II. Indications
- Dermatophyte Infection
- Cutaneous Candidiasis
- Tinea Versicolor
III. Mechanism: Broad spectrum Antifungal activity
- Antifungal for dermatophytes and yeast
- Some Gram Positive antibacterial activity
IV. Medications: Twice daily dosing
- Clotrimazole 1% (Lotrimin, Mycelex, OTC)
- Miconazole nitrate 2% (Monistat-Derm, Micatin, OTC)
- Econazole nitrate 1% (Spectazole)
V. Medications: Once daily dosing (long durability agents)
- Ketoconazole 2% (Nizoral)
- Oxiconazole nitrate 1% (Oxistat)
- Sulconazole (Exelderm)
VI. Safety
- Topical azoles are considered safe in pregnancy
- Clotrimazole 1% for dermatophyte infections
- Miconazole 2% for candida infections
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Related Studies
| clotrimazole (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| CLOTRIMAZOLE 1% SOLUTION | Generic OTC | $2.66 per ml |
| CLOTRIMAZOLE 1% TOPICAL CREAM | Generic OTC | $0.05 per gram |
| CLOTRIMAZOLE 1% VAGINAL CREAM | Generic OTC | $0.08 per gram |
| CLOTRIMAZOLE 10 MG TROCHE | Generic | $0.38 each |
| CLOTRIMAZOLE-3 2% CREAM | Generic OTC | $0.31 per gram |
| CLOTRIMAZOLE-BETAMETHASONE CRM | Generic | $0.23 per gram |
| CLOTRIMAZOLE-BETAMETHASONE LOT | Generic | $2.65 per ml |
| econazole (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| ECONAZOLE NITRATE 1% CREAM | Generic | $0.39 per gram |
| miconazole (on 4/20/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| MICONAZOLE 2% TOPICAL CREAM | Generic OTC | $0.11 per gram |
| MICONAZOLE 2% VAGINAL CREAM | Generic OTC | $0.14 per gram |
| MICONAZOLE 3 200 MG VAG SUPP | Generic | $12.11 each |
| MICONAZOLE 3 COMBO PACK | Generic OTC | $8.75 each |
| MICONAZOLE 7 100 MG VAG SUPP | Generic OTC | $1.17 each |
| MICONAZOLE 7 CREAM | Generic OTC | $0.14 per gram |
| MICONAZOLE-7 CREAM | Generic OTC | $0.14 per gram |
Ontology: Clotrimazole (C0009074)
| Definition (NCI) | A synthetic, imidazole derivate with broad-spectrum, antifungal activity. Clotrimazole inhibits biosynthesis of sterols, particularly ergosterol, an essential component of the fungal cell membrane, thereby damaging and affecting the permeability of the cell membrane. This results in leakage and loss of essential intracellular compounds, and eventually causes cell lysis. |
| Definition (PDQ) | A synthetic, imidazole derivate with broad-spectrum, antifungal activity. Clotrimazole inhibits biosynthesis of sterols, particularly ergosterol, an essential component of the fungal cell membrane, thereby damaging and affecting the permeability of the cell membrane. This results in leakage and loss of essential intracellular compounds, and eventually causes cell lysis. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39116&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39116&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C381" NCI Thesaurus) |
| Definition (MSH) | An imidazole derivative with a broad spectrum of antimycotic activity. It inhibits biosynthesis of the sterol ergostol, an important component of fungal CELL MEMBRANES. Its action leads to increased membrane permeability and apparent disruption of enzyme systems bound to the membrane. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D003022 |
| SnomedCT | 332860008, 330922006, 387325003, 5797005 |
| LNC | LP14809-5, MTHU002025 |
| English | Klotrimazole, 1H-Imidazole, 1-((2-chlorophenyl)diphenylmethyl)-, Clotrimazole [ear], Clotrimazole [skin], 1-[(2-Chlorophenyl)diphenylmethyl]-1H-imidazole, clotrimazole, CLOT, CLOTRIMAZOLE, Clotrimazole [Chemical/Ingredient], Clotrimazole [skin] (product), Clotrimazole [ear] (product), Clotrimazole product, Clotrimazole (product), Clotrimazole (substance), Clotrimazole, Clotrimazole [ear] (substance), Clotrimazole [skin] (substance) |
