Antifungals (Oral)

Drug	Dosage	Remarks
Fluconazole	Tinea corporis/cruris: 150 mg PO once weekly or 50 mg PO 24 hourly x 2-4 weeks Tinea pedis: 150 mg PO once weekly x 3 weeks or 50 mg PO 24 hourly x up to 6 weeks	Adverse Reactions GI effects (abdominal pain, diarrhea, flatulence, nausea/vomiting, taste disturbance, elevated liver enzyme levels) Special Instructions Use with caution in patients with renal and hepatic impairment Monitor for symptoms of drug interactions (eg Rifampicin, macrolides, anticoagulants, short-acting benzodiazepines, HMG-CoA reductase inhibitors, etc)
Griseofulvin	Tinea corporis/cruris: 500-1,000 mg PO 24 hourly or in divided doses x 2-4 weeks Tinea pedis: 500-1,000 mg PO 24 hourly or in divided doses x 4-8 weeks	Adverse Reactions CNS effect (headache); Dermatologic effects (rash, urticaria); GI effects (nausea/vomiting, diarrhea, epigastric distress) Special Instructions Monitor hepatic, renal and hematopoietic function if used long term
Itraconazole	Tinea corporis/cruris: 100 mg PO 24 hourly x 15 days or 200 mg PO 24 hourly x 1 week Tinea pedis: 100 mg PO 24 hourly x 30 days or 200 mg PO 12 hourly x 1 week	Adverse Reactions GI effects (dyspepsia, abdominal pain, nausea, constipation, diarrhea, increase in liver enzyme levels, hepatitis, cholestatic jaundice); CNS effects (headache, dizziness); Allergic reactions (pruritus, rash, urticaria, angioedema); Other effects (alopecia, edema, hypokalemia with prolonged treatment) Special Instructions Use with caution in patients at risk for heart failure, hepatic impairment and renal insufficiency In patients with hypochlorhydria, absorption may be improved by administering the drug with an acidic drink, (eg cola) Monitor for symptoms of drug interactions (eg Rifampicin, oral anticoagulants, short-acting benzodiazepines, calcium-channel blockers, etc)
Terbinafine	Tinea corporis/cruris: 250 mg PO 24 hourly x 2-4 weeks Tinea pedis: 250 mg PO 24 hourly x 2-6 weeks	Adverse Reactions GI effects (nausea/vomiting, diarrhea, abdominal pain, loss or disturbance of taste, liver dysfunction); CNS effect (headache); Dermatologic effects (rash, urticaria) Special Instructions Do not use in patients with hepatic impairment Perform liver function tests in all patients before starting oral therapy Use with caution in patients with psoriasis Reduce doses in patients with renal impairment

Antifungals (Topical)

Drug	Available Strength	Dosage	Remarks
Allylamines
Naftifine	1% cream, gel 2% cream	Apply 12-24 hourly	Adverse Reactions Dermatologic effects (redness, stinging sensation, itching) Special Instructions Tinea pedis: Length of therapy is usually 3-4 weeks Tinea corporis and cruris: Length of therapy is usually 1-2 weeks Continue treatment for few days-1 week after lesions clear
Terbinafine	1% cream, lotion, solution, spray, gel	Apply 12-24 hourly
Benzylamine
Butenafine	1% cream	Tinea corporis/cruris: Apply 24 hourly x 2 weeks Tinea pedis: Apply 12 hourly x 1 week or 24 hourly x 4 weeks	Adverse Reactions Dermatologic effects (contact dermatitis, burning/stinging sensation, erythema, irritation, itching) Special Instructions Tinea pedis: Length of therapy is usually 3-4 weeks Tinea corporis and cruris: Length of therapy is usually 1-2 weeks Continue treatment for few days-1 week after lesions clear
Imidazoles
Bifonazole	1% solution, cream	Apply 24 hourly	Adverse Reactions Dermatologic effects (occasional local irritation and hypersensitivity reactions, mild burning sensation, erythema, pruritus) Special Instructions Tinea pedis: Length of therapy is usually 3-4 weeks Tinea corporis and cruris: Length of therapy is usually 1-2 weeks Continue treatment for few days to 1 week after lesions clear
Clotrimazole¹	1% powder, solution, lotion, cream, spray	Apply 8-12 hourly
Econazole¹	1% cream	Apply 8-12 hourly
Fluconazole	0.5% gel	Apply 24 hourly
Isoconazole¹	1% cream	Apply 12-24 hourly
Ketoconazole	2% cream, gel, spray	Apply 12-24 hourly
Luliconazole	1% cream	Apply 24 hourly
Miconazole¹	2% powder, solution, tinct, cream, liquid soap	Apply 12 hourly
Oxiconazole	1% lotion, cream	Apply 12-24 hourly
Sertaconazole	2% cream	Apply 12-24 hourly
Sulconazole	1% cream, solution	Apply 12-24 hourly
Tioconazole	1% solution, cream	Apply 12-24 hourly
Other Agents
Amorolfine	0.25% cream	Apply 24 hourly x 2-3 weeks	Adverse Reactions Amorolfine: Dermatologic effects (erythema, pruritus, burning sensation) Ciclopirox: Dermatologic effects (pruritus, redness, burning sensation, pain) Tolnaftate: Dermatologic effects (irritation, stinging sensation, pruritus, contact dermatitis) Special Instructions Tinea pedis: Length of therapy is usually 3-4 weeks Tinea corporis and cruris: Length of therapy is usually 1-2 weeks Continue treatment for few days to 1 week after lesions clear
Ciclopirox (Ciclopiroxolamine, Ciclopirox olamine)	0.77% cream, gel 1% cream	Apply 12 hourly
Tolnaftate²	1% powder, solution, lotion, cream, ointment, spray liquid, spray powder	Apply 8-12 hourly
Combination Agents
Salicylic acid/Benzoic acid	Salicylic acid 60 mg/Benzoic acid 120 mg ointment	Apply 12 hourly	Adverse Reactions Dermatologic effects (local irritation, itchy rash, allergic reactions) Special Instructions Avoid contact with eyes, nose, mouth and other mucous membranes Avoid in patients with DM or impaired circulation Do not use for extended periods, in high concentration, over large body areas, or on broken or inflamed skin
Undecylenic acid/Zinc Undecylenate/Glycyrrhetinic acid	Undecylenic acid 5%/Zinc Undecylenate 10%/Glycyrrhetinic acid 0.5% cream	Apply 8-12 hourly	Special Instructions Avoid contact with eyes Discontinue use if symptoms (eg rash, itchiness, redness) appear
¹Combination with a corticosteroid is available. Please see the latest MIMS for specific formulations and prescribing information. ²Combination with Chlorhexidine is available. Please see the latest MIMS for specific formulations and prescribing information.

Disclaimer

All dosage recommendations are for non-pregnant and non-breastfeeding women, and non-elderly adults with normal renal and hepatic function unless otherwise stated.
Not all products are available or approved for above use in all countries.
Products listed in the Drug Summary are based on indications stated in the locally approved product monographs.
Please refer to local product monographs in Related MIMS Drugs for country-specific prescribing information.

Tinea Corporis, Cruris & Pedis Tóm tắt về thuốc

Antifungals (Oral)

Antifungals (Topical)

Disclaimer

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