CANDIDERM CREAM – IS IT SAFE? USES, SIDE EFFECTS, DOSAGE

Wednesday, February 6, 2019

What is Candiderm cream?

Candiderm cream is used to treat a wide range of skin infections. It belongs to anti-infective, azole anti-fungal, antibiotic, anti-inflammatory, antiseptic, anti-parasitic and corticosteroid group of drugs. It is applied on the skin (topical administration).

The cream is homogeneous in nature, available in a tube of 15 gm.

It is manufactured by Glenmark Pharmaceuticals Ltd.

CANDIDERM CREAM – IS IT SAFE? USES, SIDE EFFECTS, DOSAGE

What is the Generic name(s)?
What is its composition?
How does it work?
What are its uses?
Who should not use this cream?
How effective is this medicine?
Is it addictive?
What is the dosage?
How to use this cream?
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?
What are the precautions I need to take?
Is it safe to use if I am pregnant?
Is it safe to use if I am breastfeeding?
Can this medicine be given to children and infants?
Is this medicine available as over the counter product?
Frequently asked questions
Reference

What is the Generic name(s)?

The generic names are Clotrimazole, Beclometasone and Gentamicin.

What is its composition?

Active Ingredients:

1 gram of Candiderm cream contains:

Clotrimazole[1] – 10.0 mg
Beclomethasone Dipropionate[2] – 0.25 mg
Gentamicin[3] Sulfate– 1.0 mg

Inactive Ingredients:

Water
Propylene glycol[4]
Methylparaben
Vaseline
Benzyl alcohol
Liquid paraffin
Monohydrate of Dihydrosodium phosphate
Tsetomakrogol
Propylparaben
Hydrosodium phosphate

How does it work?

The active ingredient Clotrimazole is a broad spectrum anti-fungal[5] in nature. It inhibits synthesis of Ergosterol[6], an important component of the cell membrane of fungi[7] present in the body. It also acts on some bacterial species present on the skin.

The Gentamycin component is a broad spectrum antibiotic[8], it works by treating Aminoglikozidny group along with other skin pathogens and causes bactericidal effects. It suppresses actions of Klebsiella[9], Escherichia[10], Protease[11], Enterobacteria[12], Pseudomonas[13], Staphylococci[14] and Streptococci[15].

Beclomethasone is an anti-exudate, anti-allergy and anti-pruritic type. It is a steroid which prevents the growth of certain chemical messengers called Prostaglandins which are responsible for making the skin itchy, red and swollen.

Together, these ingredients treat the skin infection effectively.

What are its uses?

Bacterial skin infections
Ringworm
Fungal infections of the groin region
Allergic rhinitis
Treatment and prevention of oral thrush caused by Candida species in the mucosal membrane of the lining of the mouth.
Eczema
Seborrhoeic dermatitis
Atopic dermatitis
Contact dermatitis
Psoriasis
Fungal infection of toes
Anogenital dermatitis – an inflammatory disorder in the genital area
Fungal infection of the external ear
Pruritus Vulvae – itching of the vulva
Susceptible fungal infections like cutaneous candidiasis, oropharyngeal candidiasis, superficial mycosis, dermatophytosis, etc.
Treatment of athlete’s foot
Treatment of jock itch
Nummular dermatitis – coin shaped spots develop on the skin
Neurodermatitis – scaly patches of skin are seen on the feet, scalp, neck, limbs and ankles.
Other bacterial or fungal infections which are linked with inflammation.

Who should not use this cream?

Candiderm cream is contraindicated in following conditions:

Hypersensitivity to the product
Open or infected wounds on the affected area
Tuberculosis of the skin
Syphilitic skin
Measles
Uremia
Chicken pox
Trophic wounds
Vaccinia virus
Post vaccine reactions on the skin
Herpes simplex
Severe renal function dysfunction
Viral damages to the skin
Rozatsea (defects are seen in vessels around trigeminal nerve)
Dehydration

How effective is this medicine?

Candiderm cream is effective and satisfactory in treating a wide range of infections provided that the guidelines are followed strictly and the treatment duration is completed. It is mostly non-invasive and easy to use.

It might not be very effective in treating fungal infections affecting the whole body. In this case, taking oral anti-fungal drugs is usually prescribed.

