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processing.... Drugs & Diseases > Dermatology Tinea Pedis Medication Updated: Sep 11, 2020 Author: Courtney M Robbins, MD; Chief Editor: Dirk M Elston, MD more... Share Print Feedback Close Facebook Twitter LinkedIn WhatsApp Email webmd.ads2.defineAd({id: 'ads-pos-421-sfp',pos: 421}); Sections Tinea Pedis Sections Tinea Pedis Overview Background Pathophysiology Epidemiology Prognosis Patient Education Show All Presentation History Physical Examination Causes Complications Show All DDx Workup Laboratory Studies Histologic Findings Show All Treatment Medical Care Surgical Care Activity Long-Term Monitoring Show All Medication Medication Summary Topical imidazoles Topical pyridones Topical allylamines Topical benzylamines Oral antimycotics Dermatological agents Show All Questions & Answers References Medication Medication Summary Tinea pedis can be treated with topical or oral antifungals or a combination of both. [15, 16, 17] Topical agents are used for 1-6 weeks, depending on manufacturers' recommendations. Luliconazole, an imidazole topical cream, is applied once daily for 2 weeks. [18, 19] A patient with chronic hyperkeratotic (moccasin) tinea pedis should be instructed to apply medication to the bottoms and sides of his or her feet. For interdigital tinea pedis, even though symptoms may not be present, a patient should apply the topical agent to the interdigital areas and to the soles because of the likelihood of plantar-surface infection.

Naftifine gel or cream 2% is indicated for interdigital tinea pedis in adults and adolescents. A study using 2% gel for interdigital-type tinea pedis demonstrated greater improvement from baseline for complete cure (P = .001), mycological cure (P< .0001), and treatment effectiveness (P< .0001) as early as 2 weeks when compared with vehicle; however the highest response rates were seen 4 weeks post treatment (P< .0001, for all endpoints). Statistically significant results for complete cure, mycological cure, and treatment effectiveness (P< .0001, for all endpoints) were also seen at week 6 among subjects with moccasin-type tinea pedis. [20]

Topical imidazoles are effective in all forms of tinea pedis but are excellent treatments for interdigital tinea pedis because they are effective against dermatophytes and Candida. Some of these drugs (eg, econazole) also have antibacterial activity. An econazole foam is now available.

Miconazole damages the fungal cell wall membrane by inhibiting the biosynthesis of ergosterol. Membrane permeability is increased, causing nutrients to leak out, resulting in fungal cell death. The 2% lotion is preferred in intertriginous areas. If the 2% cream is used, apply sparingly to avoid maceration effects.

Luliconazole is an imidazole antifungal that alters the fungal cell membrane by interacting with 14-alpha demethylase (an enzyme necessary for conversion of lanosterol to ergosterol). It is indicated for interdigital tinea pedis caused by the organisms Trichophyton rubrum and Epidermophyton floccosum in adults and children aged 12 years or older. It is available as a 1% topical cream.

Naftifine is a broad-spectrum antifungal agent and synthetic allylamine derivative. Naftifine interferes with sterol biosynthesis in the fungal cell wall by inhibiting squalene monooxygenase (squalene 2,3-epoxidase). It is indicated for tinea pedis caused by the organism Trichophyton rubrum. Use the 1% cream or gel in adults for tinea pedis (twice daily for 4 wk) or the 2% cream or gel in adolescents and adults with interdigital tinea pedis (once daily for 2 wk).

Butoconazole nitrate is an imidazole derivative that has fungicidal activity in vitro against Candida spp. and has been demonstrated to be clinically effective against vaginal infections due to Candida albicans. Candida albicans has been identified as the predominant species responsible for vulvovaginal candidiasis.

5. E S Mahgoub. Clinical trial with clotrimazole cream (Bay b 5097) in dermatophytosis and onychomycosis. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. November 1975. [Accessed 19th January 2021]

Fungal infections of the skin: Apply some cream to the lesions two times daily. Rub the cream into the skin with your finger until it has fully penetrated. If the powder is used with the cream, a once daily application of both formulations is recommended. The duration of therapy varies from 2 to 6 weeks depending on the localisation and the severity of the lesion. Treatment should be continued at least one week after disappearance of all signs and symptoms.

Severe hypersensitivity reactions, including anaphylaxis and angioedema, have been reported during treatment with Daktarin Cream and with other miconazole topical formulations (see section 4.8). If a reaction suggesting hypersensitivity or irritation should occur, the treatment should be discontinued. Daktarin 2% w/w cream must not come into contact with the mucosa of the eyes.

