II. Indications
- Dermatophyte Infection
- Superficial Candida Infection
- Other off-label uses
III. Mechanism
- As with other azoles, inhibits the synthesis of ergosterol (key component of fungal cell wall)
- Blocks sterol 14-a-dimethylase (microsomal Cytochrome P450-dependent enzyme)
IV. Medications
- Precautions
- Bayer Healthcare uses the Lotrimin brand name to apply to various Antifungals (e.g. Miconazole, Butenafine)
-
Oral Candidiasis
- Clotrimazole 10 mg troche (Mycelex)
-
Topical Antifungals
- Clotrimazole Cream 1%
- Clotrimazole Solution 1%
- Vaginal Antifungals
- Clotrimazole 1 to 2% vaginal creams
- Clotrimazole 100, 200 and 500 mg vaginal tablets
V. Dosing
-
Oral Candidiasis (Thrush) in Adults and children over age 3 years
- Treatment
- Dissolve one troche (10 mg) slowly in mouth five times daily for 14 days
- Prevention in Immunocompromised patients
- Dissolve one troche (10 mg) slowly in mouth three times daily
- Continue until Chemotherapy or high dose Corticosteroid course is completed
- Treatment
- Topical (Dermatophyte Infection or Superficial Candida infection) for adults and children
- Apply twice daily to affected area
-
Yeast Vaginitis (Gyn-Lotrimin, Mycelex G)
- Clotrimazole 1% cream at bedtime for 7 days
- Clotrimazole 2% cream at bedtime for 3 days
- Clotrimazole 200 mg vaginal tab PV at at bedtime for 3 days
- Clotrimazole 100 mg vaginal tab PV at bedtime for 7 days
- Clotrimazole 500 mg vaginal tab PV at bedtime for 1 dose
VI. Adverse Effects: Oral Dosing for Thrush
- May raise Liver Function Tests
- Gastrointestinal Side effects
VII. Safety
- Pregnancy Category C orally (Category B topically)
- Considered safe in Lactation
VIII. Resources
- Clotrimazole 1% Cream (DailyMed)
- Clotrimazole Solution (DailyMed)