Clotrimazole

About Clotrimazole

Clotrimazole inhibits the growth of yeasts and other fungi by altering their cell membranes. The troche treats thrush of the mouth and throat (oropharyngeal candidiasis) confirmed by a smear or culture, one five times a day for 14 days, and lowers the chance of thrush in people whose immunity is weakened by chemotherapy, radiotherapy or steroids for leukemia, solid tumors or a kidney transplant, one three times a day until chemotherapy ends or steroids are cut to a maintenance dose. Its safety and effectiveness under age 3 have not been established, and it does not treat fungal infections elsewhere in the body. The prescription 1 percent cream and solution treat skin yeast infections (Candida albicans) and tinea versicolor, massaged in twice a day; improvement usually shows within a week, and the diagnosis is reviewed if there is none after four weeks.

Abnormal liver tests have been reported with the troches, so the label advises periodic liver checks, especially with existing liver disease. Nausea, vomiting, unpleasant mouth sensations and itching are the other reported effects, and each troche must be dissolved slowly in the mouth. On the skin, redness, stinging, blistering, peeling, swelling, itching, hives and burning can occur; the cream and solution are kept out of the eyes, and anyone allergic to an ingredient must not use them. The troche label advises use in pregnancy only if the benefit justifies the risk, and the prescription cream label advises use in the first three months of pregnancy only if clearly needed.

Over the counter, clotrimazole 1 percent cream treats athlete’s foot, jock itch and ringworm; the Lotrimin AF clotrimazole cream label says not to use it on children under 2 unless a doctor directs, and MedlinePlus expects jock itch to improve within two weeks and athlete’s foot and ringworm within four. Not every Lotrimin product is clotrimazole: the Lotrimin AF powders and sprays listed on DailyMed contain miconazole, and Lotrimin Ultra contains butenafine. Vaginal creams are used at bedtime for three or seven days, depending on the product, from age 12; a first infection, frequent infections, pregnancy, possible HIV exposure, fever, belly pain or a foul-smelling discharge call for a doctor first, and the cream can weaken condoms and diaphragms. Drugs@FDA lists Mycelex troches and prescription Lotrimin cream and solution as discontinued, and FDA has determined they were not withdrawn for safety or effectiveness reasons; MedlinePlus marks the Gyne-Lotrimin vaginal creams as no longer on the market.

Taking Clotrimazole

How to take it

Troche: let it dissolve slowly and completely in the mouth, which takes about 30 minutes. Cream or solution: wash and dry the affected skin, then gently massage a thin layer into it and the skin around it, morning and evening. Vaginal cream: one applicatorful at bedtime for the number of days on the package.

If you miss a dose

Take or apply a missed dose as soon as you remember, unless the next one is nearly due; then skip it. Do not double up.

Storage

At room temperature in the original closed container, away from heat and moisture, out of reach of children; do not freeze the troches.

Interactions to know about

The troche label lists no specific drug interactions, but tell the prescriber about every medicine you take and about any liver disease. Vaginal cream can weaken condoms and diaphragms, and tampons, douches and spermicides are avoided during treatment.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Clotrimazole differs from pharmacy to pharmacy

A treatment course of troches is 70 lozenges (five a day for 14 days), and prevention can last as long as chemotherapy, so the quantity written drives the total; bottles of 70 and 140 are made.

The prescription cream and solution are generics from several makers, so quotes for the same product differ mainly in each pharmacy’s dispensing fee and markup and in the size written. Clotrimazole 1 percent cream and solution are also sold over the counter, labeled for athlete’s foot, jock itch and ringworm rather than the prescription uses. A pharmacist cannot exchange the cream, solution, vaginal cream or troches for one another without the prescriber.

Ways to pay less for Clotrimazole without insurance

• For athlete’s foot, jock itch or ringworm, ask the prescriber whether an over-the-counter 1 percent cream would do, and check that it lists clotrimazole, since some Lotrimin AF products contain miconazole.
• Ask for the generic troche, written for the exact number the course needs, and compare more than one pharmacy for a long prevention course.
• Over-the-counter clotrimazole vaginal cream is labeled only for someone who has had a vaginal yeast infection diagnosed by a doctor before; if one is prescribed, ask for both the prescription quote and the over-the-counter price.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Clotrimazole

1. 1.How many troches do I take each day, and for how long?
2. 2.How do I let the troche dissolve properly, and can I eat or drink afterward?
3. 3.Will my liver tests need checking while I take the troches?
4. 4.Is the over-the-counter cream the same medicine as my prescription cream?

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