Appointment of clotrimazole cream. Clotrimazole cream - official * instructions for use

Fungus is not only an unpleasant disease, but also rather difficult to treat. And no matter what part of the body he touched - the feet, or the hands, or maybe the intimate area - treatment is required immediately at the first sign. Whether to look for expensive miracle drugs, or turn to available means - everyone decides for himself. But why overpay if there are effective destroyers of such a nuisance at a low cost? These include Clotrimazole ointment. What does it help from, in addition to the fungus, and to whom is the drug prescribed?

Description, composition, form of release

Clotrimazole is a drug known for a long time on the pharmacological market, the active ingredient of which is the substance of the same name, an imidazole derivative. It is a common synthetic antimycotic drug for external and local use, as well as intravaginal.

An antifungal agent is available in several dosage forms:

• one percent ointment;
• cream 1% (for topical and vaginal use);
• fungicidal powder;
• solution;
• intravaginal tablets;
• gel.

Manufacturers of the drug can be different - India, Ukraine, Poland, Russia. In our country, the most famous are Clotrimazole-Akrikhin ointment and simply Clotrimazole (from Ozone LLC) - this is the same drug produced by different companies.

The most versatile form of release of Clotrimazole is an ointment. In addition to the active ingredient (1%), the ointment contains auxiliary components: polyethylene oxides, methylparabens, propylene glycol and nipagin. Ointment tubes are available in volumes from 15 to 40 grams.

Application methods

The ointment is gently applied to the areas of the skin attacked by the fungus with an even layer several times a day, trying not to touch the mucous membranes of the eyes, nose and mouth. The duration of the course of treatment also depends on the diagnosis (mainly - up to 4 weeks).

Vaginal use of the ointment has not received much distribution, since there are more convenient forms of release of the drug for this. But the mechanism of action of the ointment is the same with the tablets.

Ointment Clotrimazole from what helps: indications for use

What is Clotrimazole ointment used for? The main purpose is the elimination of fungal skin infections caused by dermatophyte fungi, yeast, mold, lichen and erythrasma.

The drug is also indicated for:

• nail fungus;
• trichophytosis;
• fungal erosion;
• candidiasis;
• dermal mycosis;
• epidermotypes, etc.

Approvals for the use of Clotrimazole, among other things, are infectious diseases caused by pathogens resistant to nystatin and some other antifungal agents.

The mode of action of Clotrimazole is based on the ability to block the synthesis of proteins, nucleic acids and ergosterol, which is necessary for the formation of fungal cells. Clortimazole damages the cell walls of fungi and leads to cell death. The effect of the ointment also depends on the dosage:

• a low concentration of the drug has a fungistatic effect - it delays and stops the growth of fungi;
• at a dosage of 20 μg / ml, the ointment exhibits a noticeable fungicidal effect - it kills fungi;
• in high doses, it increases the concentration of hydrogen inside the fungal cell to a toxic value, destroying it.

Topically applied, Clotrimazole is absorbed by the epidermis. The highest concentration of active substance is absorbed in the reticuloderm. Clotrimazole has a good ability to penetrate the nail plate. The overall effect on the body is insignificant, metabolism occurs in the liver, and the residues of the substance are naturally removed together with waste products.

With thrush in women

Clotrimazole ointment is often prescribed for thrush in women. Reviews confirm the effectiveness of the tool.

Thrush is caused by Candida fungi, which live in small quantities in the microflora of the vagina of absolutely healthy women. But under the influence of factors favorable for reproduction, Candida multiplies, suppressing beneficial lactobacilli, which normally make up 90 percent of the total vaginal flora. The impetus for their development can be chronic or infectious diseases, and antibiotic therapy, and banal stress.

Tampons are required for treatment. A small lump of cotton wool is tightly tied with a gauze string. On a homemade tampon, ointment is evenly applied in a not thick layer and injected deep into the vaginal canal, while the end of the cord remains outside to remove the tampon.

