How bifonazole works
Bifonazole is an antifungal agent from the group of azole antifungals. It is used externally.
Fungi form a separate kingdom alongside animals and plants in the classification of living organisms whose cells contain a cell nucleus. Like the other kingdoms, fungi have certain peculiarities that medicine makes use of to develop active substances against them.
Just as animals and humans have cholesterol, which gives their cell membranes stability, fungi have a very similar substance called ergosterol, which they need to build their cell membranes.
The most commonly used agents against fungal infections (antimycotics) are substances that inhibit the production of ergosterol in fungal cells. These include the so-called azole antifungals, which all have a very similar chemical structure and whose names always end in the syllable “-azole”.
Well-known representatives include clotrimazole, itraconazole and bifonazole. Bifonazole is unique in that it attacks and blocks two points in the ergosterol production chain. In addition, the active ingredient penetrates the skin well (good penetration capacity) and remains there for a very long time.
When is bifonazole used?
How bifonazole is used
Preparations containing the active ingredient bifonazole are marketed in Germany as a cream, gel, solution and spray. In Austria, however, only creams are on the market, whereas in Switzerland no preparation containing the active ingredient is available.
Bifonazole preparations are applied once a day in the evening to the affected skin and adjacent healthy skin areas and gently massaged in. The treatment should be continued for a further two weeks after the infection has disappeared in order to prevent the spread of new spores or invisible residual infections.
In total, the active ingredient must be used for around two to four weeks for fungal skin infections and over four weeks for fungal nail infections.
What are the side effects of bifonazole?
The side effects of local therapy with bifonazole are limited to the site of application, as the active ingredient hardly passes through the skin into the bloodstream.
When applying bifonazole cream, skin irritations such as redness, burning and stinging occur in one in a hundred to one in a thousand people treated. When applied as a gel or solution (spray), this even occurs in one in ten to one in a hundred patients.
What should I bear in mind when using bifonazole?
Interactions
Limited data suggest that there may be an interaction between bifonazole and warfarin (anticoagulant) that prolongs the bleeding time. If bifonazole is used together with warfarin, the bleeding time should therefore be monitored.
Age restriction
The antifungal agent should only be used in infants and young children under medical supervision.
Pregnancy and breastfeeding
There is insufficient data available for a safety assessment for use in pregnant women. However, as hardly any active substance is absorbed into the body during topical application, a risk is not to be expected.
According to the prescribing information, breastfeeding should be discontinued during bifonazole therapy, as the active substance has been found to pass into breast milk in animal studies.
However, clinical experience shows that bifonazole can also be used during breastfeeding. However, the active ingredient should not be applied to the breastfeeding mother’s breast area in order to avoid oral absorption by the infant.
How to obtain medication with bifonazole
In Germany and Austria, remedies for skin and nail fungus containing this active ingredient are available from pharmacies, but do not require a prescription. They can therefore be purchased over the counter.
How long has bifonazole been known?
Generics with the active ingredient bifonazole are now also available on the German market.
