Comparative Pharmacology
Head-to-head clinical analysis: CLOTRIMAZOLE versus LAMISIL AT.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CLOTRIMAZOLE versus LAMISIL AT.
CLOTRIMAZOLE vs LAMISIL AT
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Clotrimazole inhibits fungal cytochrome P450 14α-demethylase, disrupting ergosterol biosynthesis and increasing membrane permeability.
Terbinafine inhibits squalene epoxidase, an enzyme in the fungal ergosterol biosynthesis pathway. This leads to accumulation of squalene and depletion of ergosterol, disrupting fungal cell membrane integrity and causing cell death.
Topical: Apply thin layer to affected area twice daily for 2-4 weeks. Oral troche: 10 mg troche dissolved slowly in mouth 5 times daily for 14 days. Vaginal: One 100 mg suppository intravaginally at bedtime for 7 days, or 200 mg suppository for 3 days, or 500 mg single dose.
Terbinafine 250 mg orally once daily for 6 weeks for fingernail onychomycosis or 12 weeks for toenail onychomycosis. Topical: 1% cream applied once daily for 1 week for tinea pedis; 1% solution applied once daily for 1 week for tinea corporis/cruris.
None Documented
None Documented
Clinical Note
moderateClotrimazole + Tranilast
"The risk or severity of adverse effects can be increased when Clotrimazole is combined with Tranilast."
Clinical Note
moderateClotrimazole + Tolfenamic acid
"The risk or severity of adverse effects can be increased when Clotrimazole is combined with Tolfenamic acid."
Clinical Note
moderateClotrimazole + Nimesulide
"The risk or severity of adverse effects can be increased when Clotrimazole is combined with Nimesulide."
Clinical Note
moderateTerminal half-life is approximately 3-6 hours; due to rapid hepatic metabolism and extensive tissue distribution, clinical effects persist longer than plasma levels suggest.
The terminal elimination half-life is approximately 11-17 hours in healthy adults; however, it increases to about 200-400 hours in the distribution phase from tissues (e.g., skin, adipose). Steady-state is reached after 10-14 days of oral dosing.
Primarily fecal (biliary) as unchanged drug and metabolites; minimal renal excretion (<1% unchanged).
Terbinafine is extensively metabolized in the liver; approximately 80% of a dose is excreted in urine as metabolites, and 20% in feces. Less than 1% is excreted unchanged in urine.
Category A/B
Category C
Antifungal
Antifungal
Clotrimazole + Risedronic acid
"The risk or severity of adverse effects can be increased when Clotrimazole is combined with Risedronic acid."