From nail and foot fungus

In case of fungal diseases of the skin on the feet, in order to prevent relapse, the use of the ointment is continued until 21 days after the disappearance of the symptoms of the fungus. Before rubbing Clotrimazole into the skin, the area of ​​the foot affected by the fungus should first be washed with warm water and soap and dried thoroughly. Then, covering an area of ​​healthy skin on the border with the affected skin, the agent is applied to the foot and nails in a thin layer, up to 3 times a day, and rubbed in with light movements. The consumption of the ointment depends on the area of ​​the lesion. So, on an area the size of a palm, a 0.5 centimeter strip of Clotrimazole is taken.

Does it help with lichen

Deprive is called skin lesions that appear as a rash that does not transform into other rashes. Lichen is caused by fungi, when it comes to the ringworm or pityriasis type. For such a disease, clotrimazole can be used.

But the viral nature of lichen is also known - for example, shingles. To get rid of it, the antifungal effect of the ointment will be useless. The same applies to pityriasis, which is also called pink lichen. This type of disease is either viral or (not precisely established) infectious-allergic origin, it is also assumed that it may be the body's response to a nervous shock or breakdown.

Lichen Clotrimazole is treated like this: rub a small amount of ointment into the skin in the lesion. The ointment is applied up to three times per day, and the duration of treatment depends on the severity of the lesion, but after the symptoms disappear, the ointment is applied for at least another 10-14 days.

With dermatitis

Clotrimazole ointment for dermatitis is ineffective, since, in fact, it is the body's response to stimuli. Distinguish between contact, atopic, allergic dermatitis, which have nothing to do with fungi.

But there is another type of dermatitis, the nature of which is associated with the fungus Malassezia. We are talking about seborrhea - a disease of the skin (scalp, body), where the sebaceous glands are most intensively developed. This is where Clotrimazole ointment comes in handy.

Seborrheic dermatitis is manifested by skin peeling, inflammation and itching. Malassezia fungi feed on sebum triglycerides, and their waste products cause skin irritation. If seborrhea is not eliminated, a secondary infection can join it.

The ointment is applied to areas of the skin attacked by the fungus (the border of hair growth, forehead, nasolabial folds, sternum, armpits, groin, etc.), and rubbed. The course of treatment is agreed with a dermatologist.

Clotrimazole ointment during pregnancy

Clotrimazole is an ointment in gynecology that is often prescribed. Already from the beginning of the second trimester, it is allowed if there are indications, it is used both for fungal infections, external and vaginal, and for sanitizing the birth canal in anticipation of an impending birth.

In the first trimester, use is not recommended, since the effect of the components of the ointment on the female body and on the fetus has not been carried out. Due to the increased risk of anomalies in the development of the embryo during the laying of internal organs and systems, any medications are used with caution!

After the birth of the baby, the drug is prohibited if the mother is breastfeeding: studies on the effect of Clotrimazole on the composition of breast milk have not been carried out, but it is assumed that the active components are able to penetrate into it.

Clotrimazole: analogs of ointment

Does Clotrimazole ointment have analogues? Certainly. They can be divided into two groups: with an identical active substance and with a different one. The first group includes:

• Amiclone;
• Candide;
• Candide - B;
• Kandibene;
• Kanesten;
• Kanizon;
• Imidil.

Like Clotrimazole, these drugs have other forms of release, in addition to cream.

The second group includes the following ointments:

• Pimafucin (active ingredient natamycin);
• Lamisil (terbinafine);
• Terbizil ();
• Fungoterbine (terbinafine);
• Fucis (fluconazole) and other analogues.

In the complex therapy of mycoses, inexpensive well-known drugs can be used that have an antiseptic, drying, healing effect:

• Salicylic ointment;
• Sulfur ointment.

It is necessary to select analogs of Clotrimazole and additional therapy after discussing the issue with your doctor!

