Products
Econazole is commercially available as a cream, powder, pump spray, vaginal cream, and vaginal suppository (Pevaryl, Gyno-Pevaryl, Pevisone + triamcinolone acetonide). The active ingredient has been approved in many countries since 1974.
Structure and properties
The imidazole derivative econazole (C18H15Cl3N2O, Mr = 381.7 g/mol) is a white powder that is practically insoluble in water. It is present in drugs as econazole nitrate, a white powder that is very sparingly soluble in water. Econazole has a chiral C atom and is a racemate.
Effects
Econazole (ATC D01AC03, ATC G01AF05) has antifungal activity against human pathogenic fungi (dermatophytes, yeasts, and molds) and additional activity against Gram-positive bacteria.
Indications
Econazole is indicated for the external treatment of fungal skin infections. Because it is additionally antibacterial, it can also be used for mixed infections with Gram-positive bacteria. Vaginal cream and vaginal ovoules are used for the treatment of vaginal mycosis. The vaginal cream is also used for balanitis mycotica, which is a yeast infection of the male member.
Dosage
According to the drug label. The sufficiently long duration of treatment beyond the improvement of symptoms must be observed. Treatment of a vaginal fungus is carried out for 15 days or alternatively for 3 days with the stronger dosed depot ovules.
Contraindications
Econazole is contraindicated in hypersensitivity and should not be used on the eye. In children under 2 years of age, medicines should be dispensed only on a doctor’s prescription. For complete precautions, see the drug label.
Interactions
Econazole is a potent inhibitor of CYPs. When used topically or vaginally, interactions are usually not expected due to low uptake into the circulation. Interactions with oral anticoagulants have been reported. Vaginally applied dosage forms may reduce the tear strength of condoms.
Adverse effects
Possible adverse effects include local skin irritation and hypersensitivity reactions.
