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Topical / vaginal imidazole antifungal

Clotrimazole

Brand names: Canesten, Canesten Combi (with hydrocortisone — Canesten HC)

Clotrimazole is a topical imidazole antifungal used to treat dermatophyte infections, candidiasis and pityriasis versicolor of the skin.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It inhibits fungal cytochrome P450-dependent 14-alpha-demethylase, blocking ergosterol synthesis and disrupting the fungal cell membrane.

Prescribing in practice

  • Continue treatment for the recommended period after lesions clear to prevent relapse, as premature discontinuation is a common cause of treatment failure.
  • It is for external use only; avoid contact with the eyes and review the diagnosis if there is no improvement after an adequate course.
  • Where significant inflammation accompanies the infection a combined antifungal-corticosteroid preparation may be considered for short-term use.

Monitoring

Monitoring is clinical, based on resolution of the rash and any local irritation at the application site.

Counselling the patient

  • Apply to the affected area and surrounding skin and keep using it for the full recommended duration even once it looks better.
  • Wash and dry the area before application and avoid sharing towels to limit spread.
  • Local stinging or redness can occur; stop and seek advice if marked irritation develops.

Evidence & guidelines

Topical imidazoles are recommended first-line for localised fungal skin infections in current prescribing references and NICE guidance.

Reference: SmPC Canesten; NICE CKS Candida (vulvovaginal); BAD Fungal Skin Infections Guidance; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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