| Swedish | Klotrimazol |
| Czech | klotrimazol |
| Finnish | Klotrimatsoli |
| Russian | KLOTRIMAZOL, KANESTEN, КАНЕСТЕН, КЛОТРИМАЗОЛ |
| Japanese | クロトリマゾール |
| Polish | Klotrimazol, Klotrymazol |
| Croatian | KLOTRIMAZOL |
| Norwegian | Klotrimazol |
| Spanish | clotrimazol (uso ótico) (producto), clotrimazol (uso ótico), clotrimazol (uso dermatológico) (producto), clotrimazol (uso dermatológico), clotrimazol (oído) (producto), clotrimazol (oído), clotrimazol (piel) (producto), clotrimazol (piel), clotrimazol (producto), clotrimazol (sustancia), clotrimazol, Clotrimazol |
| French | Clotrimazole |
| German | Clotrimazol |
| Italian | Clotrimazolo |
| Portuguese | Clotrimazol |
Ontology: Econazole (C0013547)
| Definition (MSH) | An imidazole derivative that is commonly used as a topical antifungal agent. |
| Definition (NCI) | An imidazole with antifungal property. Econazole compromises the integrity of fungal cell wall through inhibiting 14-alpha demethylase, which catalyzes conversion of lanosterol to ergosterol, an essential component of the fungal cell wall. As a result, this agent increases cellular permeability thereby resulting in leakage of cellular contents. Furthermore, econazole has also been implicated to inhibit endogenous respiration, interact with membrane phospholipids, inhibit purine uptake, and impair triglyceride and/or phospholipid biosynthesis. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D004464 |
| SnomedCT | 18952006, 373471002 |
| LNC | LP20809-7, MTHU012383 |
| English | Econazole, Ekonazole, 1H-Imidazole, 1-(2-((4-chlorophenyl)methoxy)-2-(2,4-dichlorophenyl)ethyl)-, Econazole [Chemical/Ingredient], ekonazole, econazole, ECONAZOLE, Econazole (product), Econazole (substance) |
| Swedish | Ekonazol |
| Czech | ekonazol |
| Finnish | Ekonatsoli |
| Russian | EKONAZOL, EKONAZOLNITRAT, ЭКОНАЗОЛ, ЭКОНАЗОЛНИТРАТ |
| Japanese | パラベール, 硝酸エコナゾール, エコナゾール, エコナゾール硝酸塩 |
| Polish | Ekonazol |
| Spanish | econazol (producto), econazol (sustancia), econazol, Econazol |
| French | Éconazole |
| German | Econazol |
| Italian | Econazolo |
| Portuguese | Econazol |
Ontology: Miconazole (C0025942)
| Definition (NCI) | An antifungal synthetic derivative of imidazole and used in the treatment of candidal skin infections, Miconazole selectively affects the integrity of fungal cell membranes, high in ergosterol content and different in composition from mammalian cells membranes. (NCI04) |
| Definition (MSH) | An imidazole antifungal agent that is used topically and by intravenous infusion. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D008825 |
| SnomedCT | 331197003, 326243000, 324678005, 372738006, 42720001 |
| LNC | LP19148-3, MTHU007400 |
| English | Miconazole, 1H-Imidazole, 1-(2-(2,4-dichlorophenyl)-2-((2,4-dichlorophenyl)methoxy)ethyl)-, Miconazole [genital], Miconazole [systemic], 1-[2-(2,4-Dichlorophenyl)-2-[(2,4-dichlorophenyl)methoxy]ethyl]-1H-imidazole, Miconazole [oropharyngeal], Miconazole [Chemical/Ingredient], MICONAZOLE, micronazole, miconazoles, Miconazole [systemic] (product), Miconazole [genital] (product), Miconazole [oropharyngeal] (product), miconazole, Miconazole product, Miconazole (product), Miconazole (substance), Miconazole [genital] (substance), Miconazole [oropharyngeal] (substance), Miconazole [systemic] (substance) |
| Swedish | Mikonazol |
| Czech | mikonazol |
| Finnish | Mikonatsoli |
| Russian | MIKONAZOL, МИКОНАЗОЛ |
| Japanese | ミコナゾール硝酸塩, 硝酸ミコナゾール, アムリードD, ミコナゾール, コランゾール, サラシルト, ニトコナゾン, フロリードD, フロリード |
| Polish | Mikonazol |
| Croatian | MIKONAZOL |
| Norwegian | Mikonazol |
