II. Indications

  1. Dermatophyte Infection
  2. Cutaneous Candidiasis
  3. Tinea Versicolor

III. Mechanism: Broad spectrum Antifungal activity

  1. Antifungal for dermatophytes and yeast
  2. Some Gram Positive antibacterial activity

IV. Preparations: Twice daily dosing

  1. Clotrimazole 1% (Lotrimin, Mycelex, OTC)
  2. Miconazole nitrate 2% (Monistat-Derm, Micatin, OTC)
  3. Econazole nitrate 1% (Spectazole)

V. Preparations: Once daily dosing (long durability agents)

  1. Ketoconazole 2% (Nizoral)
  2. Oxiconazole nitrate 1% (Oxistat)
  3. Sulconazole (Exelderm)

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Cost: Medications

clotrimazole (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
CLOTRIMAZOLE 1% CREAM Generic $0.55 per gram
CLOTRIMAZOLE 1% SOLUTION Generic $1.55 per ml
CLOTRIMAZOLE 10 MG TROCHE Generic $0.42 each
CLOTRIMAZOLE-3 CREAM Generic OTC $0.31 per gram
CLOTRIMAZOLE-BETAMETHASONE CRM Generic $0.55 per gram
CLOTRIMAZOLE-BETAMETHASONE LOT Generic $3.02 per ml
econazole (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
ECONAZOLE NITRATE 1% CREAM Generic $1.71 per gram
oxiconazole (on 1/18/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
OXICONAZOLE NITRATE 1% CREAM Generic $15.05 per gram
oxistat (on 12/31/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
OXISTAT 1% CREAM Generic $15.05 per gram
OXISTAT 1% LOTION $9.90 per ml
exelderm (on 1/1/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
EXELDERM 1% SOLUTION $10.24 per ml
miconazole (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
MICONAZOLE 100 MG VAG SUPP Generic OTC $0.64 each
MICONAZOLE 2% SPRAY POWDER Generic OTC $0.03 per gram
MICONAZOLE 3 200 MG VAG SUPP Generic $13.26 each
MICONAZOLE 3 COMBO PACK Generic OTC $7.57 each
MICONAZOLE 7 100 MG VAG SUPP Generic OTC $0.64 each
MICONAZOLE 7 CREAM Generic OTC $0.10 per gram
MICONAZOLE NITRATE 2% CREAM Generic OTC $0.10 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