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[kloh-TRY-mah-zohl] Pregnancy Category: C (systemic use); B (topical/vaginal use) Canesten M, Canestin 1 M, Canestin 3 M, Clotrimaderm M, FemCare, Gyne-Lotrimin, Lotrimin, Lotrimin AF, Mycelex, Mycelex-7, Mycelex-G, My-

celex OTC, Myclo-Derm M, Myclo-Gyne M, Neo-Zol [OTC] [Rx] Classification: Antifungal

See also Anti-Infectives. Action/Kinetics: Depending on concentration, may be fungistatic or fungicidal. Acts by inhibiting the biosynthesis of sterols, resulting in damage to the cell wall and subsequent loss of essential intracellular elements due to altered permeability. May also inhibit oxidative and peroxidative enzyme activity and inhibit the biosynthesis of triglycerides and phospholipids by fungi. When used for Candida albicans, the drug inhibits transformation of blasto-phores into the invasive mycelial form. Poorly absorbed from the GI tract and metabolized in the liver to inactive compounds that are excreted through the feces. Duration: up to 3 hr.

Uses: Broad-spectrum antifungal effective against Malassezia furfur, Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, Microsporum canis, C. albicans. Oral troche: Oropharyn-geal candidiasis. Reduce incidence of oropharyngeal candidiasis in clients who are immunocompromised due to chemotherapy, radiotherapy, or steroid therapy used for leukemia, solid tumors, or kidney transplant. Topical OTC products: Topically to treat tinea pedis, tinea cruris, and tinea corporis. Topical prescription products: Same as OTC plus candidi-asis and tinea versicolor. Vaginal products: Vulvovaginal candidiasis. Contraindications: Hypersensitiv-ity. First trimester of pregnancy. Special Concerns: Use with caution during lactation. Safety and effectiveness for PO use in children less than 3 years of age has not been determined.

Side Effects: Skin: Irritation including rash, stinging, pruritus, urticaria, erythema, peeling, blistering, edema. Vaginal: Lower abdominal cramps; urinary frequency; bloating; vaginal irritation, itching or burning; dyspa-reunia. Hepatic: Abnormal liver function tests. GI: N&V following use of troche.

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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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