Also, treatment of fungal infections of nails using Candiderm might not give the required results. It would be better to use other medicine for this condition.

Is it addictive?

Candiderm cream is not addictive in nature.

What is the dosage?

The cream is to be applied two to three times a day. The amount of cream should be such that it covers the whole affected part along with the adjacent areas.

The duration of treatment is 2 to 4 weeks which depends upon the condition and its severity. Some individuals might require lesser time to recover. One should follow the instructions provided on the packaging and also consult with the doctor before using it.

How to use this cream?

Firstly, wash your hands using a mild soap, anti-allergic in nature. This procedure is to be pursued before and after applying the cream.
Wash the affected area with water and dry it thoroughly.
Take some amount of cream from the tube and massage it onto the skin in a circular manner. This is to be done gently using fingers.
The layer of cream applied should be thin and uniform all over.
Let it air dry. Do not bandage, wrap or cover the affected area unless advised so by your physician.

It is strongly advised to wear loose fitting comfortable clothes after applying the cream. Wearing tight clothes will irritate the infected area even further and will slow down healing.

What if I miss a dose?

The fungal or bacterial infection will subjugate because of the treatment only when the cream is applied regularly. Thus, steady and routine dosage is an important component of the treatment. Ergo, missing a dose should be avoided as it will prolong the treatment’s duration.

If in case, a dose is missed, apply the cream as soon as remembered. If the missed dose is near to the next dose, continue with the normal procedure and do not apply double the dosage. Discuss with the doctor regarding the missed dose.

What to do in case of overdosage?

Overdosage will only result if patients apply the cream in excess quantities. It can lead to pilling of skin.

Symptoms seen will be:

Glycosuria (excretion of glucose into urine)
Increase in blood pressure i.e. hypertension
Hypopotassemia (or hypokalemia) – abnormal low concentration of potassium ions in blood flow
An unusual increase in body weight
Other symptoms of hypercorticoidism.

If you have applied more than the dose and see these stated symptoms, rush to the emergency room for treatment. The treatment will include adjustment of electrolyte balance to normal values.

What to do if there is an allergic reaction?

An allergic reaction after applying the cream can manifest if the individual has an allergy to any of the active ingredients or even to the additional inactive ones. To prevent the reaction, make sure that you have no allergies to any of the ingredients and only then apply the cream.

In case of allergic reaction, the following symptoms will be seen:

Increased swelling
Rashes
Hives
Irritation on the skin

The reaction is nothing too serious and therefore running the area under cold water and using ice to massage it at home will help. Applying a mild and non-scented moisturizer or lotion after some time can help too.

A serious reaction to the cream is very rare as the ingredients present are considered mild. If the reaction is indeed serious, report to your physician or any nearby hospital immediately. The symptoms will be:

Breathlessness or wheezing
Puffiness
Hives
Difficulty is swallowing
Chest pain
Severe dizziness

What are the side effects?

Mild burning sensation
Stinging on skin
Dryness
Redness or erythema
Blistering
Peeling of skin
Inflammation

These side effects are seen very commonly in patients.

Using occlusive dressing after applying the cream can further increase these side effects and can also cause miliaria (sweat rash; marked by tiny and itchy rashes on the skin) and maceration (over saturation of skin; marked by wrinkled and soft skin along with whitish colouration).

Severe side effects are:

Atrophy of underlying muscles.
Stretch marks on the part where the cream is applied.
Changes in skin tone or colour (pigmentation changes)
Cushing’s syndrome (a disease of hypercortisolism; signs are: moon like face, pink or purple stretch marks, fatty hump on both the shoulders, bone loss and high blood pressure)
Using the cream for longer duration can also lead to suppression of adrenal glands.
Alteration in the sensation of taste.
Unusual tiredness
Increased thirst or urination
Weight loss
Problems in vision
A severe headache
Swelling of ankles and feet

In case of these effects, stop using the cream immediately and report to your doctor.

Does this medicine has any drug interactions?

The cream has a topical route of administration. Due to this reason, very little amount of the drug is absorbed into systemic circulation. Therefore it’s highly unlikely that the cream has pharmacological drug interactions. Some medicine which can interact with Candiderm or its ingredients are:

Ibuprofen
Cidofovir
Latex contraceptives
Cisplantin
Aminoglycosides
Cephaloridine

What are the precautions I need to take?