Clotrimazole ointment: reviews of patients and doctors

It is difficult to find negative reviews about Clotrimazole. The drug has proven itself to be an effective and safe remedy with a minimum set of side effects. This is far from a novelty on the pharmaceutical market, which means that it has been tested by time.

Dermatovenereologists are often cunning, pretending that apart from expensive and advertised antifungal agents there is no salvation from mycosis. It is profitable for pharmacies to sell expensive goods, and therefore Clotrimazole ointment, instructions for use, the price and effectiveness of which would attract all buyers, is not positioned as a popular drug.

Harm and contraindications

As confirmed by numerous studies, side effects of Clotrimazole are rare. Possible manifestations of allergic reactions with intolerance to the active or secondary components of the drug when applied to the skin:

• burning sensation and palpable itching;
• edema;
• rashes of blisters;
• erythrem.

In such conditions, it is necessary to immediately cancel the use of Clotrimazole and consult a doctor.

In some cases, the ointment is prohibited if one of the following occurs:

• hypersensitivity to clotrimazole substance;
• pregnancy from 1 to 14 weeks (in the first trimester);
• children under 12 years of age.

Is it worth overpaying trying to get rid of fungal diseases if there is a reliable and affordable remedy - clotrimazole ointment? What helps the drug, how and for how long to use it, what are the contraindications - all this is detailed in the instructions for use. Be sure to check it out!

Content

To eliminate lichen pathogens, with fungal infections, the antibacterial drug Clotrimazole is prescribed - the instructions for use of which include information on the dosage and method of use. This medication with antimycotic action does not belong to antibiotics, but has a detrimental effect on microorganisms. Read the indications for its use, possible side effects described in the instructions.

Clotrimazole from fungus

According to the pharmacological classification, Clotrimazole belongs to the group of drugs with an antifungal effect and a wide spectrum of action. With its help, you can eliminate the signs of multi-colored lichen, fungal manifestations on the skin and mucous membranes of the genital tract. An agent with an antimycotic effect is used locally, externally or intravaginally, has several different forms of release. It is allowed to be used by children and adults.

Composition and form of release

There are six forms of drug release: cream, ointment, gel, solution, vaginal suppositories and tablets. Check out the detailed composition of each medicine:

	Clotrimazole concentration	Supporting components	Description	Package
	1 g per 100 g	Cetostearyl and benzyl alcohol, sorbitan stearate, octyldodecanol, polysorbate, water, synthetic spermaceti	White, uniform	Aluminum tube 20 g
		Monoglycerides, cetostearyl alcohol, castor oil, emulsion wax, polysorbate, glycerol, methyl and propyl parahydroxybenzoate, propylene glycol, water	White-yellowish with a faint odor	15 and 30 g aluminum tubes
	10 mg per 1 g	Ethyl alcohol, glycerol, macrogol, carbomer, sage extract, propylene glycol	Homogeneous clear gel with sage scent	20 and 40 g aluminum tubes
	10 mg per ml	Ethanol, propylene glycol, polyethylene glycol	Clear colorless liquid	25 ml glass bottles with applicators
Vaginal suppositories	100 mg per 1 pc.	Semi-synthetic glycerides	Cylindrical-conical shape, white-yellow color, on the cut an air rod or a depression in the form of a funnel	6 pcs. in cell contour packagings
Vaginal pills		Magnesium stearate, adipic acid, lactose monohydrate, sodium bicarbonate, potato starch, sodium lauryl sulfate, colloidal silicon dioxide	White oblong	6 pcs. in blisters

Pharmacodynamics and pharmacokinetics

The main substance inhibits the growth and reproduction of microorganisms, has a fungistatic effect and fungicidal activity, and leads to the death of fungi. By inhibiting the synthesis of ergosterol, the component combines with phospholipids of the fungal cell membrane, changing its permeability. In high concentrations, clotrimazole damages fungal cells by lysis without suppressing the synthesis of ergosterol, prevents the formation of proteins, fats and polysaccharides of fungi, destroys their nucleic acids and increases the excretion of potassium.

