Clotrimazole (Mucous membrane, Oral)

Clotrimazole lozenges treat thrush and a handful of other fungal infections by stopping the spread of the fungus.

Overview

Clotrimazole is used to prevent and treat a fungal infection of the mouth and throat known as candidiasis. Candidiasis, also known as thrush and white mouth will cause a strange white rash to develop inside the patient's mouth. Candidiasis may also cause a diaper rash in infants, and can cause a vaginal yeast infection in females. The condition is rare in healthy adult populations, typically infecting infants and the chronically ill. Clotrimazole fights off candidiasis by stopping the growth of the fungus, allowing it to simply wither away. This function also makes clotrimazole an especially strong preventative medicine, and is sometimes prescribed to patients who might be at special risk of contracting candidiasis.

Clotrimazole was first developed in 1969 by Bayer. In 1983, the FDA approved Bayer's new form of the drug, a lozenge designed to be dissolved slowly in the mouth. Since then, clotrimazole has been added to the World Health Organization's list of essential medicines. A complete treatment's worth off clotrimazole usually costs around twenty five dollars.
Clotrimazole is available in its generic form. In some locations, the branded form of clotrimazole, known as Mycelex Troche, is available. Mycelex Troche is manufactured by Bayer Healthcare LLC.

Type of Medicine

  • Antifungal

Conditions Treated

Side Effects

Clotrimazole can cause a wide variety of different side effects. Some side effects may be serious and demand medical attention. Other side effects may simply be the byproduct of the patient's body adapting to the medication, and only as serious as the discomfort they cause to the patient.
No potentially serious side effects of clotrimazole are currently known. Patients who begin to experience unexpected effects should contact their doctor to determine how best to proceed.

Not all side effects necessarily demand medical attention. Some side effects are only as serious as the discomfort they cause for the patient. Patients who experience any of the following side effects should contact their doctor to determine how best to mitigate the effects they find most unpleasant.

  • Abdominal pain
  • Stomach cramping
  • Stomach pain
  • Itching
  • Nausea
  • Vomiting
  • Unpleasant sensations in the mouth

It will be useful for patients to note that the stomach and digestion related side effects, such as stomach cramps, vomiting, and diarrhea are usually experienced only when clotrimazole is swallowed. Patients should avoid swallowing the clotrimazole lozenge to avoid suffering from these side effects.

Dosage

Patients should not chew or swallow the lozenge whole. Patients who chew or swallow their lozenge will not receive the proper strength of treatment, and may also experience nausea, vomiting, and other stomach dysfunctions.

The clotrimazole lozenge is designed to be dissolved slowly in the mouth (taking as long as 15 to 30 minutes) so the mucous membranes in the patient's mouth can absorb the clotrimazole. The standard treatment procedure calls for the patient to slowly dissolve one lozenge in their mouth five times a day for a duration of fourteen days.

Clotrimazole is sometimes used as a preventative treatment in patients who have become immunocompromised, either by chemotherapy, radiotherapy, or steroids. For this purpose, immunocompromised patients will usually slowly dissolve one lozenge in their mouth three times daily for the duration of their therapy treatment.

There typically is no adjustment for age for either the treatment or prophylactic use of clotrimazole.

Clotrimazole lozenges usually contain 10 milligrams of clotrimazole. The dosing regimes described above assume a strength of 10 milligrams per lozenge.

Patients who forget to take a dose should take it as soon as they remember. If it is nearly time for their next dose, the patient should simply wait and take their next dose at the proper time. Patients should never double their dose in an attempt to make up for lost doses.

The dosages described here are recommended and standard dosages and may not be optimal for all patients. Patients should follow their doctor's instruction concerning when and how much clotrimazole to take.

