an adult's palm. It is necessary to use the agent regularly, missed therapy helps to reduce the reactivity of the infection to the active component. Treatment is carried out until the symptoms disappear completely, plus 3-5 days, with a fungus of the skin of the feet, it is necessary to additionally be treated for 14 days. Usually the course lasts 10-28 days, depending on the type of infection. With a combination of bacterial and fungal infections, the course is 1 month. Erythrasma usually resolves in 2-3 weeks, with pityriasis versicolor, 1-3 weeks are treated.
On the recommendation of a doctor, the ointment can be used to treat thrush of the oral cavity (although a solution is usually used for this purpose). Treatments are done 1-2 times a day, the maximum course is 7 days. The ointment is injected into the vagina on a tampon or using an applicator in the same doses once a day at night. The course for thrush, trichomoniasis is 5-6 days.