The drug has a wide effect on dermatophytes, yeast, dimorphic and mold fungi, protozoa, plus destroys gram-positive bacteria. Fungistatic activity is manifested in relation to the mycelium of dermatophytes, budding fungi from the genus Candida. The component is practically not absorbed into the systemic circulation when applied to intact and non-inflamed skin. The concentration in the serum is insignificant, with intravaginal use, absorption is 3-10% of the dose. The drug breaks down in the liver to inactive metabolites, is excreted by the kidneys and intestines.

From what clotrimazole ointment

When applied externally, ointment, gel, cream and solution, according to the instructions, the following indications are distinguished:

• fungal diseases caused by dermatophytes, yeast-like fungi, mold pathogens sensitive to the active ingredient;
• mycoses of feet, hands;
• vulvitis candidiasis, balanitis with localization of the fungus inside the body;
• versicolor versicolor, erythrasma;
• mycosis of the skin;
• fungal infection of the outer ear.

When using intravaginal forms of the drug (solution, suppositories and tablets), the indications are:

• genital infections caused by yeast-like fungi of the genus Candida;
• vulvovaginal candidiasis;
• urogenital infections;
• trichomoniasis;
• genital superinfections caused by microorganisms that are sensitive to the active ingredient of the drug;
• sanitation of the birth canal before childbirth.

Method of administration and dosage

The instructions and reviews say that Clotrimazole can be used vaginally or externally. Dosage, course of treatment and method of use depend on the type of disease, individual characteristics of patients, their age and the type of pathogen. Cream, ointment and gel are often applied to the skin to eliminate mycoses and lichens, tablets and suppositories are used intravaginally to treat urogenital candidiasis.

Clotrimazole cream

For external use, Clotrimazole cream is intended. According to the instructions, it is applied to dry, clean affected areas up to three times / day. If the symptoms have already disappeared, it is recommended to continue treatment for another two weeks to prevent relapse. The cream is applied to the skin washed with soap of neutral acidity, without a bandage, on the feet, it is used between the toes. The course of treatment is:

• dermatomycosis - up to 4 weeks;
• erythrasma - up to a month;
• versicolor versicolor - up to 3 weeks;
• vulvitis candidiasis - up to 2 weeks;
• the minimum duration is 3 weeks.

Gel

Clotrimazole gel is also used externally on the skin. It should be used on the affected areas 2-3 times / day. According to the instructions, the minimum course of treatment will be 2-4 weeks. It is allowed to use the gel for treating the oral cavity - up to two times / day for no more than a week. If the drug is prescribed for intravaginal administration, use 100-150 mg of Clotrimazole daily for 1-6 days.

Clotrimazole ointment

According to the instructions, the ointment is applied in a thin layer 2-3 times / day on cleansed with neutral soap and dried skin. The composition should be rubbed in gently and left to absorb. The duration of therapy is:

• dermatomycosis - from a month;
• pityriasis versicolor - 1-3 weeks;
• at the end of the course, it is worth continuing the treatment for another 2 weeks;
• with fungal infections of the nails of the feet - for 2-3 weeks.

Solution

Like the gel, Clotrimazole solution can be used externally to treat the skin and intravaginally to eliminate the causative agents of candidiasis. In the first case, the solution is applied to the affected dry areas up to three times / day for 0.5-1 months. For the treatment of the mouth, rinses and applications with cotton swabs are intended twice a day for no more than a week. According to the instructions, intravaginal use of the solution should not exceed six days.

Suppositories Clotrimazole

Suppositories with Clotrimazole are intended for local use. According to the instructions, they are administered intravaginally by women and adolescent girls. They are inserted into the vagina in the evening, very deeply, lying on the back with bent legs. The course of treatment lasts six days - in each of them one suppository is inserted into the vagina. Re-therapy is prescribed by the doctor after examination.

