Avison

• Superficial Fungal Infections with Inflammatory Component:
• Treatment of dermatophytoses (tinea corporis, tinea cruris, tinea pedis) accompanied by significant inflammation and pruritus.
• Cutaneous Candidiasis with Inflammation:
• Management of candidal infections of the skin presenting with erythema, itching, and swelling.
• Other Superficial Mycoses with Inflammation:
• Pityriasis versicolor with inflammatory symptoms.
• Off-label Uses:
• Inflammatory dermatoses complicated by secondary superficial fungal infections.

• Adults and Children (typically >12 years):
• Apply a thin film of the topical cream or ointment to the affected area 1–2 times daily.
• Duration:
• Generally 1 to 2 weeks; treatment should not exceed 2 weeks due to corticosteroid component.
• Pediatrics (<12 years):
• Use only under medical supervision; not generally recommended due to corticosteroid risk.
• Elderly:
• Same as adults; monitor for skin thinning or other corticosteroid-related adverse effects.
• Special Populations:
• Avoid use on large areas, broken skin, or mucous membranes to minimize systemic absorption.
• Administration Instructions:
• Clean and dry affected area prior to application.
• Avoid occlusive dressings unless directed by a healthcare professional.

Econazole nitrate is a broad-spectrum imidazole antifungal that inhibits ergosterol synthesis by blocking lanosterol 14-α-demethylase, an essential enzyme in fungal cell membrane formation. This disruption compromises fungal cell membrane integrity, leading to increased permeability and cell death. Triamcinolone acetonide is a medium-potency synthetic corticosteroid that exerts anti-inflammatory, antipruritic, and vasoconstrictive effects by binding to glucocorticoid receptors, modulating gene expression to reduce the production of inflammatory mediators. The combination provides both antifungal activity and rapid relief of inflammation, redness, and itching.

• Absorption:
• Minimal systemic absorption of econazole nitrate when applied topically; triamcinolone acetonide absorption varies based on skin integrity and area treated.
• Distribution:
• Limited systemic distribution due to topical application.
• Metabolism:
• Econazole metabolized locally in the skin; triamcinolone undergoes hepatic metabolism if systemically absorbed.
• Excretion:
• Primarily via renal elimination for absorbed corticosteroid metabolites.
• Onset of Action:
• Symptomatic relief from inflammation and pruritus typically occurs within 1–3 days of application.

• Pregnancy:
• Limited data available; topical use considered low risk but corticosteroids should be used cautiously and only if benefits outweigh risks.
• Lactation:
• Minimal systemic absorption suggests low risk; avoid application on the breast to prevent infant exposure.
• General: Use with caution during pregnancy and lactation; consult healthcare provider.

• Primary Therapeutic Class: Combination topical antifungal and corticosteroid.
• Subclass: Imidazole antifungal + medium-potency topical corticosteroid.

• Known hypersensitivity to econazole nitrate, triamcinolone acetonide, or any excipients.
• Untreated bacterial or viral skin infections (e.g., herpes simplex).
• Use on rosacea, perioral dermatitis, acne vulgaris, or skin ulcers.
• Application to mucous membranes or eyes.

• Prolonged use may cause skin atrophy, striae, or telangiectasia due to corticosteroid effects.
• Avoid use on large surface areas or under occlusion unless prescribed.
• Monitor for signs of secondary infection or worsening symptoms.
• Use with caution in children and elderly due to increased risk of side effects.
• Avoid abrupt discontinuation after prolonged use to prevent rebound inflammation.
• Discontinue if hypersensitivity or severe irritation occurs.

• Common:
• Burning or stinging at application site
• Pruritus or dryness
• Mild skin irritation
• Less Common:
• Erythema or folliculitis
• Skin atrophy or thinning with prolonged use
• Rare but Serious:
• Hypersensitivity reactions such as rash or angioedema
• Secondary fungal or bacterial infections due to corticosteroid-induced immunosuppression
• HPA axis suppression with excessive use over large areas or prolonged duration

• Minimal systemic interactions due to topical application.
• Concurrent use with other topical products containing corticosteroids or antifungals may increase risk of local irritation or systemic absorption.
• Avoid concomitant use with strong CYP3A4 inhibitors if significant systemic absorption is expected, as triamcinolone is metabolized via CYP3A4.
• Alcohol and food interactions are not applicable for topical formulations.

• Current guidelines recommend limiting duration of combined antifungal-corticosteroid products to short courses (generally 1–2 weeks) to reduce corticosteroid-related adverse effects.
• Regulatory agencies emphasize avoiding use in uncomplicated fungal infections without inflammation due to potential masking of symptoms and risk of resistance.
• No major changes in approved indications; emphasis on cautious, judicious use.

• Store at controlled room temperature: 20°C to 25°C (68°F to 77°F).
• Protect from excessive heat, moisture, and light.
• Keep container tightly closed when not in use.
• Do not freeze.
• Avoid contamination by not sharing tubes or containers.