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Econazole (Monograph)

Drug class: Azoles
ATC class: D01AC03
VA class: DE102
Chemical name: (±)-1-[2-[(4-Chlorophenyl)methoxy]-2-(2,4-dichlorophenyl)ethyl]-1H-imidazole mononitrate
Molecular formula: C18H15Cl3N2OβHNO3
CAS number: 68797-31-9

Introduction

Antifungal; azole (imidazole derivative).

Uses for Econazole

Dermatophytoses

Treatment of tinea corporis (body ringworm) and tinea cruris (jock itch) caused by Epidermophyton floccosum, Microsporum audouinii, M. canis, M. gypseum, Trichophyton mentagrophytes, T. rubrum, or T. tonsurans.

Treatment of tinea pedis (athlete’s foot) caused by E. floccosum, M. audouinii, M. canis, M. gypseum, T. mentagrophytes, T. rubrum, or T. tonsurans.

Topical antifungals usually effective for treatment of uncomplicated tinea corporis or tinea cruris. An oral antifungal may be necessary when tinea corporis or tinea cruris is extensive, dermatophyte folliculitis is present, infection is chronic or does not respond to topical therapy, or patient is immunocompromised because of coexisting disease or concomitant therapy.

Topical antifungals usually effective for treatment of uncomplicated tinea pedis. An oral antifungal may be necessary for treatment of hyperkeratotic areas on the palms and soles, for chronic moccasin-type (dry-type) tinea pedis, and for tinea unguium (fingernail or toenail dermatophyte infections, onychomycosis).

Pityriasis (Tinea) Versicolor

Treatment of pityriasis (tinea) versicolor caused by Malassezia furfur (Pityrosporum orbiculare or P. ovale).

Topical antifungals usually effective; an oral antifungal (with or without a topical antifungal) may be necessary in patients who have extensive or severe infections or have failed to respond to or have frequent relapses with topical therapy.

Cutaneous Candidiasis

Treatment of cutaneous candidiasis caused by Candida albicans.

Econazole Dosage and Administration

Administration

Topical Administration

Apply topically to the skin as a 1% cream.

Do not apply to the eye or administer intravaginally.

Apply a sufficient amount of cream to cover affected areas.

Dosage

Pediatric Patients

Dermatophytoses
Tinea Corporis or Tinea Cruris
Topical

Apply once daily for 2 weeks.

If clinical improvement does not occur after treatment, reevaluate diagnosis. Occasionally, a treatment duration of ≥6 weeks may be necessary.

Tinea Pedis
Topical

Apply once daily for 1 month.

If clinical improvement does not occur after treatment, reevaluate diagnosis. Occasionally, a treatment duration of ≥6 weeks may be necessary.

Pityriasis (Tinea) Versicolor
Topical

Apply once daily for 2 weeks.

If clinical improvement does not occur after treatment, reevaluate diagnosis.

Cutaneous Candidiasis
Topical

Apply twice daily (morning and evening) for 2 weeks.

If clinical improvement does not occur after treatment, reevaluate diagnosis. Occasionally, a treatment duration of ≥6 weeks may be necessary.

Adults

Dermatophytoses
Tinea Corporis or Tinea Cruris
Topical

Apply once daily for 2 weeks.

If clinical improvement does not occur after treatment, reevaluate diagnosis. Occasionally, a treatment duration of ≥6 weeks may be necessary.

Tinea Pedis
Topical

Apply once daily for 1 month.

If clinical improvement does not occur after treatment, reevaluate diagnosis. Occasionally, a treatment duration of ≥6 weeks may be necessary.

Pityriasis (Tinea) Versicolor
Topical

Apply once daily for 2 weeks.

If clinical improvement does not occur after treatment, reevaluate diagnosis.

Cutaneous Candidiasis
Topical

Apply twice daily (morning and evening) for 2 weeks.

If clinical improvement does not occur after treatment, reevaluate diagnosis. Occasionally, a treatment duration of ≥6 weeks may be necessary.

Special Populations

No special population dosage recommendations at this time.

Cautions for Econazole

Contraindications

Known hypersensitivity to econazole or any ingredient in the formulation.

Warnings/Precautions

Warnings

Administration Precautions

For external use only. Use only for topical application to the skin; not for ophthalmic or intravaginal use.

Fetal/Neonatal Morbidity and Mortality

Fetotoxicity and embryotoxicity demonstrated in animals receiving oral econazole. (See Pregnancy under Cautions.)

Sensitivity Reactions

Hypersensitivity Reactions

Contact dermatitis reported following topical application of econazole or other imidazole-derivative azole antifungals.

If irritation or sensitivity occurs, discontinue the drug.

Possible cross-sensitization among the imidazoles.

Specific Populations

Pregnancy

Category C.

Use during first trimester of pregnancy only when considered essential to the welfare of the patient; use during second and third trimesters only if clearly needed. (See Fetal/Neonatal Morbidity and Mortality under Cautions.)

Lactation

Distributed into milk following oral administration in rats; not known whether distributed into human milk. Use caution.

Pediatric Use

No unusual adverse effects reported when used in children ≥3 months of age.

Common Adverse Effects

Burning, stinging, pruritus, erythema.

Drug Interactions

Specific Drugs

Drug

Interaction

Corticosteroids (hydrocortisone, triamcinolone acetonide)

Corticosteroids inhibit antifungal activity of econazole against Saccharomyces cerevisiae and Candida albicans

Econazole does not alter activity of corticosteroid

No effect on antibacterial activity of econazole against Staphylococcus

Econazole Pharmacokinetics

Absorption

Bioavailability

Minimal systemic absorption occurs following topical application to skin.

Distribution

Extent

About 7.6–9.6% of a topical dose found in stratum corneum; also found in epidermis and middle region of dermis.

Distributed into milk following oral administration in rats; not known whether distributed into human milk.

Elimination

Elimination Route

Systemically absorbed drug excreted in urine and feces (<1% of topical dose).

Stability

Storage

Topical

Cream

20–25°C or <30°C.

Actions and Spectrum

Advice to Patients

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Econazole Nitrate

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Topical

Cream

1%*

Econazole Nitrate Cream (with benzoic acid)

Perrigo

AHFS DI Essentials™. © Copyright 2024, Selected Revisions July 1, 2007. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

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