Naftifine (Topical)

Naftifine is a prescription drug sold under the brand name Naftin that is used to treat a variety of fungal infections on most areas of the body except the scalp, eyes and mouth.

Overview

The human body is susceptible to a wide variety of fungal and yeast infections. As with many different types of drugs, some of the older anti-fungal drugs are losing their effectiveness in treating conditions that they once easily cured. Newer antifungal drugs like Naftifine have been introduced to combat fungal and yeast infections. Since Naftifine is a newer drug, a prescription is required.

Naftifine is in a class of drug known as azole antifungals. Drugs in this class treat a wide range of fungal and yeast infections including Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton tonsurans, Epidermophyton floccosum and various species of Candida. These fungal and yeast organisms are responsible for a number of fungal conditions such as athlete's foot between the toes, athlete's foot that covers the entire foot, body ringworm, jock itch, onychomycosis and epidermal yeast infections.

In addition to these fungal infections, naftifine will treat several other types of fungus including Microsporum canis, Microsporum audouini and Microsporum gypseum. While naftifine has proven to be very effective in treating fungal infections caused by these organisms, the drug is not marketed by the manufacturer to treat fungal infections caused by these organisms.

Naftifine has also demonstrated that it is effective against several bacterial agents. It also has anti-inflammatory properties. Until further testing is completed, patients should not use this medication to treat a bacterial skin infection nor should they use the medication to treat skin inflammation.

Naftifine is a drug that is used topically. It should never be used in or around the mouth. It should not be used in or around the eyes. The product is not effective for fungal infections of the scalp.

This drug is made in two different strengths with strength levels containing one or two percent of the active ingredient. The medication comes in both a cream form and a gel form. The gel form of the drug has a different dosage level that the cream, and the gel is used to treat specific conditions that the cream is not as beneficial for.

Naftifine works by inhibiting a substance that fungi need to grow. Ergosterol is necessary for fungi to replicate. If fungi do not have ergosterol, a substance known as squalene builds up within the fungi structure. When squalene builds up in a fungus, the fungus weakens and dies. Naftifine inhibits the process which allow ergosterol to biosynthesize and convert squalene.

When naftifine is applied to the body, it rapidly absorbs into the skin. The medication has a half-life of two to three days in the human body. The drug is then excreted through the kidneys metabolized by the liver.

When a patient is using naftifine, there are some important precautions that need to be taken. The fungal and yeast infections that the drug treats are highly contagious, and they can easily spread from one portion of the patient's body to another. Patients who use this medication should thoroughly wash their hands before and after each application of the drug. Failure to do so may cause the drug to spread on the patient's body, and it may cause others to contract a fungal or yeast infection.

Conditions Treated

Both the cream and the gel treat the following conditions:

  • Interdigital athlete's foot
  • Athlete's foot on other areas of the foot
  • Jock itch
  • Body ringworm
  • Various yeast infections caused by Candida

The 2% cream and the 2% gel are used for more recalcitrant infections.

  • The 2% gel is recommended for interdigital tinea pedis.
  • The gel form only is used to treat fingernail infections.

Type Of Medication

  • Anti-fungal and anti-yeast medication.

Side Effects

One very serious side effect has been noticed in patients using naftifine. Agranulocytosis has been reported in patients who have been using the drug for a few days. Agranulocytosis causes a severe lowering of a patient's white cell count. This causes a patient to have a reduced capacity to fight infections including opportunistic infections.

Skin irritation resulting in redness and inflammation of the skin is the most common side effect. This side effect is seen in up to five percent of patients using the medication. Normally, if skin irritation is going to occur, the patient will notice it early on. Sometimes, the drug must be discontinued if irritation is too extensive.

Up to 5% of patients also report a skin rash in and around the area where the drug is applied. Depending on severity, the medication may need to be discontinued. Erythema occurs in .5 to 5% of patients. This can be fairly extensive in some patients.

