Econazole Nitrate

• Superficial Fungal Infections:
• Tinea corporis (ringworm of the body)
• Tinea cruris (jock itch)
• Tinea pedis (athlete’s foot)
• Tinea versicolor (pityriasis versicolor)
• Cutaneous candidiasis (yeast infections of the skin)
• Seborrheic Dermatitis: Due to Malassezia species.
• Other Superficial Mycoses: Treatment of fungal infections caused by susceptible dermatophytes and yeasts, including pityriasis versicolor and candidal intertrigo.
• Off-label Uses: Occasionally used topically for other superficial fungal or yeast infections as determined by clinical judgment.

• Adults and Children (typically older than 2 years):
• Apply a thin layer of the topical formulation (cream, lotion, or powder) to the affected area 1–2 times daily, depending on the product formulation and severity.
• Duration:
• Usually 2 to 4 weeks, depending on infection type and clinical response. Continue treatment for at least 1 week after clinical resolution to prevent recurrence.
• Special Populations:
• Use with caution in infants and young children under 2 years; safety not well established.
• No dosage adjustment needed based on renal or hepatic function since it is used topically with minimal systemic absorption.
• Administration Instructions:
• Clean and dry the affected area before application.
• Avoid contact with eyes and mucous membranes.
• Hands should be washed after applying unless the hands are the treated area.

Econazole nitrate is a broad-spectrum imidazole antifungal that inhibits the biosynthesis of ergosterol, an essential component of fungal cell membranes. It inhibits the cytochrome P450-dependent enzyme lanosterol 14-α-demethylase, leading to disruption of the fungal cell membrane’s integrity and function. This disruption increases membrane permeability, causing leakage of cellular contents and ultimately fungal cell death. Econazole also exhibits some antibacterial activity against gram-positive bacteria and yeast.

• Absorption: Minimal systemic absorption through intact skin; absorption may increase if applied to large areas or broken skin.
• Distribution: Negligible systemic distribution due to topical use.
• Metabolism: Not systemically metabolized to a significant extent due to minimal absorption.
• Excretion: Primarily eliminated via skin desquamation; negligible renal or hepatic excretion.
• Onset of Action: Clinical improvement generally seen within days of consistent topical use.

• Pregnancy:
• Classified as FDA Pregnancy Category B (no evidence of risk in animal studies; human data limited). Topical use considered relatively safe when used as directed. Avoid excessive or systemic exposure.
• Lactation:
• Minimal systemic absorption suggests low risk during breastfeeding. Caution advised to avoid application on the breast area to prevent infant exposure.
• General: Data are limited; use topical econazole during pregnancy and lactation only if clearly indicated.

• Primary Therapeutic Class: Antifungal agent
• Subclass: Imidazole derivative, topical antifungal

• Known hypersensitivity to econazole nitrate or any component of the formulation.
• Hypersensitivity to other imidazole antifungals.
• Application on mucous membranes or open wounds (unless specifically indicated and directed by a healthcare provider).

• Avoid contact with eyes, mucous membranes, and open wounds.
• Use caution when applying to large skin areas or broken skin due to increased systemic absorption risk.
• Discontinue use if signs of hypersensitivity (rash, itching, swelling) or severe local irritation occur.
• Not intended for systemic fungal infections; topical use only.
• Patients with extensive skin infections or immunocompromised status should be monitored closely.
• If no improvement after 4 weeks of treatment, reassess diagnosis and consider alternative therapies.

• Common (usually mild and localized):
• Local burning or stinging sensation at application site
• Itching or irritation
• Redness or dryness of the skin
• Less Common:
• Allergic contact dermatitis
• Erythema or edema
• Rare:
• Severe hypersensitivity reactions (anaphylaxis very rare)
• Secondary bacterial infections due to skin barrier disruption
• Side effects generally occur early and resolve upon discontinuation.

• No significant systemic drug interactions expected due to minimal systemic absorption.
• Avoid concomitant use with other topical products that may cause irritation or reduce econazole’s effectiveness.
• No known interactions with food or alcohol.

• Current guidelines continue to endorse econazole nitrate as an effective first-line topical treatment for dermatophyte and yeast infections.
• No recent changes to approved indications or dosing regimens.
• Emphasis on proper application technique and treatment duration to prevent recurrence and resistance.
• WHO and dermatology consensus guidelines recommend econazole among preferred topical antifungals for superficial mycoses.

• Store at controlled room temperature: 20°C to 25°C (68°F to 77°F).
• Protect from moisture, heat, and direct sunlight.
• Keep container tightly closed.
• Do not freeze.
• For topical suspensions or creams, avoid contamination by not sharing tubes or containers.