Sulconazole

Pronunciation

(sul KON a zole)

Index Terms

• Sulconazole Nitrate

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Cream, External, as nitrate:

Exelderm: 1% (15 g, 30 g, 60 g) [contains cetyl alcohol, propylene glycol]

Solution, External, as nitrate:

Exelderm: 1% (30 mL) [contains propylene glycol]

Brand Names: U.S.

• Exelderm

Pharmacologic Category

• Antifungal Agent, Imidazole Derivative
• Antifungal Agent, Topical

Pharmacology

Substituted imidazole derivative which inhibits metabolic reactions necessary for the synthesis of ergosterol, an essential membrane component. The end result is usually fungistatic; however, sulconazole may act as a fungicide in Candida albicans and Candida parapsilosis during certain growth phases.

Absorption

Topical: ~8.7% percutaneously (Franz 1988)

Excretion

Primarily urine

Use: Labeled Indications

Fungal infections:

Cream: Treatment of tinea pedis (athlete's foot), tinea cruris, and tinea corporis caused by Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, and Microsporum canis; treatment of tinea versicolor

Solution: Treatment of tinea cruris and tinea corporis caused by Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, and Microsporum canis; treatment of tinea versicolor

Limitations of use: Effectiveness has not been proven in tinea pedis (athlete's foot).

Contraindications

Hypersensitivity to sulconazole or any component of the formulation

Dosing: Adult

Tinea corporis/tinea cruris/tinea versicolor: Topical: Apply a small amount to the affected and surrounding skin areas once or twice daily for 3 weeks

Tinea pedis: Topical: Cream: Apply a small amount to the affected area twice daily for 4 weeks

Dosing: Geriatric

Refer to adult dosing.

Dosing: Renal Impairment

There are no dosage adjustments provided in the manufacturer’s labeling.

Dosing: Hepatic Impairment

There are no dosage adjustments provided in the manufacturer’s labeling.

Administration

For external use only; avoid contact with the eyes. Apply a small amount and gently massage into affected and surrounding skin areas.

Storage

Avoid excessive heat, above 40°C (104°F); protect solution from light.

Drug Interactions

CloZAPine: CYP1A2 Inhibitors (Weak) may increase the serum concentration of CloZAPine. Monitor therapy

TiZANidine: CYP1A2 Inhibitors (Weak) may increase the serum concentration of TiZANidine. Management: Avoid these combinations when possible. If combined use cannot be avoided, initiate tizanidine at an adult dose of 2 mg and increase in 2-4 mg increments based on patient response. Monitor for increased effects of tizanidine, including adverse reactions. Consider therapy modification

Adverse Reactions

1% to 10%:

Central nervous system: Localized burning

Dermatologic: Localized erythema, pruritus, stinging of the skin

Warnings/Precautions

Concerns related to adverse effects:

• Irritation: Discontinue if sensitivity or irritation occurs.

Concurrent drug therapy issues:

• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.

Other warnings/precautions:

• Appropriate use: For topical use only; avoid contact with eyes.

Pregnancy Risk Factor

C

Pregnancy Considerations

Adverse events have been observed in animal reproduction studies with large doses administered orally. Systemic absorption is limited following topical administration.

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience burning, itching, redness, or stinging. Have patient report immediately to prescriber severe skin irritation (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.