Uses

Clotrimazole treats fungal infections by inhibiting the synthesis of ergosterol, which builds the cell walls of the fungus. It is one of the most effective and commonly used antifungals and is used to treat infections such as candidiasis, candidal vulvovaginitis, tinea cruris, and tinea corporis.

How to Use

Topical Cream: This is for external use only, do not take it by mouth. Avoid contact with your eyes(if this occurs you can rinse with water).  Wash your hands before and after applying the medicine. If you are applying it  to your hands, wash only before applying and then allow to absorb into the skin. A thin layer should be gently massaged into the skin forming  a small circle around the affected area. Apply exactly as directed and at regular intervals. Do not use it more often than directed. It is important to complete the entire course of treatment as directed by your doctor. Do not to stop using it because you are feeling better. Do not stop using it suddenly without consulting with your doctor.

Clotrimazole Lozenge: Place the lozenge into your mouth and allow it to slowly dissolve for 15-30 minutes. You should not eat or drink anything while the lozenge is dissolving, and should not chew the lozenge or swallow it.

Vaginal Tablet: It is important to read all instructions and use as directed. Start by washing and drying your hands. Insert the tablet into the applicator. Lie flat on your back, and gently insert the applicator into the vagina. Push the plunger to release the medicine. Remove the applicator from the vagina. Wash the applicator in warm water with soap and also wash your hands after use. Do not take the tablets by mouth.

Important Information

Vaginal Tablet:

Finish the entire course of this medication even if you are feeling better.

Continue to take this medicine even if your menstral period starts while taking it.

Avoid the use of tampons if using the vaginal tablet. Tampons can absorb the medication.

Avoid sexual intercourse until after treatment. This medicine can damage condoms so they may not work properly.

Tell your doctor immediately if symptoms return within 2 months of the treatment.

Contact your doctor if your symptoms are not improving or getting worse.

If you miss a dose, use it as soon as you can. If it is already almost time for your next dose, apply only that next dose. Do not double up or take extra doses.

Cream:

Finish the entire course of this medication even if you are feeling better.

If this medicine is being used for “jock itch”, it is important to apply the medicine to areas of skin that are completely dry. Try to wear loose fitting cotton underwear and not tight fitting underwear made from synthetic fibers such as nylon.

If this medicine is being used for athlete’s foot it is important to apply the medicine to areas of the skin that are completely dry. Change socks once a day. Wear cotton socks as opposed to nylon, wool, or rayon containing socks. Allow your feet to have as much ventilation as possible and change your socks more often if you are sweating more than usual.

Contact your doctor if your symptoms are not improving or getting worse after 5-7 days.

If you miss a dose, use it as soon as you can. If it is already almost time for your next dose, apply only that next dose. Do not double up or use extra.

Be sure that your prescribing doctor is aware if you have any of the the following conditions before taking this medication

A history of allergic reactions, diabetes(for tablet form), infections(for tablet form), immune system conditions(HIV),  pregnancy, breastfeeding, trying to become pregnant.

Side effects that should be immediately reported to your healthcare provider

Allergic reaction(hives, itching, swelling of the face or mouth), changes in the passage of urine(for tablet forms), vaginal pain or irritation(for tablet forms),  trouble breathing.

Other Side Effects

Skin irritation. vaginal irritation (tablet form).

Adult Dose

Oropharyngeal Candidiasis(thrush)

Lozenge: Dissolve 1 lozenge slowly by mouth 5 times per day for 7-14 days.

Oropharyngeal Candidiasis Prophylaxis for Immunocomprimised Patients

Lozenge: Dissolve 1 lozenge slowly by mouth 3 times per day.

Tinea Corporis

Cream or Solution: Apply a thin layer of 1% cream or solution to the affected area of skin twice daily for up to 4 weeks.

Tinea Cruris

Cream or Solution: Apply a thin layer of 1% cream or solution to affected area of skin twice daily for up to 4 weeks.

Lotion: Apply a thin layer of lotion to affected area of skin twice daily for 2 weeks.

Tinea Pedis

Apply a thin layer of 1% cream or solution to affected area of skin twice daily for up to 4 weeks.

Candidal Vulvovaginitis

1% Cream: Insert 5 grams(1 applicatorful) at bedtime for 7-14 days.

1% Cream: Apply cream to the vulva 1-2 times daily for up to 7 days.

2% Cream: Insert 1 applicatorful into vagina at bedtime for 3 days.

Vaginal Tablet: Insert 500 mg(1 tablet) into vagina at bedtime for one single dose.

Vaginal Tablet: Insert 100 mg (1 tablet) into vagina once daily for 7 days OR 200 mg(2 tablets)  into vagina once daily for 3 days.

For Patients with HIV(Candidal Vulvovaginitis): Uncomplicated cases are treated for 3-7 days. Severe or recurring cases are treated for 7 days or more. For chronic suppression, the medication is used daily until the CD4+ count is at or above 200 cell/mcl.

Sources

1. Borgers M. Mechanism of action of antifungal drugs, with special reference to the imidazole derivatives. Rev Inf Dis. 1980;2:520-34.

2. Centers for Disease Control and Prevention (CDC): Sexually transmitted diseases (STDs): prevention. Centers for Disease Control and Prevention (CDC). Atlanta, GA. 2015.

3. Mycelex® -7 combo pack, clotrimazole topical cream, vaginal cream, vaginal inserts[package insert]. Morristown, NJ: Bayer Consumer Care; 2006.

4. Mycelex® -G vaginal tablets, clotrimazole vaginal tablets[package insert]. West Haven, CT: Bayer Corporation; 1995.

5. Clotrimazole troche oral lozenges, clotrimazole troche oral lozenges[package insert]. Minneapolis, MN: Paddock Laboratories Inc; 2005.

6. Clotrimazole topical cream, clotrimazole topical cream[package insert]. Ontario, Canada: Taro Pharmaceuticals Inc; 1996.