SKIN - Tinea Corporis, Tinea Cruris, Tinea Pedis - Topical Treatment (Trichophyton sp.)

 

 

Clotrimazole (OTC)

(Lotrimin®, Mycelex®)

Generics available

Pregnancy: B; Lactation: Unk

 

Cream 1%: 30 g, 15 g

 

Children and Adult: Apply after washing and drying twice daily for 2-3 weeks, or for several days after all signs of infection have cleared.

 

Avoid contact with eye(s).

Lotion 1%: 20 mL, 30 mL

Topical Solution 1%: 10 mL, 30 mL

 

 

 

 

 

Econazole

(Spectazole®)

Pregnancy: C; Lactation: Unk

 

Cream 1%

Available in 15, 30, and 85 g

 

 

 

Children and Adult: Apply after washing and drying daily for 2-4 weeks or until cleared.

 

Avoid contact with eye(s).

Wash hands after application. Wear well ventilated shoes.

 

Miconazole (OTC)

(Monistat-Derm®, Micatin®, Ting®)

Generics Available

Pregnancy: C; Lactation: Unk

 

 

Children and Adult: Apply after washing and drying twice daily for 2-3 weeks or for several days after all signs of infection have cleared.

 

Avoid contact with eye(s).

Cream 2%, Powder 2%

Topical Solution 2%, Spray 2%

 

 

 

 

 

Terbinafine

(Lamisil®)

Pregnancy: B; Lactation: Unsafe

 

Cream 1% (OTC): 15 g, 30 g -   

Gel (Rx only) 1%: 5 g, 15 g, 30 g

 

Children: Not recommended

.

Adult (Cream): Apply after washing and drying once or twice daily for at least one week, but do not exceed 4 weeks.

 

Adult (Gel): Apply to affected area once daily for 7 days.

 

 

Avoid contact with eye(s), nose, lips.

 

Notify prescriber if skin or eye(s) become yellow.

 

Tolnaftate (OTC)

(Tinactin®, Ting®)

Generics available

Pregnancy: C; Lactation: Unknown

 

Spray Liquid, Powder 1%

Cream 1%, Topical Gel, Liquid, or Powder 1%

 

 

Children and Adult: Apply after washing and drying two or three times daily for 2-4 weeks, or for several days after all signs of infection have cleared.

 

Avoid contact with eye(s).

 

SKIN - Tinea Corporis, Tinea Cruris, Tinea Pedis - Oral Treatment (Trichophyton sp.)

 

 

Griseofulvin microsize

(Grifulvin-V®, Fulvicin U/F®)

Generics available

Pregnancy: C; Lactation: Unk

Oral Susp: 125 mg/5 mL

 

 

Children >2 years: 10-20 mg/kg/day (max 500 mg)

 

Using 125 mg/5 mL @ 10 mg/kg/day

 

5 kg (11 lb) = 2 mL Q24H

7.5 kg (16 lb) = 3 mL Q24H

10 kg (22 lb) = 4 mL Q24H

12.5 kg (28 lb) = 5 mL (1 tsp) Q24H

15 kg (33 lb) = 6 mL Q24H

20 kg (44 lb) = 8 mL Q24H

25 kg (55 lb) = 10 mL (2 tsp) Q24H or

250 mg tab/cap Q24H

 

Adult: 500 mg once daily.

Duration: Tinea corporis 2-4 weeks Tinea pedis 4-8 weeks

 

 

Food: Food decreases stomach upset. Fatty meals increase absorption.

 

Important side effects: Rash, urticaria, headache, dizziness.

Caution: In patients with liver problems and systemic lupus, avoid prolonged exposure to sunlight. Avoid alcohol.

 

Fluconazole

(Diflucan®)

Pregnancy: C; Lactation: Likley Safe

 

Tabs: 50 mg, 100 mg, 150 mg    

 

Children: N/A

Adult: 150 mg once per week for 2-4 weeks.

 

Food: May take with or without meals.

 

Important side effects: Nausea, vomiting, diarrhea, dizziness. Advise patient to report any prodromal signs of liver failure. Potentially significant drug interactions. Consult a pharmacist.

 

 

 

Itraconazole

(Sporanox®)

Pregnancy: C; Lactation: Unsafe

 

Caps: 65 mg, 100 mg     

Tablet: 200 mg

 

Children: Not approved

.

Adult: 100 mg daily for 2 weeks or 200 mg once daily for 7 days.

 

Food: Avoid grapefruit products while taking. Take capsules with food. Take oral solution on an empty stomach. Not well absorbed with acid-suppressing drugs.

 

Important side effects: Advise patient to report any prodromal signs of liver failure. Potentially significant drug interactions. Consult a pharmacist.

 

 

Caution: May cause hepatitis. Use with caution in persons with history of liver disease. Consider periodic liver function tests. May cause or contribute to congestive heart failure or cardiac dysrhythmias. Use with caution in persons with history of cardiac disease.

Use for onychomycosis is contraindicated in patients with history of ventricular dysfunction or CHF. Use is contraindicated in any patient taking cisapride, dofetilide, quinidine, midazolam, triazolam, pimozide, lovastatin, or simvastatin.

 

 

Not well absorbed with acid-suppressing drug. Has caused bone defects and changes in tooth appearance in rats; implications for humans are not established.

 

 

 

Terbinafine

(Lamisil®)

Pregnancy: B; Lactation: Unsafe

 

Tabs: 250 mg  

 

Adult: 250 mg PO once daily for 14 days. Baseline LFTs should be obtained, and patient should be advised to contact provider if any side effects occur.

 

Food: May take with or without meals.

 

Important side effects: Ocular changes, rash, neutropenia, hepatobiliary dysfunction, nausea. Advise patient to report any prodromal signs of liver failure.