Adult: As 10 mg loz: For local treatment: Dissolve 1 loz slowly (approx 30 minutes) 5 times daily for 14 days. As prophylaxis to reduce the incidence of infection in immunocompromised patients receiving chemotherapy, radiotherapy, or steroid therapy for leukaemia, solid tumours, or renal transplantation: Dissolve 1 loz slowly (approx 30 minutes) tid for the duration of immunosuppressant treatment. Child: ≥3 years As 10 mg loz: For local treatment: Dissolve 1 loz slowly (approx 30 minutes) 5 times daily for 14 days. Treatment recommendations may vary among countries and between individual products (refer to specific product guidelines).
Otic/Aural Otomycosis
Adult: As 1% otic solution: Instil 2-6 drops into the affected ear 2-3 times daily for at least 10-14 days. Dosage and treatment recommendations may vary among countries and between individual products (refer to specific product guidelines).
Topical/Cutaneous Skin fungal infections
Adult: As 1% topical cream, ointment, spray, lotion, or solution: Apply thinly onto the affected area 2-3 times daily for 2-4 weeks. As 1% powder: Adjunctive therapy or for prevention of reinfection: Apply onto the affected area 2-3 times daily. Treatment recommendations, including treatment duration, may vary among countries and between individual products (refer to local or specific product guidelines).
Vaginal Vulvovaginal candidiasis
Adult: As pessary or vaginal tab: Insert 100 mg once daily for 6 days, or 200 mg once daily for 3 days. Alternatively, 500 mg as a single dose. Insert as deeply as possible into the vagina, preferably at night. Treatment course may be repeated once if necessary. As 1% vaginal cream: Insert 1 applicatorful (5 g) of cream once daily into the vagina as deeply as possible, preferably at night, for 6 or 7 days. Alternatively, apply thinly onto the affected areas 2-3 times daily. As 2% vaginal cream: Insert 1 applicatorful (5 g) of cream once daily into the vagina as deeply as possible, preferably at night, for 3 days. Alternatively, apply thinly onto the vulva and surrounding area 2-3 times daily. As 10% vaginal cream: Insert 1 applicatorful (5 g) of cream into the vagina as deeply as possible, preferably at night; may repeat dose once if necessary. Dosage and treatment recommendations may vary among countries and between individual products (refer to specific product guidelines). Child: Treatment recommendations may vary among countries and between individual products (refer to specific product guidelines).
What are the brands available for Clotrimazole in Hong Kong?
Vaginal: Patient with history of STD or exposure to partner with STD; >2 infections of candidal vaginitis in the last 6 months; abnormal vaginal bleeding or blood-stained discharge, irregular vaginal bleeding, vulval or vaginal ulcers, blisters or sores; lower abdominal pain, dysuria, fever, chills, diarrhoea, nausea, vomiting, foul-smelling vaginal discharge. Clotrimazole loz is not intended for systemic fungal infection. Hepatic impairment. Children. Pregnancy and lactation.
Adverse Reactions
Significant: Irritation or sensitivity; abnormal LFTs, including AST (oral). Gastrointestinal disorders: Nausea (oral/vaginal); vomiting, unpleasant mouth sensations (oral); abdominal pain (vaginal). General disorders and administration site conditions: Application site irritation, oedema, pain (vaginal/topical). Immune system disorders: Hypersensitivity reactions (vaginal/topical). Reproductive system and breast disorders: Vaginal discharge, exfoliation, and haemorrhage, vulvovaginal discomfort, erythema, burning sensation, pain, and pruritus. Respiratory, thoracic and mediastinal disorders: Dyspnoea (vaginal/topical). Skin and subcutaneous tissue disorders: Pruritus; rash, urticaria (vaginal/topical); blisters, erythema, skin exfoliation, stinging or burning sensation (topical). Vascular disorders: Syncope, hypotension (vaginal/topical).
Vaginal: Do not use during menstrual period due to the risk of being washed out by menstrual flow. Do not use tampons, vaginal douches, spermicides, or other vaginal products during treatment. Avoid vaginal intercourse during treatment. Clotrimazole may damage and reduce the effectiveness of latex contraceptives (e.g. condoms, diaphragms). Topical: Avoid contact with the eyes and mucous membranes.
Monitoring Parameters
Oral: Monitor LFTs periodically (particularly in patients with preexisting hepatic impairment). May consider potassium hydroxide (KOH) smear or culture before initiating treatment to confirm oropharyngeal candidiasis. Topical/Vaginal: Monitor for hypersensitivity reaction or local irritation.
Drug Interactions
May increase the plasma concentrations of tacrolimus and sirolimus.