Clotrimazole tablets

Another form of release for intravaginal use is tablets. The course of treatment with them lasts 6-7 days, during which one tablet / day is prescribed, or three days, one tablet twice / day. If there is no effect within three days, the diagnosis is revised, and if after a week the treatment does not work, a medical consultation is required. Repeated therapy is possible, but increases the risk of detecting the pathology of diabetes mellitus or HIV infection.

If symptoms occur after a couple of months, the patient is referred to a doctor. It is allowed to combine tablets with a cream when the vulva is infected. To completely dissolve the first, you need to create normal moisture in the vaginal mucosa, if it is dry, the tablet can stand out. To prevent this from happening, insert the pill as deep as possible. According to the instructions, treatment during menstruation is not carried out. If sanitation is necessary, one tablet is prescribed to the woman before childbirth.

special instructions

According to the instructions for the types of the drug, there are special instructions that must be followed when using them:

• Avoid getting the cream on the mucous membranes of the eyes, do not ingest.
• Treat the infected areas at the same time, for vaginal lesions, treat the male partner in the same way.
• Cetearyl alcohol in the formulation can cause contact dermatitis.
• If sensitivity or skin irritation develops, therapy is discontinued.
• Contraceptives containing latex are destroyed by the active substance - alternative drugs should be used five days after treatment.
• There is no data on the effect of the drug on the speed of psychomotor reactions.
• It is necessary to monitor the functional state of the liver in patients with hepatic insufficiency.

During pregnancy

The use of the drug is indicated for pregnant women only as directed by a doctor if he assesses the benefits to the mother above the risk to the fetus. Epidemiological studies did not reveal any irregularities in the course of bearing a child or his health when using the drug. There is no data on the effect of the medication on fertility. Suppositories are contraindicated in the first trimester of pregnancy.

In childhood

For the treatment of fungal diseases in children, you can use cream, ointment and Clotrimazole solution. The dosage is according to the instructions, does not differ from adults. Vaginal tablets are allowed to be used from the age of 12. Indications for use:

• Treatment of oral candidiasis. 10-20 drops of the solution are applied to a cotton swab and wipe the affected areas 3-4 times / day, the course lasts until the symptoms disappear completely (about 2-3 days).
• Fungal lesions of the skin, mucous membranes, nail fungus. A cream or ointment is used 1-3 times / day.

Drug interactions

The instructions for use of the medicinal product indicate its interaction with other medications:

• Amphotericin, Nystatin and Natamycin reduce the effectiveness of Clotrimazole, except for the ointment format that acts in the layers of the epidermis.
• The vaginal combination of Clotrimazole and oral administration of Tacrolimus (an immunosuppressive drug) increases the concentration of the latter in the blood plasma, requiring careful monitoring of patients.

Side effects

Depending on the use of different forms of release of Clotrimazole, the following side effects are indicated, indicated in the instructions:

• allergic reactions, urticaria, fainting, arterial hypotension, shortness of breath;
• rash, itchy skin, peeling, pain, swelling, irritation, burning;
• discharge, itching, burning and swelling of the vaginal mucosa;
• headache, abdominal pain;
• increased urination;
• the appearance of blisters;
• cystitis;
• pain during intercourse, burning of the partner's penis.

Overdose

Symptoms of accidental ingestion of the drug are dizziness, vomiting, nausea. Treatment is symptomatic. When applied externally, overdose is unlikely. When using vaginal forms of Clotrimazole in an amount exceeding the recommended amount, the manifestation of a dangerous condition is impossible. If pills or suppositories are swallowed, drowsiness, hallucinations, vomiting, and anorexia may occur. To eliminate symptoms, patients are given activated charcoal. There is no specific antidote.

