Bifonazole

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[edit] BRAND NAMES

[edit] STRUCTURE

Bifonazole.jpg

[edit] MECHANISM OF ACTION

Bifonazole is an antifungal agent of the imidazole class. It inhibits lanosterol 14α-demethylase, a cytochrome P-450 enzyme that converts lanosterol to ergosterol.

Ergosterol is an essential component of the fungal cell membrane. The inhibition of its synthesis results in accumulation of toxic 14α-methylated sterols and the production of a defective cell membrane with altered permeability and leakage of cellular contents.

Bifonazole penetrates the skin better than other imidazole derivatives (ketoconazole , clotrimazole), maintaining a high concentration for 48-72 hours.

[edit] INDICATIONS

Bifonazole cream is a topical antifungal cream used to treat skin infections such as tinea, Athlete's foot, jock itch, ringworm of the body, and other skin infections caused by fungi or yeasts.

[edit] DOSAGE

Apply once a day, at best before retiring. It should be applied thinly to the affected skin area and rubbed in.

The duration of treatment is 2 to 4 weeks depending on the type of infection and site involved.

[edit] CONTRAINDICATIONS

Hypersensitivity to bifonazole.

[edit] PRECAUTIONS

Patients with a history of hypersensitivity reactions to other imidazole antifungal agents (e.g. econazole, clotrimazole, miconazole) must use bifonazole containing products with caution.

[edit] PREGNANCY AND LACTATION

In the first 3 months of pregnancy bifonazole should only be used after risk:benefit evaluation by a doctor. Two cases of newborns with severe limb defects who were exposed to high doses of oral (an unacceptable route) and/or intravaginal bifonazole during the entire first trimester of pregnancy were described. Although only two cases are insufficient to establish a relationship, the data suggest that maternal intake of bifonazole in early pregnancy poses a risk of morphogenic malformations.[1]

Bifonazole should only be used in breast-feeding woman after risk:benefit ratio evaluation by a doctor. During lactation period bifonazole should not be applied in the chest area.

[edit] SIDE EFFECTS

Occasionally, skin reactions such as redness, burning, itching, irritation and peeling may occur. These side effects are reversible after discontinuation of the treatment

[edit] RELATED LINKS

Azoles mechanism of action
Canesten bifonazol Anwendervideo bei Nagelpilz (Deutsch)

[edit] BIBLIOGRAPHY

[edit] REFERENCES

  1. http://www.ncbi.nlm.nih.gov/pubmed/20014436
Antifungals
Ergosterol target : Cell membrane target Azoles (lanosterol 14 alpha-demethylase inhibitors) : Ergosterol inhibitors Imidazoles Topical: Bifonazole   Clotrimazole   Econazole   Fenticonazole   Ketoconazole   Isoconazole   Miconazole   Sertaconazole   Tioconazole
Triazoles Topical: Fluconazole   Terconazole
Systemic: Fluconazole   Itraconazole   Posaconazole   Voriconazole
Polyene antimycotics (ergosterol binding; they form pores in the membrane) Topical: Nystatin
Systemic: Amphotericin B
Allylamines (squalene epoxidase inhibitors) : Ergosterol inhibitors Topical: Amorolfine   Naftifine   Terbinafine
Systemic: Terbinafine
Echinocandins (β-glucan synthase inhibitors) : Cell wall target Anidulafungin   Caspofungin   Micafungin
Pyrimidine analogues / Thymidylate synthase inhibitors : Nucleic acid inhibitors Flucytosine
Mitotic inhibitors Griseofulvin
Others Ciclopirox