CANDIZOLE CREAM- Is it safe?Uses, Side effects, Dosage
WHAT IS CANDIZOLE CREAM?
Candizole Cream is an anti-fungal cream which has got Clotrimazole as the active generic ingredient.
CANDIZOLE CREAM- Is it safe? Uses, Side effects, Dosage
What is the Generic name(s)?
How does it work?
What are its uses?
HOW EFFECTIVE IS THIS MEDICINE?
Is it addictive?
What is the dosage?
What if I miss a dose?
What to do in case of overdosage?
What to do if there is an allergic reaction?
What are the side effects?
Does this medicine has any drug interactions?
Precautions
Is it safe to use if I am pregnant?
Is it safe to use if I am breastfeeding?
CAN THIS MEDICINE BE USED FOR CHILDREN AND INFANTS?
IS THIS MEDICINE AVAILABLE AS OVER THE COUNTER(OTC) PRODUCT?
Frequently asked questions
Reference
WHAT ARE THE GENERIC NAME(s)?
Candizole Cream contains Clotrimazole as the generic content. Clotrimazole, on a pharmacological basis, belongs to the Imidazole subgroup of Azole category under Antifungal class of drugs. Imidazole also includes ketoconazole, miconazole, tioconazole, fenticonazole, isoconazole and fenticonazole. The other subgroup is Triazole which includes fluconazole and itraconazole.
Clotrimazole also comes as combination brands with Betamethasone (Clotrimazole+Betamethasone), Fluconazole (Canesoral combipack), Terbinafine (Clotrimazole+Terbinafine) etc.
HOW DOES IT WORK?
Candizole Cream/Clotrimazole as already mentioned above, falls under antifungal class, more specifically under topical azoles. These imidazoles, as explained by theories work by the following mechanism wherein they will be interfering with the fungal oxidative enzyme after their topical administration. This said interference will cause accumulation of hydrogen peroxide, which is quite lethal. This mechanism also causes a reduced formation of ergosterol. Ergosterol is one of the most important constituents of fungal cell walls as is peptidoglycans for bacterial cell wall. Thereby they increase the permeability of the fungal cell wall. The ergosterol synthesis is inhibited by inhibition of fungal Cytochrome P450 enzyme called as 14-alpha-demethylase. This enzyme is said to convert lanosterol to ergosterol. It is also explained that the azole drugs show a greater affinity towards fungal CYP450 enzyme than the human isoenzyme.
Apart from its interaction with the enzyme and cell wall, the clotrimazole is found to inhibit the fungal cell’s endogenous respiration and inhibit the formation of mycelial forms from the transformation of yeast.
They interact with ion-channels as well, where they have proved their action of inhibiting the calcium, potassium ion movement across the cell membrane by blocking the well-famous Grados channel on a biochemical point of explanation.
WHAT ARE IT’S USES?
The dosage form for Clotrimazole is not restricted to the topical form instead they are available also as vaginal tablets, troches, and lotions. Each dosage form has separate indications. Candizole (cream) has the below indications:
Vulvovaginal Candidiasis
They are classified as uncomplicated vulvovaginal candidiasis, complicated vulvovaginal candidiasis and recurrent vulvovaginal candidiasis. Candizole cream (1%) topical application once a day for 4 days in indicated for Uncomplicated Vulvovaginal Candidiasis.
Complicated Vulvovaginal Candidiasis follows an extended regimen of this cream for 7 days.
Recurrent Vulvovaginal Candidiasis where there happens more than 4 episodes of infection within a year and follows an induction therapy with Candizole (1%) for 10-14 days
Oropharyngeal Candidiasis
Topical antifungal therapy is the standard treatment of choice for milder cases of Oropharyngeal Candidiasis. Among the antifungal, Candizole (Clotrimazole 1%) is the drug of choice unless otherwise, the patient is a healthy adult with no underlying co-morbid conditions.
Mycoses of skin, nail and hair
These include the following condition
Tinea pedis (Athlete’s foot)
Tinea cruris (Jock itch)
Tinea corporis (Ringworm)
Tinea versicolor
Fungal Nappy rashes
Another dosage form like troche is indicated for the treatment oro-pharyngeal candidiasis and oral thrush. Vaginal Tablets too are indicated for vulvovaginal candidiasis.