Interactions

Clotrimazole can interact with a wide variety of different drugs in the body. The most common form of interaction between clotrimazole and another drug is an increased concentration of the other dug in the bloodstream. Some genetic markers may predict whether or not these interactions will be serious or not.
The following drugs interact seriously with each other. Patients who must take any of the following drugs concurrently with clotrimazole should consult with their doctor to determine how best to continue. Dosage adjustments or alternative treatments may be necessary. Patients should disclose a complete list of all drugs, medications, and supplements they are taking to their doctor prior to deciding to take clotrimazole.

  • Alfentanil
  • Amiodarone
  • Astemizole
  • Brexpiprazole
  • Butorphanol
  • Eliglustat
  • Fentanyl
  • Halofantrine
  • Hydrocodone
  • Ivabradine
  • Leflunomide
  • Levomethadyl acetate
  • Lomitapide
  • Mipomersen
  • Neratinib
  • Oxycodone
  • Ranolazine
  • Sirolimus
  • Sonidegib
  • Tacrolimus
  • TerfenadineTeriflunomide
  • Valbenazine

The following drugs can interact with clotrimazole in the patient's body if taken concurrently with clotrimazole. Interactions will either be more moderate than those listed above or less likely. Patients who are taking any of the following drugs should consult with their doctor prior to deciding whether or not to take clotrimazole. Patients should disclose a complete list of all drugs, medications, and supplements to their doctor prior to deciding to take clotrimazole.

  • Abemaciclib
  • Acalabrutinib
  • Alfuzosin
  • Aliskiren
  • Alprazolam
  • Amlodipine
  • Apixaban
  • Aprepitant
  • Aripiprazole
  • Atazanavir
  • Atorvastatin
  • Axitinib
  • Bedaquiline
  • Bepridil
  • Black cohosh
  • Boceprevir
  • Bortezomib
  • Bosentan
  • Bosutinib
  • Brentuximab
  • Brigatinib
  • Budesonide
  • Buprenorphine
  • Cabazitaxel
  • Cabozantinib
  • Cariprazine
  • Ceritinib
  • Cerivastatin
  • Cevimeline
  • Chlorotrianisene
  • Cilostazol
  • Cisapride
  • Clofarabine
  • Cobicistat
  • Cobimetinib
  • Conjugated estrogens
  • Copanlisib
  • Crizotinib
  • Daclatasvir
  • Darifenacin
  • Dasatinib
  • Diazepam
  • dienestrol
  • Diethylstilbestrol
  • Dihydroergotamine
  • Diltiazem
  • Dofetilide
  • Dronedarone
  • Dutasteride
  • Efavirenz
  • Eletriptan
  • Enzalutamide
  • Eplerenone
  • Ergonovine
  • Ergotamine
  • Esterified estrogens
  • Estradiol
  • Estrone
  • Estropipate
  • Eszopiclone
  • Ethinyl estradiol
  • Etonogestrel
  • Etravirine
  • Everolimus
  • Felodipine
  • Fesoterodine
  • Flibanserin
  • Fosaprepitant
  • Gefitinib
  • Guanfacine
  • Hydroxyprogesterone
  • Ibrutinib
  • Idelalisib
  • Imatinib
  • Interferon beta-1a
  • Interferon beta-1b
  • Isavuconazonium
  • Isradipine
  • Ivacaftor
  • Ixabepilone
  • Lapatinib
  • Levobupivacaine
  • Levonorgestrel
  • Lovastatin
  • Macitentan
  • Maraviroc
  • Medroxyprogesterone
  • Methadone
  • Methotrexate
  • Methylergonovine
  • Methysergide maleate
  • Midazolam
  • Midostaurin
  • Mifepristone
  • Naldemedine
  • Naltrexone
  • Nicardipine
  • Nifedipine
  • Nilotinib
  • Nimodipine
  • Nisoldipine
  • Norethindrone
  • Norgestrel
  • Olaparib
  • Osimertinib
  • Paclitaxel
  • Palbociclib
  • Panobinostat
  • Pazopanib
  • Peginterferon beta-1a
  • Pimavanserin
  • Pimozide
  • Ponatinib
  • Progesterone
  • Quetiapine
  • Quinestrol
  • Quinidine
  • Quinine
  • Red yeast rice
  • Repaglinide
  • Rivaroxaban
  • Saxagliptin
  • Sildenafil
  • Silodosin
  • Simvastatin
  • Solifenacin
  • Suvorexant
  • Tadalafil
  • Tamsulosin
  • Tasimelteon
  • Telaprevir
  • Temsirolimus
  • Thioguanine
  • Ticagrelor
  • Tolterodine
  • Toremifene
  • Trabectedin
  • Triazolam
  • Valdecoxib
  • Vardenafil
  • Venetoclax
  • Venlafaxine
  • Verapamil
  • Vilazodone
  • Zonisamide