Contraindications

According to the instructions, contraindications for the use of the medication are as follows:

• Hypersensitivity to components.
• First trimester of pregnancy, menstruation with suppositories.
• The drug is used with caution during breastfeeding, in the first case of vaginal candidiasis.
• For tablets - age up to 12 years; more than two cases of thrush in the past six months; a history of sexually transmitted diseases; pregnancy; age over 60; hypersensitivity to imidazoles.
• It is forbidden to use tablets for bleeding from the vagina, uterine hemorrhages, ulcers, blisters on the vulva. Do not use them for dysuria, fever or diarrhea, vomiting, back and shoulder pain.

Terms of sale and storage

The cream is dispensed in pharmacies with a prescription, other forms - without it. Storage conditions: dry, clean place without the access of children. Shelf life: cream, suppositories and tablets - 3 years, ointment - 2 years.

Analogs

According to the active substance and pharmacological action, the following analogs of Clotrimazole are isolated, produced in the form of a cream, tablets, solution and suppositories:

• Candide;
• Kanizon;
• Imidil;
• Kandibene;
• Kanesten;
• Ganesten;
• Lotrimin;
• Mycosporin;
• Panmicol;
• Alokandp;
• Antifungol;
• Dignotrimanol;
• Factodin;
• Funginal;
• Ginelotrimine.

Clotrimazole price

The cost of the drug depends on the form of its release, the seller's margin and the manufacturer's cost. You can buy Clotrimazole online or at your usual pharmacy. Approximate prices in Moscow are as follows.

Instructions for use:

Clotrimazole is a widely used synthetic antifungal drug for external use.

pharmachologic effect

The active ingredient of Clotrimazole has an antifungal effect against:

• Candidaalbicans;
• Malasseziafurfur;
• Cryptococcusneoformans;
• Coccidioidesimmitis;
• Trichophyton;
• Blastomycesdermatitidis;
• Sporothrix schenckii;
• Epidermophyton;
• Microsporum;
• Aspergillus.

According to the instructions, Clotrimazole has a very high penetrating ability and also exhibits antichomonas, antibacterial (gram-positive microorganisms, in particular, staphylococci, streptococci, and less pronounced - corynebacteria) and antiamebic (cysts of pathogenic nongleria) action.

Release form

Clotrimazole is available in various dosage forms:

• White biconvex homogeneous, parallelepiped-shaped with rounded edges of vaginal tablets Clotrimazole (Clotrimazole suppositories) containing 100 mg of the active ingredient - clotrimazole. 6 pieces in a blister;
• White homogeneous antifungal ointment Clotrimazole for external use. 1 g of ointment contains 10 mg of active ingredient. Vtubah 30 g each;
• 1% cream Clotrimazole, applied externally, in tubes of 20 g;
• 2% vaginal clotrimazole cream, in tubes of 50 g;
• 1% solution for external use in orange bottles, 15 ml and 30 ml each.

Indications for the use of Clotrimazole

According to the instructions, Clotrimazole is used for fungal diseases of the skin, mucous membranes, mycoses of the skin folds and feet:

• Epidermophytosis;
• Erythrasme;
• Dermatomycosis;
• Genital infections and superinfections (vulvovaginal candidiasis, trichomoniasis);
• Candidamycosis;
• Superficial candidiasis caused by various types of fungi sensitive to clotrimazole;
• Dermatophytosis;
• Stomatitis;
• Mycoses complicated by secondary pyoderma;
• Pityriasis versicolor;
• Microsporia.

Suppositories Clotrimazole (vaginal tablets Clotrimazole) are used to sanitize the birth canal before childbirth, as well as to prevent infection before genital surgery.

Contraindications

Clotrimazole has a small list of contraindications.

The drug is not used in case of hypersensitivity to clotrimazole or other components of the drug, as well as in the first trimester of pregnancy.

In the second or third trimesters of pregnancy and during lactation, Clotrimazole tablets are used with caution, strictly according to indications.

