Pronunciation
kloe-TRIM-a-zole

Trade Name(s)

• Mycelex

Indications

• Treatment of oropharyngeal candidiasis.

• Prevention of oropharyngeal candidiasis in immunocompromised patients (receiving chemotherapy or radiation for cancer or corticosteroids for cancer or transplant).

Action

Affects the permeability of the fungal cell wall, allowing leakage of cellular contents.

Therapeutic Effect(s):
Decrease in or prevention of symptoms of oropharyngeal candidiasis.

Pharmacokinetics

Absorption: Minimal systemic absorption.

Distribution: Inhibitory concentrations remain in saliva for up to 3 hr after troche dissolves.

Metabolism and Excretion: Metabolized by liver; <1% excreted unchanged in urine.

Half-life: 24 hr.

TIME/ACTION PROFILE

Contraindication/Precautions

Contraindicated in:

• Hypersensitivity to clotrimazole or other components of formulation;

• Systemic candidiasis.

• Hepatic impairment;

• OB: Use only if potential benefit justifies potential risk to fetus;

• Pedi: Children <3 yr (safety and effectiveness not established).

Adverse Reactions/Side Effects

GI: abnormal mouth sensations, ↑ liver function tests, nausea, vomiting.

Derm: pruritis.

*CAPITALS indicates life-threatening.
*italic indicates most frequent.

Interactions

Drug-Drug

• May ↓ metabolism and ↑ risk of toxicity from CYP3A4 substrates , including cyclosporine , HMG-CoA reductase inhibitors , some benzodiazepines ( alprazolam , midazolam , triazolam ), calcium channel blockers , colchicine , fentanyl , tacrolimus , and warfarin .

• .

Route/Dosage

• PO (Adults and Children ≥3 yr): Treatment—One troche 5 times daily for 14 days; Prophylaxis—One troche 3 times daily for the duration of chemotherapy or until steroid doses are reduced to maintenance levels..

Availability

• Troche: 10 mg

Assessment

• Assess oropharnyngeal mucosa prior to and periodically during therapy.

• Monitor hepatic function prior to and periodically during therapy. May cause ↑AST.

Potential Nursing Diagnoses

• Impairedoral mucous membrane (Indications)

Implementation

PO: Allow each troche to dissolve slowly in mouth to achieve maximum effect.

Patient/Family Teaching

Instruct patient to take clotrimazole as directed. Allow each troche to slowly dissolve in mouth.

Evaluation/Desired Outcomes

Decrease in or prevention of symptoms of oropharyngeal candidiasis.