Clotrimazole will interact with most forms of opiates by raising blood concentrations of the opiates. This can put the patient of serious risk of overdose. Patients should avoid taking clotrimazole and opiate painkillers concurrently. Patients who must take clotrimazole concurrently with an opiate should consult with their doctor to determine adequate alternative treatments. Patients should disclose a complete list of all drugs, medications, and supplements to their doctor prior to deciding to take clotrimazole.

This is not necessarily a complete list of all the drugs which may interact with clotrimazole. Patients should rely on their doctor to identify any potential interactions between any of the drugs, medications, and supplements they are taking and clotrimazole. Patients should make sure that their doctor is completely apprised of all drugs, medications, and supplements they are currently taking when they discuss clotrimazole treatment with their doctor.

Warnings

Patients who think they have consumed too might clotrimazole should contact poison control immediately. The symptoms of clotrimazole overdose are unclear.

Clotrimazole is considered a class C drug in terms of pregnancy. This means that there is insufficient data to determine whether or not clotrimazole has any effect on human fetuses. Studies performed on rats demonstrated some adverse effects to fertility and on the survivability of young at doses more than 100 times the human dose. No effects were noticed on mice at doses of around 60 times the human dose. Pregnant patients should only use clotrimazole if the benefits outweigh the risks to the fetus.

There is no data on long term use of clotrimazole. As a result, patients should try to limit the amount of time they are on clotrimazole. Patients should rely on their doctor to recommend a dosing schedule that does not put them at risk.

Clotrimazole can cause abnormal liver function. This is typically manifested in elevated SGOT levels in the liver, reported by roughly 15% of patients tested. Patients with preexisting hepatic conditions should be vigilant for potential interactions. Periodic assessments of liver function may be necessary. Patients with preexisting hepatic conditions should notify their doctor of their liver condition and any other medical condition prior to taking clotrimazole.

Patients should avoid swallowing the clotrimazole lozenge. When swallowed, the lozenge can produce a range of adverse effects on the patients, including stomach cramps, abdominal pain, nausea, vomiting, and diarrhea.

Clotrimazole lozenges should never be given to patients 3 years old or under. These patients may not be able to properly consume the lozenge, and it can be a choking hazard. Patients under three years old who must be treated with clotrimazole should find an alternative route for treatment.

This is not necessarily a complete list of warnings. Patients should rely on their doctor to inform them of all potential risks associated with taking clotrimazole and of all precautions they should take when considering taking clotrimazole.

Storage

Clotrimazole lozenges should be stored at a room temperature between 68 and 77 degrees Fahrenheit.

Clotrimazole should be kept away from children, especially infants three years old or younger. Clotrimazole lozenges can be a choking hazard

Summary

Clotrimazole is an effective and forgiving medicine. The average treatment last for only two weeks, and is broadly comparable to consuming hard candy. The side effects are modest, and whether or not the patient will experience some of the most severe side effects (nausea, vomiting, cramps, and more) is largely under the control of the patient. BY simply not swallowing the lozenge, they can avoid the worst of the stomach problems. On top of that, because of its' delivery system it doesn't have a huge presence in the bloodstream, interacting with a relatively short list of other drugs and not causing any unique effects.
Patients who respect clotrimazole as the drug it is will usually find it to be a safe, simple, and effective treatment for their condition.