HOW EFFECTIVE IS THIS MEDICINE?
Sawyer et al has explained the effectiveness of clotrimazole in Springer which scientifically says that clotrimazole is found to be most active against Candida spp., Microsporum spp., Trichophyton spp. and Malassezia furfur. The comparison study of clotrimazole and the conventional anti-fungal drug Nystatin results say that their cure rate for the treatment of vulvovaginal candidiasis is comparable. Patients not responsive to Nystatin and Amphotericin B showed a successful response to Clotrimazole.
Prevalence of Candida fungal skin infection always remain high and is found to be effectively treated with Clotrimazole/Candizole, as reported by various patients. The symptomatic relief of all symptoms occur within the first three days of starting the therapy with this cream and reports a complete resolution of disease within a week, as reported by Post Marketing Surveillance studies.
The high effectiveness of the medication can clearly be attributed to its lesser side effects and hence, is well tolerated.
IS IT ADDICTIVE?
This cream is not at all addictive.
WHAT IS THE DOSAGE?
VulvoVaginal Candidiasis
Use 1 applicator (which is equivalent to 50mg) to the anogenital area, twice daily. Preferably morning and before bedtime. Continue the treatment for 3 weeks, extend to one more week if symptoms don’t resolve.
Dermal Infections
Apply 1 Finger Tip Unit as a thin film coat over the affected area twice daily for 7 consecutive days. If there is no improvement in the symptoms, it is advisable that you get re-diagnosis with your physician.
Tinea Infections
Tinea infections need much more prolonged therapy. Its indicated to use 1% Candizole for consecutive days till 4 weeks, twice daily and evaluate the improvement.
Pediatric and Geriatric Dosing
Physicians advise the same dose for pediatric and geriatric patients for a maximum of 14 days. Though the resolution of symptoms always depends on the severity and duration of the infection along with the skin type of the patient.
If you take care to use the medicine at the same time all the days, it will definitely provide you with the best results.
WHAT IF I MISS A DOSE?
Every treatment will provide the best result when you follow the treatment regimen as per instructed by the physician.
This cream’s application which is generally suggested for two times a day regimen and if you miss a dose, you are advised to apply the missed dose soon as you remember of it. In case the next dosing time is near, you can skip the missed dose.
Kindly keep away the thought to apply double the amount of cream if you have missed a dose. Doing this is not going to provide you with any extra clinical benefit or better cure rate.
The fast cure rate is obtained only when you follow the right regimen at right time in the right dose.
WHAT TO DO IN CASE OF OVERDOSAGE?
The incidence of overdosage with this cream as a topical agent is a very rare occurrence. Unintended symptoms during the therapy would be a side effect rather than overdosage.
Even then, if any unpleasant occurrence of events happens, you are highly recommended to stop the treatment and consult your physician who has prescribed the medication. But if you face any serious symptoms don’t wait to consult the physician who has prescribed the medicine instead immediately reach out for an emergency centre nearby you.
WHAT TO DO IF THERE IS AN ALLERGIC REACTION
Commonly manifested allergic reactions include, burning sensations in the applied area, itching, redness and soreness, rashes or blisters.
If this reaction occurs immediately after the medication application, wash the medicine immediately. Discontinue the therapy and seek medical help.
Also, Prevention is always better than cure and take care to do a sensitive test with a mild dose before you apply the medicine on a therapeutic dose.
WHAT ARE THE SIDE EFFECTS?
Following side effects occur on treatment with this cream with variable frequency:
- General Skin Rashes
- Blistering
- Itching
- Burning and Redness
- Urticaria
- Thinning and Drying
- Peeling and Stinging
DOES THIS MEDICATION HAS ANY DRUG INTERACTION?
No interactions are documented.
Clinical explanation from experts on this states that the systemic absorption of this cream is relatively poor or inadequate (Intra vaginally only 3-10% is absorbed) and because of that there happens no interaction with any systemically given drugs.
PRECAUTIONS
- Kindly do a sensitivity test before you apply the medicine on a regular basis. Though there are rare cases of allergy reported, it is not judicious to completely neglect that hypersensitivity will not occur.
- Don’t use tight clothing in the area where medicine is applied. Take care to use only clean loose cotton cloth if private areas.
- Don’t wash off the medicine soon after you have applied it.
