Canesten , Gyne-Lotrimin, Gyne-Lotrimin-3, Lotrimin, Mycelex, Mycelex-G
Classifications: antibiotic; azole antifungal; Therapeutic: antibiotic; antifungal, azole
Pregnancy Category: B (topical); C (oral)
1% cream, solution, lotion; 10 mg troches; 100 mg, 200 mg, 500 mg vaginal tablets; 1% vaginal cream
Acts by altering fungal cell membrane permeability, permitting loss of phosphorous compounds, potassium, and other essential
intracellular constituents with consequent loss of ability to replicate.
Has broad-spectrum fungicidal activity. Active against a wide variety of fungi, yeast, dermatophytes and certain gram-positive
Dermal infections including tinea pedis, tinea cruris, tinea corporis, tinea versicolor; also vulvovaginal and oropharyngeal
Ophthalmic uses; systemic mycoses. Safe use during pregnancy (category C for oral troches, category B for topical preparations),
and in children <3 y not established.
Hyersensitivity to other azole antifungals; hepatic impairment, diabetes mellitus; HIV; lactation.
Route & Dosage
Adult: Topical Apply small amount onto affected areas b.i.d. a.m. and p.m.
Adult: Intravaginal Insert 1 applicator full or one 100 mg vaginal tablet into vagina at bedtime for 7 d, or one 500 mg vaginal tablet at bedtime
for 1 dose
Adult/Child: PO 1 troche (lozenge) 5 times/d q3h for 14 d
- Instruct patient taking the oral lozenge to allow it to dissolve slowly in mouth over 1530 min for maximum effectiveness.
- Apply skin cream and solution preparations sparingly. Protect hands with latex gloves when applying medication.
- Avoid contact of clotrimazole preparations with the eyes.
- Do not use occlusive dressings unless directed by physician to do so.
- Consult physician about skin cleansing procedure before applying medication. Regardless of procedure used, dry skin thoroughly.
- Store cream and solution formulations at 15°30° C (59°86° F); do not store troches or vaginal
tablets above 35° C (95° F) unless otherwise directed.
Adverse Effects (≥1%)GI:
Abnormal liver function tests; occasional nausea and vomiting (with oral troche). Skin:
Stinging, erythema, edema, vesication, desquamation, pruritus, urticaria, skin fissures. Urogenital:
Mild burning sensation, lower abdominal cramps, bloating, cystitis
, urethritis, mild urinary frequency, vulval erythema
and itching, pain and vaginal soreness during intercourse.
Intravaginal preparations may inactivate spermicides
Minimal systemic absorption; minimally absorbed topically. Peak:
High saliva concentrations <3 h; high vaginal concentrations in 824 h. Metabolism:
In liver. Elimination:
Eliminated as metabolite in bile.
Assessment & Drug Effects
- Evaluate effectiveness of treatment. Report any signs of skin irritation with dermal preparations.
- Anticipate signs of clinical improvement within the first week of drug use.
Patient & Family Education
- Use clotrimazole as directed and for the length of time prescribed by physician.
- Generally, clinical improvement is apparent during first week of therapy. Report to physician if condition worsens or if
signs of irritation or sensitivity develop, or if no improvement is noted after 4 wk of therapy.
- If receiving the drug vaginally, your sexual partner may experience burning and irritation of penis or urethritis; refrain
from sexual intercourse during therapy or have sexual partner wear a condom.