Lamisil AF

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Lamisil AF

Classes

Other Dermatological Agents
Topical Dermatological Antifungals

Administration

For storage information, see specific product information within the How Supplied section.

Topical Administration

Topical tolnaftate preparations are for external use only. Do not apply to blistered, oozing, or raw skin. Do not apply to the eye or mucus membranes.
Cleanse and dry affected area thoroughly prior to using topical tolnaftate preparations.
Do not use dressings that do not allow air circulation over the affected area (occlusive dressings) unless otherwise directed. A light breathable dressing may be used to protect clothing.

Cream/Ointment/Lotion Formulations

Cream: Rub tolnaftate cream solution gently into cleansed affected skin.

Other Topical Formulations

Gel or solution: Rub tolnaftate gently into cleansed affected skin.
Aerosol liquid or aerosol powder: Shake well before using. Spray onto cleansed affected skin. Spray evenly, at a distance of 6 to 10 inches from the infected area. If treating the feet, spray between the toes.
Powder: Apply to cleansed affected skin. The powder may be used in conjunction with other preparations of tolnaftate for active treatment.
Wipes or swabs: Rub wipe gently into cleansed affected skin.

Adverse Reactions
Moderate

erythema / Early / Incidence not known
contact dermatitis / Delayed / Incidence not known

Mild

pruritus / Rapid / Incidence not known
xerosis / Delayed / Incidence not known
skin irritation / Early / Incidence not known

Common Brand Names

Absorbine Athletes Foot, Absorbine Jr. Antifungal, Aftate For Athletes Foot, Aftate for Jock Itch, Antifungal, Dr. Scholl's Odor-X, Fungi-Guard, Lamisil AF, Micomitin, Micotrin AL, Mycozyl AL, Q-Naftate, Termin8, Tinactin, Tinactin Deodorant, Tinactin Jock Itch, Tinactin Topical, Tinaderm, Ting Antifungal

Dea Class

OTC, Rx

Description

Topical thiocarbamate antifungal used primarily for treatment of mild to moderate tinea pedis (athlete's foot), tinea cruris (jock itch), tinea corporis (ringworm), tinea manuum, and tinea versicolor.

Dosage And Indications
For the treatment of tinea cruris, tinea corporis, tinea manuum, tinea pedis, tinea barbae, and tinea capitis caused by T. rubrum, T. mentagrophytes, T. tonsurans, M. canis, M. audouinii, and E. floccosum; also effective in the treatment of tinea versicolor infections due to M. furfur.
NOTE: Tolnaftate is not recommended in the treatment of deeper skin infections or infection of the nail beds (onychomycosis).
NOTE: Tolnaftate powder may not be effective as monotherapy; for active treatment, use of the powder may be combined with other topical dosage forms if required.
Topical dosage (all skin products) Adults, Geriatric, Adolescents, and Children >= 2 years

Apply to affected area twice daily, morning and evening for 2—4 weeks.

For the treatment of fungal otitis externa†. Topical dosage (1% topical solution†) Adults, Geriatric, Adolescents, and Children >= 2 years

A typical dosage is 3—4 drops into affected ear four times daily for 7 days.

†Indicates off-label use

Dosing Considerations
Hepatic Impairment

It is not known if tolnaftate is absorbed through the epidermis nor how tolnaftate is metabolized, therefore use with caution. Quantitative recommendations are not available.

Renal Impairment

It is not known if tolnaftate is absorbed through the epidermis nor how tolnaftate is metabolized, therefore use with caution. Quantitative recommendations are not available.

Drug Interactions

There are no drug interactions associated with Tolnaftate products.

How Supplied

Absorbine Athletes Foot/Fungi-Guard/Q-Naftate/Tinactin/Tinactin Jock Itch/Ting Antifungal/Tolnaftate Topical Cream: 1%
Absorbine Jr. Antifungal Topical Gel: 1%
Antifungal/Lamisil AF/Tinactin/Tinactin Deodorant/Tinactin Jock Itch/Tinactin Topical/Tolnaftate Topical Pwd: 1%
Fungi-Guard/Micotrin AL/Mycozyl AL/Termin8/Tinaderm/Tolnaftate Topical Sol: 1%
Lamisil AF Topical Spray: 1%
Tinactin Topical Topical Aer: 1%

Maximum Dosage
Adults

Maximum dosage information not available.

Elderly

Maximum dosage information not available.

Adolescents

Maximum dosage information not available.

Children

>= 2 years: Maximum dosage information not available.
< 2 years: Not recommended.

Infants

Not recommended.

Mechanism Of Action

Mechanism of Action: Tolnaftate, like naftifine and terbinafine, is a reversible and noncompetitive inhibitor of fungal squalene epoxidase. The membrane bound epoxidase plays a key role in the biosynthetic pathway from acetate to sterols. The blockade of this enzyme results in the accumulation of squalene and a deficiency of ergosterol. Tolnaftate has been shown to distort hyphae and stunt mycelial growth in susceptible fungi. Resistance to tolnaftate has been reported only rarely. However, the potential to develop resistance by the action of multidrug efflux transporters does exist. Tolnaftate is fungistatic or fungicidal depending on its concentration at the site of infection and the specific susceptibility of the organism.Tolnaftate, compared to naftifine and terbinafine, is the least effective topical antimycotic. In general, tolnaftate is active against the following organisms in vitro: Microsporum gypseum, M. canis, M. audouinii, M. japonicum, Trichophyton rubrum, T. mentagrophytes, T. schoenleinii, T tonsurans, and Epidermophyton floccosum. Tolnaftate is ineffective against Candida albicans, Cryptococcus neoformans, and Aspergillus fumigatus.

Pharmacokinetics

Tolnaftate is applied topically. There are no data available on the pharmacokinetics of tolnaftate. It is unknown if tolnaftate is absorbed through the epidermis or if detectable systemic concentrations of tolnaftate are achieved in the blood.

Pregnancy And Lactation
Pregnancy

There are no data available regarding the use of tolnaftate in pregnant women and the absorption of tolnaftate through the epidermis and potential effects on the fetus and reproductive capacity are unknown. As with any drug in pregnancy, use only under the advice of a physician.

Data are limited regarding use of tolnaftate during breast-feeding, and its excretion in human milk is unknown. Following topical application, it is poorly absorbed and likely poses low risk to a nursing infant. To minimize potential infant exposure, instruct patients to avoid topical application to the breast. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. If a breast-feeding infant experiences an adverse effect related to a maternally administered drug, health care providers are encouraged to report the adverse effect to the FDA.