Instructions for the use of Clotrimazole

Clotrimazole vaginal tablets are inserted into the vagina usually in the evening, as deep as possible in the supine position. To do this, use the applicator included in the package. The course is - 1 suppository Clotrimazole daily for 6 days.

Repeated treatment with Clotrimazole is prescribed by a doctor.

For candidal vulvitis or candidal balanitis, suppositories are used simultaneously with Clotrimazole cream, which is applied externally several times a day to the affected areas for one to two weeks. In case of trichomoniasis, it is recommended to combine the use of Clotrimazole suppositories with oral chemotherapy drugs (metronidazole).

Ointment Clotrimazole for external use is applied to clean affected areas of the skin with a thin layer several times a day, rubbing gently. The duration of treatment depends on the location, severity of the disease and the effectiveness of therapy:

• Dermatomycosis is treated for at least a month;
• Pityriasis versicolor - up to three weeks;
• Fungal diseases of the skin of the legs - therapy is continued for at least two weeks after the symptoms disappear.

Clotrimazole cream can also be used to treat these diseases.

After applying Clotrimazole ointment, do not apply sealed dressings.

Side effects

With external use of Clotrimazole ointment, edema may occur, as well as burning, peeling or irritation of the skin, itching, erythematous rashes, paresthesias, blistering or urticaria.

When using clotrimazole suppositories, burning, itching, swelling of the mucous membrane are possible. Also, sometimes when using clotrimazole suppositories, according to the instructions, vaginal discharge appears, urination becomes more frequent, intercurrent cystitis occurs, and pain during intercourse and a burning sensation in the penis of the partner may also occur.

According to reviews, with frequent use of Clotrimazole cream, headache and gastralgia may occur.

Storage conditions

Clotrimazole is available without a prescription.

Antifungal drug for external use

Active substance

Release form, composition and packaging

◊ Cream for external use 1% in the form of a homogeneous mass of white.

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.

20 g - aluminum tubes (1) - cardboard packs.

pharmachologic effect

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 spectrum antifungal and antibacterial activity: dermatophytes (Epidermophyton floccosum, Microsporum canis, Trichophyton mentagrophytes, Trichophyton rubrum), yeast (Candida spp., Cryptococcus neoformans), dimorphic fungi (Coccidioides immitis, Histoplasma capsulatum, Paracoccinalioides)

He also active in relation to 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 external treatment of fungal caused by dermatophytes, yeast-like fungi, mold fungi, as well as pathogens sensitive to clotrimazole:

- mycoses of feet, hands, trunk, skin folds;

- candidal vulvitis, candidal balanitis;

- versicolor versicolor, erythrasma;

- fungal infections of the outer ear.

Contraindications

- hypersensitivity to clotrimazole or other components of the drug.

Dosage

For external use. The cream should be applied to the affected skin 2-3 times / day.

For relapse prevention 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.

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).

On the part of the skin and subcutaneous tissues: unknown - rash, itching, blistering eruptions, peeling, pain or discomfort, swelling, burning, irritation.

Overdose

Symptoms: if you accidentally take the drug inside, you may experience nausea, vomiting.

Treatment: if the cream is accidentally taken inside, symptomatic treatment should be carried out. With external use of the drug, an overdose is unlikely.

Drug interactions

Has not been studied.

special instructions

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, contact).

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 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.

Pregnancy and lactation

The use of the drug Clotrimazole 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.

Conditions of dispensing from pharmacies

The drug is dispensed without a prescription.

Storage conditions and periods

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.

Sage essential extract.

Compound cream 1%: clotrimazole at a concentration of 10 mg / g, cetostearyl and benzyl alcohols, polysorbate 60, synthetic spermaceti, octyldodecanol, sorbitan stearate, water.

Compound ointments 1%: clotrimazole at a concentration of 10 mg / g, polyethylene oxides 400 and 1500, propylene glycol, methylparaben, nipagin.