This cream is meant for external use only.
Inform the doctor about the medical history and the list of currently and previously used skin creams, medicines or supplements.
Do not apply the cream inside the mouth, nose, rectum or vagina as it can lead to toxic effects when absorbed. Wash the area as soon as possible with cold water if applied in these regions accidentally.
This cream is not for ophthalmic use.
Do not apply the cream on face.
Consult your doctor if the affected area is chapped or has a sun burn.
Do not wash the affected part after applying the cream.
In case the individual has jock itch, inform the doctor if the condition worsens or does not improve even after regular application for one week. The same goes for ring worm and the duration of application is two weeks.
The active ingredient Beclomethasone can cause thinning of skin after prolonged use. Report it to the doctor as soon as it has been noticed.
Do not use this cream for diaper rash.
The cream will be more effective if taken at same times every day.
Do not stop applying the cream before completion of treatment course just because the infection has disappeared. If the infection remains, it will grow on a larger scale and will be severe than before.
Avoid excessive exposure to direct sunlight after application of the cream.
If the cream in the tube gets finished during the treatment course, switch to another packet and continue with the routine.
After applying this cream, do not apply other medicines or creams on the affected area.
This cream should be used with utmost caution in following patients:

Diabetes
Elderly patients
Patients with liver disease
Acquired immunodeficiency syndrome
Patients with other immune system problems
Patients with renal impairment
Significant obesity
Cystic fibrosis
Conditions predisposing to nephrotoxicity and ototoxicity.
Myestina gravis
Parkinsonism

Is it safe to use if I am pregnant?

This medicine comes under Pregnancy Category B. There have not been enough clinical studies to prove the safety of candiderm cream in pregnancy. Thus, it should only be taken after a doctor prescribes it. Also, do not use the cream in large amounts or for longer periods.

Is it safe to use if I am breastfeeding?

Safety of the drug in lactating women or whether or not the medicine can enter breast milk is not established. In these women, the cream should be applied only after consulting with the doctor or gynaecologist. The patient should be well informed about the risks and benefits of using this medicine. As a precautionary measure, do not apply the cream near chest area.

Can this medicine be used for children and infants?

Candiderm cream should not be used for children below 3 years. For pediatric use (from 4-17 years of age), the cream should be applied only after consulting with the physician. Children are more sensitive to this cream as it can enter the bloodstream and lead to unwanted adverse effects in the body.

Is this medicine available as over the counter product?

Yes. This cream is available in any local pharmacy as OTC but is advised to be purchased after consulting with your doctor especially in case of a severe skin infection.

Frequently asked questions

Q: What is the cost of Candiderm Cream?

One tube of Candiderm cream of 15 gm. costs around INR 80/-.

Q: Is this cream safe for elderly?

For most geriatric individuals, this cream is safe to use provided that is applied only after consulting with the doctor. But in few elderly with thin skin, this cream is not prescribed as it can be easily absorbed into systemic circulation in larger quantities and can lead to severe adverse effects.

Q: Is it safe to drive after applying this cream?

Ordinarily, there is no problem in driving or operating any heavy machinery after applying this cream. But if any effects like dizziness or tiredness are observed, it will be unsafe to drive.

Q: Can this cream treat acne?

No, it is not advised to apply this cream on acne. Rather, the active ingredient Beclomethasone will lead to acne eruption and this will aggravate the pain already present.

Q: How to store Candiderm Cream?

Keep the medicine away from children and pets.
The cream should be stored at room temperature.
Do not freeze the medicine.
Store the medicine in a dry place away from direct sunlight and moisture.
Always make sure that the cap of the tube is placed back after using and the cream is not exposed.

Q: How long does it take for this medicine to work?

Usually, this cream works just after when it is applied on the affected skin region. But for the drug to work on the infection and show its results plus provide relief, it can take up to a week.

Q: When does this cream expire?

The cream lasts for about 3 years from the date of packaging a printed in the label. Check the packet of the cream to know the exact expiry of that tube.

Q: What are the substitutes of Candiderm cream?

The substitutes of this cream along with their manufacturers are: