Clotrimazole + Hydrocortisone: Indication, Dosage, Side Effect, Precaution

Generic Medicine Info Patient Medicine Information

This information is not country-specific. Please refer to the Malaysia prescribing information.

Generic Medicine Info

Indications and Dosage

Topical/Cutaneous
Inflammatory skin fungal infections

Adult: As 1% cream: Apply thinly and evenly to the affected area bid and rub in gently. Max duration: 7 days. Max: 10 mg/kg; 500 mg for 50 kg adult equivalent to approx 2 cm to be divided into 2 applications per day.
Elderly: Use minimum quantity for the shortest duration.
Child: Require shorter course of treatment.

Contraindications

Hypersensitivity. Use on broken skin. Diseases affecting the skin (e.g. acne, perioral dermatitis); any untreated bacterial skin diseases; viral skin diseases (e.g. herpes simplex, chicken pox); dermal vaccination reactions.

Special Precautions

Elderly, childn and infant. Pregnancy and lactation.

Adverse Reactions

Allergic reaction (e.g. syncope, urticaria, dyspnoea, hypotension), blisters, oedema, discomfort/pain, erythema, peeling/exfoliation, irritation. Rarely, hypothalamic-pituitary adrenal axis suppression, cushingoid features, delayed wt gain/growth retardation in childn, glaucoma, HTN, hyperglycaemia/glucosuria, osteoporosis, cataract, increased wt/obesity, decreased endogenous cortisol levels, steroid withdrawal syndrome.

Patient Counseling Information

Do not apply on large areas (>5-10% of the body surface), under occlusive dressings (e.g. nappies and bandages). Do not use in long-term continuous therapy. May damage latex contraceptives.

Drug Interactions

May reduce effectiveness of contraceptives.

Action

Description:
Mechanism of Action: Clotrimazole inhibits ergosterol synthesis, which leads to structural and functional impairment of fungal cytoplasmic membrane. Hydrocortisone, a weak corticosteroid w/ both glucocorticoid and to a lesser extent mineralocorticoid activity, has antiphlogistic, antipruriginous, antiexudative and antiallergic effects.
Pharmacokinetics:
Absorption: Clotrimazole: Penetrates the epidermis w/ a little systemic absorption. Absorbed 3-10% of a dose (vag use). Hydrocortisone: Absorbed through the skin particularly in denuded areas.
Distribution: Hydrocortisone: Plasma protein binding: >90%.
Metabolism: Clotrimazole: Hepatically metabolised to inactive compounds. Hydrocortisone: Metabolised in the liver and tissues.
Excretion: Clotrimazole: Via faeces and urine. Hydrocortisone: Via urine. Biological half-life: Approx 100 min.

Chemical Structure

Storage

Store below 25°C.

MIMS Class

Antifungals

ATC Classification

D01AC - Imidazole and triazole derivatives ; Used in the topical treatment of fungal infection.

References

Buckingham R (ed). Clotrimazole. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/03/2016.

Buckingham R (ed). Hydrocortisone. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/03/2016.

Joint Formulary Committee. Hydrocortisone with Clotrimazole. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/03/2016.

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