Pruritis, which is intense itching, is noted in about one percent of patients. This type of side effect has a rapid onset. Patients experiencing severe pruritis will need to use a different medication. Leukopenia is another delayed side effect seen in a few patients. If it occurs it may range from mild to moderate severity.

The following side effects have been noted in a few patients using naftifine:

Dosage

When the 1% cream is used in the treatment of jock itch, the patient should apply the medication to the affected areas and surrounding areas once per day for a period of four weeks. If the 1% gel is being used, the gel should be thoroughly applied to the affected areas and surrounding areas twice a day for a period of four weeks. A 2% cream may also be used for recalcitrant cases of jock itch. When used, it should be applied once per day for two weeks.

When using this medication to treat interdigital tinea pedis, the manufacturer recommends that the gel be used. The 1% gel should be applied thoroughly between the toes twice a day for four weeks. The 2% gel is used for harder to treat cases, and it is to be applied once per day for a period of two weeks.

The cream formula may be used for other types of tinea pedis. When the 1% cream is used, it should be applied to the affected areas once a day for four weeks. The 2% strength should be used once per day for two weeks.

For the treatment of body ringworm, the 1% gel may be used. It should be applied to affected areas twice each day for four weeks. The 1% cream needs to be used once per day for four weeks. The 2% cream is only used to treat body ringworm caused by Trichopyhton rubrum. The cream should be used once a day for two weeks.

When patients are treating fungal infections of the fingernails. The 1% gel is used. The gel should be applied to the nails and the area around the nail twice a day for a period of six months. This product is only effective in curing fingernail fungus in approximately 40 to 60 percent of patients. Often, oral fungal treatments must be used for recalcitrant cases. This product has not been shown to help those with fungal infections of the toe nails. It can be used to help halt the spread of fungus from the nail beds to the skin surrounding the nails.

Interactions

Patients being treated with naftifine should not use another anti-fungal drug in the same location where naftifine is being applied. This may cause irritation.

There are no known drug interactions between naftifine and other prescription and nonprescription drugs. Patients are advised to always inform their healthcare providers regarding all medications and supplements that they are currently taking.

Warnings

This medication has not been tested on children under the age of 12. Therefore, the drug is not recommended for use in those under the age of 12.

This drug is listed as Pregnancy Category B. The drug has not been shown to cause any defects in the fetus when used during pregnancy.

Testing has not been performed as to whether this medication is excreted in breast milk. The medication is absorbed into the system, so nursing mothers are advised to take precautions. If a mother wants to breastfeed, she should only use naftifine if other drugs are not effective in treating her condition.

Those using this drug should take precaution so that the fungal and yeast infections for which they are being treated to do not spread to other parts of their body or to others with whom the patients have contact. Those using naftifine should thoroughly wash and dry their hands before and after each application of the medication to prevent the spread of infection.

Patients should not place a dressing or a covering over the area where naftifine is applied. This may cause irritation to the area.

If the patient does not see improvement after four weeks, further testing should be carried out to determine if the patient truly has a fungus or yeast susceptible to naftifine.

Storage

Both the cream and gel forms of naftifine should be stored at room temperature in a dry place.

Summary

Naftifine is a newer form of anti-fungal and anti-yeast drug that is part of the azole family medications. Naftifine is used to treat many different types of fungal and yeast infections. Some of the the infections treated by this medication include athlete's foot, jock itch, body ringworm and onochomycosis.

Naftifine comes in both a cream and gel form, and there is both a one percent and two percent strength level. The gel form is recommended for interdigital athlete's foot and for treating fungal infections of the fingernails. This medication is not effective in treating fungal infections of the toe nails or the scalp.

Most of the side effects associated with the use of naftifine are mild and involve the skin. Skin irritation, redness, itching and burning are the most common side effects. One severe side effect known as agranulocytosis has been noted after several days use of the drug. Some other minor side effects have been noted, but removal of the drug is not usually necessary.