Econazole Nitrate

About Econazole Nitrate

Econazole nitrate is an antifungal applied to the skin. The label approves the 1 percent cream for tinea pedis (athlete’s foot), tinea cruris (jock itch) and tinea corporis (ringworm) caused by named dermatophyte fungi, for cutaneous candidiasis (yeast infection of the skin) and for tinea versicolor. Enough cream to cover the affected area is applied once daily for the tinea infections and tinea versicolor, and twice daily, morning and evening, for cutaneous candidiasis. Candidal infections, jock itch and ringworm are treated for two weeks and athlete’s foot for one month; tinea versicolor usually clears after two weeks. If the skin has not improved by the end of the course, the label says the diagnosis should be looked at again. A separate 1 percent topical foam (Ecoza) is approved only for athlete’s foot between the toes in patients 12 years and older, applied once daily for four weeks.

There is no boxed warning. The cream is not for use in the eyes, and it should be stopped if a reaction suggesting sensitivity or chemical irritation develops. It must not be used by anyone who has had a hypersensitivity reaction to any of its ingredients. In clinical trials a small share of patients reported burning, itching, stinging or redness where the cream was applied, and one case of an itchy rash was reported. The one drug interaction on the label is with warfarin: enhanced anticoagulation has been reported, with the risk higher when the cream is applied under a dressing, to the genital area or over a large area of skin, and the label says INR or prothrombin time monitoring may be needed in those cases.

The label says the cream should be used in the first trimester of pregnancy only when the physician considers it essential, and in the second and third trimesters only if clearly needed; it is not known whether econazole passes into human milk, so nursing mothers use it with caution. The label has no section on use in children. Because the brand is gone, every tube dispensed is a generic, in 15 g, 30 g and 85 g sizes. MedlinePlus adds that the cream is used for the full course even when the skin looks better, and that cosmetics, lotions or other skin medicines should not go on the treated area unless the prescriber agrees.

Taking Econazole Nitrate

How to take it

Clean and dry the area, then gently rub in just enough cream to cover it, once a day for athlete’s foot, jock itch, ringworm or tinea versicolor and twice a day, morning and evening, for a skin yeast infection. Wash your hands afterward, keep it out of your eyes and mouth, and finish the full course even if the skin looks better.

If you miss a dose

Apply it as soon as you remember, unless it is almost time for the next application; then skip the missed one. Do not apply extra to make up for it.

Storage

At room temperature, 68 to 77 degrees Fahrenheit, in the original tube, tightly closed, away from heat and moisture and out of reach of children.

Interactions to know about

Tell the prescriber if you take warfarin: enhanced anticoagulation has been reported, especially when the cream is used under a dressing, on the genital area or over a large area of skin. Do not put cosmetics, lotions or other skin medicines on the treated area unless the prescriber says so.

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 Econazole Nitrate differs from pharmacy to pharmacy

Econazole cream is an old generic made by several companies, so the cream itself costs pharmacies little and the dispensing fee is a large part of any quote. Quotes differ mainly by tube size and quantity: a two week course for ringworm on a small patch needs far less cream than a month of treatment for both feet, and a prescription that specifies the 85 g tube or more than one tube is quoted differently from one 15 g tube. Pharmacies that carry the cream on a flat price generic list quote it one way; those that order it in for a single prescription quote it another.

The foam is a brand product; an authorized generic is listed but may not be on pharmacy shelves, so quotes for it look nothing like quotes for the cream, and not every pharmacy stocks it.

Ways to pay less for Econazole Nitrate without insurance

• Ask the prescriber to write for a tube size that covers the whole course, so you pay one dispensing fee instead of two.
• Ask whether the pharmacy lists econazole cream on a flat price generic list; many old topical antifungals are on such lists.
• Compare more than one pharmacy, since the dispensing fee drives the quote for a cheap generic cream and fees differ widely.
• If you were prescribed the foam, ask the prescriber whether the cream would suit your infection, since the foam is approved only for athlete’s foot between the toes while the cream covers that and several other infections and has more makers.
• 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 Econazole Nitrate

1. 1.How much cream will my course actually need, and is the tube on my prescription the right size?
2. 2.I take warfarin: does using this cream on a large area mean my INR should be checked?
3. 3.Should I keep applying it for the full two weeks or month even if the rash clears sooner?
4. 4.Can I use my usual lotion or foot powder on the same area while I am treating it?

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