- Either apply the medicine after you have taken bath or take bath after two hours you have applied medicine. It is not advisable that you wash off the medicament before its action.
- After applying the medicine, wash off the hand with which you have applied medicine. Let the medicine remain only on the affected parts.
- Apply the medicine only on the affected parts.
- Take only a sufficient amount of cream from the tube. A fingertip of cream will do the necessary work.
- Do not swallow or apply the cream on to your eyes. Keep the medicine away from children.
- Best results are achieved if you apply the medicine on same time on all days of the entire duration of the treatment.
- Take care not to stop the medicine even if your symptoms have disappeared. By doing so there are chances of re-bound infection.
IS IT SAFE TO USE IF I AM PREGNANT?
FDA has classified Topical Clotrimazole (Candizole) under pregnancy category B. This indicates that its safe during pregnancy.
Vulvovaginal Candidiasis is one of the most common conditions during pregnancy and is classified as uncomplicated Vulvovaginal Candidiasis, where Clotrimazole remains as the drug of choice as per treatment guidelines.
Though it is safe during pregnancy you are always advised to inform your doctor if you are a mother to be or if you are planning to be one.
IS IT SAFE TO USE IF I AM BREASTFEEDING?
Topical Clotrimazole is categorized under Lactation category L1 and is safe during breastfeeding.
Systemic absorption of this cream is very less and so is its excretion in breast milk. Apart from excretion in milk, take care that the medicine does not get ingested by the baby from mother’s infected skin/part of the skin itself; which would be more harmful if not taken care of.
CAN THIS MEDICINE BE GIVEN TO CHILDREN AND INFANTS?
The use of this cream in the pediatric population is safe and is being prescribed for decades with effective results. In fact, this cream is the drug of choice with maximum effectiveness in children for various fungal infection. It has the least systemic absorption, which makes it an ideal choice of drug in the pediatric population.
It is only that you should take care of few things when the patient is pediatric like, the maximum course of treatment is 14 days, keep it away from their reach, do not let them swallow the medicine.
IS THIS MEDICINE AVAILABLE AS OVER THE COUNTER (OTC) PRODUCT?
Yes, this cream is available as OTC products. Patients have been buying since ages especially for Diaper rashes and Vulvovaginal Candidiasis.
When you are buying medicine as an OTC, take care to complete the course of the treatment. Never stop the medicine application soon after you feel a symptomatic relief because skin infections either bacterial or fungal has the power to cause re-bound infection if you leave the treatment course in the middle.
Majority of anti-fungal medicines start their action by the end of the 1st week only, which will definitely provide relief to the symptoms. If you are to stop the treatment judging this as an indication of cure, then you are highly mistaken. The onset of action has just begun and would take weeks to complete.
So, the advice is; CONSULT YOUR DOCTOR FIRST AND GET THE RIGHT INFORMATION ABOUT TREATMENT DURATION BEFORE YOU BUY MEDICINES AS OTC.
FREQUENTLY ASKED QUESTIONS
- How do we apply Candizole Cream?
Take a fingertip-quantity of the cream with your index finger. Make sure that your hand is properly washed and dried before taking the medicine. Apply the cream to the affected area as a thin film coat, to get easily absorbed. Don’t massage or rub the affected area after applying the medicine. Do not wash off the area after you apply the medicine. Give it sufficient time to get absorbed. - Can we use Candizole cream on the face?
Never use this cream for your face. Skin of your face is comparatively delicate and the absorption rate of medicines will differ a lot when compared the skin of other body parts. Special formulations for the face are available in the market which is mild in nature. - How to apply Candizole for VulvoVaginal candidiasis?
Clean and dry both your hands and vagina with warm soapy water. You will get an applicator with a plunger attached from the pharmacy store designed especially for vaginal applications. Attach it to the tube of cream and squeeze the desired amount.
Position yourself so that your hand with the applicator can reach your vaginal opening with ease. Open up the vulva portion of your vagina and insert the applicator, plunge it until whole medicine is released.
Wash the applicator it hot water and dry it. - Can we use the cream when we are menstruating?
Definitely Yes, you can and you should. It is very important to complete the course of the anti-fungal treatment for the best results. Menstruation will not affect the cream absorption and effectiveness.
But you are advised to use sanitary pads only and not insert tampons while applying the medication.
Reference
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