Econazole Nitrate + Triamcinolone Acetonide

Econazole Nitrate + Triamcinolone Acetonide is a combination of econazole nitrate (a broad-spectrum antifungal) and triamcinolone acetonide (a synthetic corticosteroid). Econazole covers dermatophytes (Trichophyton, Epidermophyton, Microsporum, Cladosporium), yeasts (Candida, Cryptococcus neoformans, Torulopsis, Rhodotorula), moulds (Scopulariopsis brevicaulis, Aspergillus flavus, Histoplasma capsulatum), Malassezia furfur and Nocardia minutissima. It also has antibacterial effect on gram-positive cocci and bacilli. Triamcinolone inhibits early and later manifestations of inflammation. Apply sparingly to skin lesions no more than 2 times daily for up to 2 weeks. Contraindicated in tuberculous lesions, viral skin infections, rosacea and hypersensitivity.

• Eczematous Mycoses
• Psoriasis
• Tinea Pedis (Athlete's foot)
• Tinea Corporis (Ring worm)
• Tinea Cruris (Jock itch)
• Inflammatory Intertrigo
• Diaper Dermatitis
• Onychomycoses (in combination with oral antimycotic)

Econazole Nitrate is a broad-spectrum antimycotic effective against dermatophytes, yeasts and moulds. Triamcinolone Acetonide is a synthetic corticosteroid that reduces inflammation, pruritus and allergic reactions. Econazole Nitrate is only slightly (<0.1%) absorbed from the skin, but Triamcinolone Acetonide is well absorbed from sites of local application.

Econazole modifies fungal cell wall membrane permeability and interferes with RNA and protein synthesis. Triamcinolone has mainly glucocorticoid activity, suppressing polymorphonuclear leukocyte migration and reducing capillary permeability, thereby decreasing inflammation.

Adult Dose: Apply sparingly to skin lesions no more than 2 times daily (morning and evening). Do not apply with occlusive dressing or to large areas. Continue until inflammatory symptoms subside but not longer than 2 weeks. After 2 weeks, continue with econazole or econazole nitrate alone if needed.

Pediatric Dose: Caution required. Use for short periods (<2 weeks) and on small areas (<10% of body surface area).

For external use only. Do not use in eyes or mouth. Apply a thin layer to clean, dry affected area and rub in gently. Wash hands after application.

If you miss a dose, apply it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular schedule.

Common Side Effects:

• Transient local mild irritation
• Itching
• Redness
• Skin thinning and atrophy (with prolonged use)
• Striae, telangiectasis and purpura
• Adrenal suppression (in infants/children or with occlusive dressings)

• For external use only. Avoid contact with eyes and mucous membranes.
• Discontinue if hypersensitivity or chemical irritation occurs.
• Corticosteroids can be absorbed to produce systemic effects including adrenal suppression. Absorption increases with large areas, damaged skin, occlusive dressings and prolonged use.
• Prolonged use may cause skin thinning, atrophy, striae, telangiectasis and purpura.
• Increased caution required in children due to larger skin surface area to body weight ratio.
• Refer to ophthalmologist if blurred vision or other visual disturbances occur.

• Hypersensitivity to any ingredient
• Tuberculous lesions
• Varicella, herpes simplex or other viral skin infections
• Vaccination sites
• Decubitus ulcers
• Viral, bacterial or fungal skin infections (e.g., cutaneous tuberculosis, syphilis, herpes simplex, herpes zoster, chickenpox)
• Rosacea and rosacea-like dermatitis

Econazole: Theoretical potential for compounds metabolized by CYP3A4/2C9, oral anticoagulants (warfarin & acenocoumarol).

Triamcinolone: Lowers plasma salicylate levels. Increased GI bleeding and ulceration risk with NSAIDs. Antagonizes blood glucose-lowering effects of antidiabetics. Increased hyperkalemia risk with amphotericin B, beta-blockers, potassium-depleting diuretics, theophylline. Increased clearance with ciclosporin, carbamazepine, phenytoin, barbiturate, rifampicin.

No known food interactions.

Econazole does not cross placenta but Triamcinolone Acetonide does. Topical corticosteroids during pregnancy can cause fetal developmental abnormalities. Large amounts or prolonged use should not be used in pregnancy.

Negligible amount of econazole and some triamcinolone may be excreted in breast milk. Should not be prescribed to lactating mothers or lactation should be withheld during treatment.

Caution required in children. Use for <2 weeks and on <10% of body surface area.

Limited information available regarding dose adjustment for elderly patients.

Renal impairment: Use with caution in kidney disease.

Hepatic impairment: Use with caution in liver disease.

For cutaneous use only. Corticosteroids including triamcinolone can be absorbed to produce systemic effects. In case of accidental ingestion, treat symptomatically. If applied to eyes, wash with clean water or saline and seek medical attention.

Store below 30°C in a cool, dry place away from light. Keep out of reach of children.

Econazole Nitrate + Triamcinolone Acetonide