| Spanish | miconazol [uso sistémico] (producto), miconazol [uso genital], miconazol (orofaríngeo), miconazol (orofaríngeo) (producto), miconazol [uso sistémico], miconazol [uso genital] (producto), miconazol (producto), miconazol (sustancia), miconazol [sistémico] (producto), miconazol [sistémico], miconazol, Miconazol |
| French | Miconazole |
| German | Miconazol |
| Italian | Miconazolo |
| Portuguese | Miconazol |
Ontology: oxiconazole (C0069765)
| Definition (NCI) | A broad spectrum imidazole derivative with antifungal activity. Although the exact mechanism of action has yet to be fully elucidated, oxiconazole, like other azole antifungals, most likely inhibits the cytochrome P450-dependent demethylation of lanosterol. This prevents the synthesis of ergosterol which is a crucial component of fungal cell membrane. By disrupting fungal cell membrane synthesis and integrity, oxiconazole alters fungal cell membrane permeability, promotes loss of essential intracellular components and eventually inhibits fungal cell growth. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C022155 |
| SnomedCT | 372778004, 57263002 |
| English | Ethanone, 1-(2,4-dichlorophenyl)-2-(1H-imidazol-1-yl)-, O-((2,4-dichlorophenyl)methyl)oxime, (Z)-, mononitrate, oxiconazole, oxyconazole, oxiconazole [Chemical/Ingredient], Oxiconazole, Oxiconazole (product), Oxiconazole (substance), OXICONAZOLE |
| Spanish | oxiconazol (producto), oxiconazol (sustancia), oxiconazol |
Ontology: sulconazole (C0075503)
| Definition (NCI) | A topical imidazole derivative with broad-spectrum antifungal and antibacterial activity. Sulconazole is excreted in both the feces and urine. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C033308 |
| SnomedCT | 350207002, 108920000, 373448004 |
| English | sulconazole, sulconazole [Chemical/Ingredient], 1-(beta-(4''-chlorobenzylthio)-2'4'-dichlorophenethyl)imidazole, 1-[2-[[(4-chlorophenyl)methyl]thio]-2-(2,4-dichlorophenyl)ethyl]-1H-imidazole, SULCONAZOLE, Sulconazole, Sulconazole (product), Sulconazole (substance) |
| Spanish | sulconazol (producto), sulconazol (sustancia), sulconazol |
Ontology: Azole antifungal (C0360363)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| SnomedCT | 350195009, 373236000 |
| English | azole agents, azole agents (medication), azole antifungal, antifungals azole, antifungals azoles, Azole antifungal, Azole antifungal (product), Azole antifungal (substance), Azole Antifungals |
| Spanish | antimicótico azólico (producto), antimicótico azólico (sustancia), antimicótico azólico, azol antimicótico (producto), azol antimicótico (sustancia), azol antimicótico |
Ontology: Imidazole antifungal (C0360364)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| SnomedCT | 350196005, 372631007 |
| English | Imidazole antifungal, Imidazole antifungal (product), Imidazole antifungal (substance) |
| Spanish | antifúngico imidazol, antimicótico imidazol (sustancia), antimicótico imidazol, antimicótico imidazólico (producto), antimicótico imidazólico, imidazol antimicótico (sustancia) |
Ontology: Lotrimin (C0699670)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D003022 |
| English | Schering Brand of Clotrimazole, Clotrimazole Schering Brand, lotrimin, Lotrimin |
Ontology: Exelderm (C0720336)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C033308 |
| English | Exelderm, exelderm, Bioglan brand of sulconazole nitrate, Westwood brand of sulconazole nitrate |
Ontology: Micatin (C0721705)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| English | Micatin, micatin |
Ontology: Oxistat (C0722355)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C022155 |
| English | Glaxo Wellcome brand of oxiconazole nitrate, GlaxoSmithKline brand of oxiconazole nitrate, Oxistat |
Ontology: Spectazole (C0723418)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| English | Spectazole, spectazole |
