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Topical imidazole antifungal

Econazole nitrate

Brand names: Pevaryl, Ecostatin, Gyno-Pevaryl

Econazole nitrate is a topical imidazole antifungal used for dermatophyte infections, cutaneous and vulvovaginal candidiasis, and pityriasis versicolor.

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 lanosterol 14-alpha-demethylase, impairing ergosterol synthesis and disrupting the integrity of the fungal cell membrane.

Prescribing in practice

  • It is for external (or intravaginal) use only and should be kept away from the eyes; discontinue if marked local irritation or a hypersensitivity reaction occurs.
  • Treatment should usually be continued for a period after the lesions have healed to reduce the risk of relapse.
  • Intravaginal and some topical formulations may damage latex condoms and diaphragms, reducing their reliability.

Monitoring

No specific laboratory monitoring is required; assess clinical response and watch for local irritation or contact sensitisation.

Counselling the patient

  • Apply to the affected area and surrounding skin as directed and complete the full course even once symptoms settle.
  • Stop and seek advice if the skin becomes red, itchy or sore beyond the treated infection.
  • Avoiding reliance on latex barrier contraceptives while using vaginal formulations is advisable.

Evidence & guidelines

Topical imidazoles such as econazole are well-established first-line agents for superficial fungal skin infections in standard dermatological practice.

Reference: NICE CKS Candidiasis; NICE CKS Tinea; 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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