| TOLNAFTATE (tole-naf'tate)
 Aftate, Pitrex
  , Tinactin Classifications: antifungal antibiotic; Therapeutic: antifungal antibiotic
 Pregnancy Category: C
 
 | 
 
 
 
 Availability
 
 1% cream, solution, gel, powder, spray
 
 Action
 
 Synthetic topical antifungal agent. Tolnaftate distorts hyphae and stunts mycelial growth on susceptible fungi.
 
 Therapeutic Effect
 
 Fungistatic or fungicidal as well as antiinfective against bacteria, protozoa, and viruses.
 
 Uses
 
 Tinea pedis (athlete's foot), tinea cruris (jock itch), tinea corporis (body ringworm); also tinea capitis and tinea unguium 
 if infection is superficial, plantar or palmar lesions adjunctively with keratolytic agents, and tinea versicolor (caused 
 by Malassezia furfur). 
 
 
 Contraindications
 
 Skin irritations prior to therapy, nail and scalp infections; immunosuppressed patients, diabetes mellitus, peripheral vascular 
 disease. Hypersensitivity to tolnaftate; lactation; occlusive dressing over drug; pregnancy (category C). Safe use in children 
 <2 y is not established. 
 
 
 Cautious Use
 
 Excoriated skin.
 
 Route & Dosage
 
  
  
 | Tinea Infestations Adult/Child: Topical Apply 0.51 cm (1/4? in.) of cream or 3 drops of solution b.i.d. in morning and evening; powder 
 may be used prophylactically in normally moist areas
 
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Administration
Topical 
 - Cleanse site thoroughly with water and dry completely before applying. Massage thin layer gently into skin. Make sure area 
 is not wet from excess drug after application. 
 
- Shake aerosol powder container well before use.
-  	Note: Cream and powder are not recommended for nail or scalp infection. 
- Use liquids (solutions) for scalp infection or to treat hairy areas.
- Store cream, gel, powder, and topical solution in light-resistant containers at 15°30° C (59°86° 
 F); store aerosol container at 2°30° C (38°86° F). Avoid freezing and exposure to light. 
 
Adverse Effects (≥1%)
Skin: Local irritation, stinging of skin from aerosol formulation. 
 
Nursing Implications
 
 Patient & Family Education
 
  
 - Expect relief from pruritus, soreness, and burning within 2472 h after start of treatment.
- Continue treatment for 23 wk after disappearance of all symptoms to prevent recurrence.
- Return to physician for reevaluation in absence of improvement within 4 wk.
-  	Note: If skin has thickened as a result of the infection, desired clinical response may be delayed for 46 wk. 
- Avoid contact with eyes of all drug forms.
- Place container in warm water to liquify contents if solution solidifies. Potency is unaffected.