Action
Description: Overview: Clotrimazole is an imidazole antifungal agent. It has a broad antimycotic spectrum of activity against moulds, yeasts, dermatophytes, and other fungi. Additionally, it has activity against Gram-positive (Streptococcus, Staphylococcus, and Gardnerella vaginalis) and Gram-negative (Bacteroides) microorganisms. Mechanism of Action: Clotrimazole inhibits the synthesis of ergosterol, a major component of the fungal cell membrane. It acts by binding to phospholipids in the fungal cell membrane, altering cell wall permeability, leading to loss of essential intracellular constituents. Pharmacodynamics: Resistance to clotrimazole has been associated with the overexpression of efflux pump genes and has been reported in certain Candida isolates, especially among immunocompromised patients. Cross-resistance may develop among azole antifungals, such as clotrimazole, miconazole, and ketoconazole. Pharmacokinetics: Absorption: Minimally absorbed from intact or inflamed skin (topical); absorbed 3-10% of the dose (vaginal). Distribution: Highest concentration is present in the stratum corneum after topical application. Metabolism: Metabolised in the liver to inactive compounds. Excretion: Via faeces and urine.
Chemical Structure
Clotrimazole Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 2812, Clotrimazole. https://pubchem.ncbi.nlm.nih.gov/compound/Clotrimazole. Accessed Nov. 25, 2024.
Storage
Oral: Loz: Store between 20-25°C. Avoid freezing.
Vaginal: Pessary/Vaginal tab/Vaginal cream: Store below 30°C.
Otic: Otic solution: Store below 30°C.
Topical: Cream/Solution/Lotion/Spray/Ointment: Store below 30°C. Powder: Store below 30°C. Protect from light.
Storage recommendations may vary among countries and between individual products. Refer to specific product guidelines.
G01AF02 - clotrimazole ; Belongs to the class of imidazole derivative antiinfectives. Used in the treatment of gynecological infections. A01AB18 - clotrimazole ; Belongs to the class of local antiinfective and antiseptic preparations. Used in the treatment of diseases of the mouth. D01AC01 - clotrimazole ; Belongs to the class of imidazole and triazole derivatives. Used in the topical treatment of fungal infection.
References
Bayer New Zealand Limited. Canesten Thrush 6 Day, 3 Day and 1 Day Internal Vaginal Cream; Canesten Thrush 6 Day and 1 Day Vaginal Pessary data sheet 4 April 2022. Medsafe. http://www.medsafe.govt.nz. Accessed 01/12/2025.Brayfield A, Cadart C (eds). Clotrimazole. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/12/2025.Candazole Lotion 1% w/v (HOE Pharmaceuticals Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 01/12/2025.Candazole Solution 1% w/v (HOE Pharmaceuticals Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 01/12/2025.Candid Dusting Powder (Glenmark Pharmaceuticals [Malaysia] Sdn Bhd). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 01/12/2025.Canesten 10% w/w Vaginal Cream (Bayer plc). MHRA. https://products.mhra.gov.uk. Accessed 01/12/2025.Canesten 100 mg Pessary (Bayer plc). MHRA. https://products.mhra.gov.uk. Accessed 01/12/2025.Canesten 500 mg Pessary (Bayer plc). MHRA. https://products.mhra.gov.uk. Accessed 01/12/2025.Canesten Combi Soft Gel Pessary & External Cream 500 mg / 2% w/w Vaginal Capsule & Cream (Bayer plc). MHRA. https://products.mhra.gov.uk. Accessed 01/12/2025.Canesten Dermatological Spray (Bayer plc). MHRA. https://products.mhra.gov.uk. Accessed 01/12/2025.Canesten Solution (Bayer plc). MHRA. https://products.mhra.gov.uk. Accessed 01/12/2025.Canesten V Cream (Bayer). MIMS Malaysia. http://www.mims.com/malaysia. Accessed 12/02/2026.Clotrimazole (Oral). UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 01/12/2025.Clotrimazole (Otic). UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 01/12/2025.Clotrimazole (Topical). UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 01/12/2025.Clotrimazole 1% Cream (Cooper Consumer Health B.V.). MHRA. https://products.mhra.gov.uk. Accessed 01/12/2025.Clotrimazole 500 mg Vaginal Tablets (Nevik Limited). MHRA. https://products.mhra.gov.uk. Accessed 01/12/2025.Clotrimazole Cream 1% (Estiva Generics Corporation). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 01/12/2025.Clotrimazole Lozenge (Rising Pharma Holdings, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 01/12/2025.Clotrimazole Topical Solution 1% (Allegis Holdings, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 01/12/2025.Clotrimazole Vaginal Cream (Sun Pharmaceutical Industries, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 01/12/2025.Clotrimazole. UpToDate Lexidrug, AHFS DI (Adult and Pediatric) Online. American Society of Health-System Pharmacists, Inc. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 01/12/2025.Cotren Vaginal Tablets (Medispec [M] Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 01/12/2025.Creobic Cream (Kotra Pharma [M] Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 01/12/2025.Joint Formulary Committee. Clotrimazole. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/12/2025.Ottozole Ear Drops (KCK Pharmaceutical Industries Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 01/12/2025.Terrasil Anti-fungal Treatment Max Ointment (Aidance Scientific, Inc., DBA Aidance Skincare & Topical Solutions). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 01/12/2025.Therapex Anti-fungal Spray 1% w/v (Biofizz Marketing Sdn Bhd). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 01/12/2025.
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