In animals miconazole nitrate has shown no teratogenic effects but is foetotoxic at high oral doses. Only small amounts of miconazole nitrate are absorbed following topical administration. However, as with other imidazoles, miconazole nitrate should be used with caution during pregnancy.

Miconazole nitrate is an imidazole antifungal agent and may act by interfering with the permeability of the fungal cell membrane. It possesses a wide antifungal spectrum and has some antibacterial activity.

Aluminium tube inner lined with heat polymerised epoxy-phenol resin with a white polypropylene cap containing 15 g, 30 g or 70 g* of cream, or aluminium tube inner lined with heat polymerised epoxy-phenol resin with a high density polyethylene cap containing 5 g of cream.

Sulconazole Nitrate Cream contains sulconazole nitrate, USP 10 mg/g in an emollient cream base consisting of propylene glycol, stearyl alcohol, isopropyl myristate, cetyl alcohol, polysorbate 60, sorbitan monostearate, glyceryl stearate (and) PEG-100 stearate, ascorbyl palmitate, and purified water, with sodium hydroxide and/or nitric acid added to adjust the pH.

Terconazole is the generic name for Terazol. It is a triazole antifungal drug that was approved by the FDA in 1987. Unlike miconazole, terconazole can only be obtained with a prescription from a doctor. It is available in a 0.4% and 0.8% vaginal cream as well as an 80 mg vaginal suppository.

In a double-blind, randomized, multicenter trial, 900 patients with vaginal yeast infections were treated with terconazole or miconazole cream. While both drugs were shown to be effective with mild side effects, the terconazole cream had a higher cure rate (87.9% for the 0.4% terconazole group, 83.8% for the 0.8% terconazole group, and 81.3% for the 2% miconazole group).

Another review from the journal of Clinical Therapeutics concluded that patients with vaginal yeast infections experienced faster relief with 0.4% terconazole cream than those who were treated with 2% miconazole cream. However, no statistically significant differences were found between treatment with 80 mg terconazole suppositories and treatment with 100 mg miconazole nitrate suppositories.

Terconazole is only available with a prescription from a doctor. Most people can get a 3-day or 7-day prescription for generic terconazole cream. However, the average retail cost of terconazole is well over $50. With a SingleCare terconazole coupon, the cost can be around $20 at participating pharmacies.

Since terconazole and miconazole creams are applied topically in and around the vagina, the active drugs are rarely absorbed into the bloodstream. This means that drug interactions are rare. Most cases of drug interactions occur when these antifungal agents are taken orally.

Miconazole buccal tablets (Oravig) may interact with warfarin and increase the risk of bleeding. Vaginal miconazole creams and suppositories may interact with intravaginal contraceptives, such as NuvaRing, which contain ethinyl estradiol. Although the clinical significance is minimal, miconazole can potentially increase ethinyl estradiol levels in the body.

Those who have a known sensitivity to the ingredients in terconazole or miconazole creams should avoid these agents or use them with caution. Otherwise, these drugs may cause a potentially severe allergic reaction.

Terconazole is an antifungal agent that treats vulvovaginal candidiasis. It is available as a vaginal cream or suppository. Terconazole comes in a three-day treatment pack called Terazol 3 as well as a seven-day treatment pack called Terazol 7.

Miconazole is an antifungal medication available as a topical cream, vaginal cream, vaginal suppository, and buccal tablet. It is primarily used to treat vulvovaginal candidiasis. However, it can also treat fungal infections caused by Candida on the skin and in the mouth.

Terconazole and miconazole are not the same. Terconazole is a triazole antifungal drug that is only available with a prescription. Miconazole is an imidazole antifungal drug that is available with a prescription or over the counter. Miconazole also comes in other formulations and is approved to treat fungal skin and mouth infections.

The inflammation of thrush can cause burning when passing urine (dysuria). Active thrush can also produce a discharge, usually described as cheese-like, although it can be creamy or mucous-like. In very severe cases the skin can crack and ulcerate.

Dr Fox provides the most widely used types of capsules and creams to treat thrush. These treatments are with drugs called imidazoles: Canesten contains the imidazole clotrimazole, while Gyno-Daktarin contains miconazole, and Diflucan capsules contain fluconazole. 59ce067264

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