Compound solution 1%: clotrimazole at a concentration of 10 mg / ml (calculated on dry matter), polyethylene glycol 400, propylene glycol, ethanol 96%.

Compound candles: one suppository contains 100 mg of the active substance and the base in the amount necessary to obtain a suppository weighing 2 g. As a base, suppositories with Clotrimazole contain semisynthetic glycerides.

Compound pills: 100, 200 or 500 mg 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 a derivative imidazole .

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 epidermis ... The highest concentration of a substance is determined in 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 treatment fungal skin infections which are caused by mold and yeast , dermatophytes and other pathogens sensitive to clotrimazole.

They are also used as remedies for depriving caused by Malassezia furfur, and erythrasma (pathogen - Corynebacterium minutissimum).

Ointment, cream, gel and Clotrimazole solution help: from nail fungus ( , fungal paronychia ), trichophytosis , dermatophytosis , fungal erosion and diaper rash, candidiasis , , , dermatomycosis complicated secondary pyoderma mycoses .

Indications for the use of ointments, gel, cream and solution include infectious diseases, pathogens that are resistant to and a number of other antifungal agents.

For treatment lichen pink the drug is not suitable, since this disease most likely has viral or infectious-allergic origin , and can also be the body's response to a strong shock or nervous breakdown. Clotrimazole is effective for fungal infections .

The use of Clotrimazole ointment, gel and cream with clotrimazole in gynecology is shown:

• for treatment and prevention ;
• for prevention repeated fungal infections of the female reproductive system that develop with prolonged antibiotic treatment or against the background of immunodeficiency states.

Also, a solution, gel, cream and ointment in gynecology is used to sanitize the genital tract before delivery.

Candles - what are they from?

The indication for the use of vaginal suppositories is 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 resistant to nystatin strains) caused by other pathogens sensitive to clotrimazole genital superinfection , for sanitation of 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;
• 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 , the appearance of vaginal discharge, increased urination, pain during intercourse.

When applied topically with mycoses of the oral cavity there may be redness of the mucous membrane, tingling and burning sensation at the site of application of the drug, irritation.

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.

At dermatomycosis the course of treatment lasts from 3 to 4, with erythrasme - from 2 to 4, at - 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.

Using the ointment for thrush in women, it allows blocking the spread of fungal cells and - when prescribing higher doses - ensures their complete destruction. For therapeutic purposes, Clotrimazole from thrush use 2 r. / day, rubbing the ointment into the affected areas of the perineum.

For men, the method of application for thrush and others (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 is ensured with thrush in men and women.

Clotrimazole cream: instructions for use

The cream is intended for topical use. At thrush and other fungal diseases it is applied to the affected area twice or thrice 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 ) up to 3-4 weeks (at 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.

At 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. 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 synonymous drugs with thrush and others fungal infections of the genitals apply:

• 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.

For rehabilitation of the genital tract before delivery, a woman is injected with 200 mg of clotrimazole once.

At 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

Candles from thrush applied 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 with thrush and others urogenital mycoses do not apply 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 ( , , ) 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;
• 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.

At in addition to the drug, chemotherapeutic agents are prescribed for systemic treatment ( inside).

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 mycoses of the skin caused by dermatophytes ( trichophytosis , microsporia ), erythrasma , pityriasis versicolor , individual cases

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?

Main component — antimycotic antibiotic nitamycin ... Sensitivity to the drug is manifested mainly molds and yeasts (including childbirth Penicillium, Candida, Cephalosporium, Aspergillus and Fusarium).

Less sensitive to Pimafucin are Pseudoallescheria boydii and dermatophytes ... 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 is less common than Pimafucin , provokes imbalance in the microflora of the genital organs.

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 the patient menarche .

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 regarding the effect of the drug on in women were not carried out, in experiments on animals, no adverse effects were revealed.

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.