econazole
Sources réglementaires consultées
Indications approuvées
- Mousse Ecoza à 1 % : teigne interdigitale du pied due à des dermatophytes sensibles chez les patients âgés de 12 ans ou plus.
- Crème d’éconazole à 1 % : teignes du pied, inguinale ou corporelle, candidose cutanée et pityriasis versicolor.
Contre-indications
Absolues
- La crème est contre-indiquée en cas d’hypersensibilité à l’un de ses composants ; l’étiquette de la mousse ne mentionne aucune contre-indication.
Mises en garde cliniques
- Mise en garde majeure · La mousse est inflammable : éviter la chaleur, les flammes et le tabac pendant et immédiatement après l’application ; ne pas perforer ni incinérer le récipient sous pression. — openFDA Ecoza foam set ID 0bb5fa27-32ed-ed13-e063-6394a90a1577
- La crème est réservée à l’usage cutané et ne doit pas être utilisée par voie ophtalmique. — DailyMed econazole nitrate cream set ID 64d82b8b-d749-4bfe-ba3e-25836d54e115
- Avec la mousse, des réactions au site d’application sont survenues chez moins de 1 % des participants aux essais cliniques. — openFDA Ecoza foam set ID 0bb5fa27-32ed-ed13-e063-6394a90a1577
Interactions médicamenteuses
- SévèreWarfarine
Mécanisme: L’éconazole topique peut renforcer l’anticoagulation, notamment sous occlusion, sur la région génitale ou sur une grande surface corporelle augmentant l’absorption.
Recommandation: Envisager une surveillance de l’INR ou du temps de prothrombine, surtout lors d’une application étendue, génitale ou sous occlusion.
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=64d82b8b-d749-4bfe-ba3e-25836d54e115
Effets indésirables
Communs (≥1%)
Crème : brûlure, prurit, picotements ou érythème (environ 3 % au total)
Grossesse et allaitement
Catégorie FDA: C (clasificación histórica de la FDA para la espuma)
Mousse : n’utiliser pendant la grossesse que si le bénéfice potentiel justifie le risque fœtal. Crème : n’utiliser au premier trimestre que si elle est essentielle, et aux deuxième ou troisième trimestres que si elle est clairement nécessaire. On ignore si l’éconazole passe dans le lait maternel ; utiliser avec prudence pendant l’allaitement.
Bibliographie récente (PubMed)
Filamentous fungal infections of the cornea known as filamentous fungal keratitis (FK) are challenging to treat. Topical natamycin 5% is usually first-line treatment following the results of several landmark clinical trials. However, even when treated intensively, infections may progress to corneal perforation. Current topical antifungals are not always effective and are often unavailable. Alternatives topical therapies to natamycin include voriconazole, chlorhexidine, amphotericin B and econazole. Surgical therapy, typically in the form of therapeutic penetrating keratoplasty, may be required for severe cases or following corneal perforation. Alternative treatment strategies such as intrastromal or intracameral injections of antifungals may be used. However, there is often no clear treatment strategy and the evidence to guide therapy is often lacking. This review describes the different treatment options and their evidence and provides a pragmatic approach to the management of fungal keratitis, particularly for clinicians working in tropical, low-resource settings where fungal keratitis is most prevalent.
Fungal infections are a growing healthcare concern worldwide. Aspergillus, Candida and Cryptococcus are considered the most important genera of human pathogenic fungi and treatment of their infections is often challenging. The limited efficacy of available antifungal drugs is largely associated with toxicity and the rising rates of resistance. Thus, alternative therapeutic modalities such as the utilization of nanomedicines have emerged and even introduced in clinical practice. These antifungal nanosystems have been explored as drug delivery systems and/or as intrinsic antifungal agents. Although the establishment of direct interactions between nanomaterials and fungi is recognized as being important for activity and, ultimately, clinical success, such matter remains poorly understood. Mechanisms of action leading to fungi inhibition or death upon exposure to antifungal nanomaterials are quite diverse and include cell wall and membrane bonding, structural damage, metabolic changes and genotoxicity. The present review discusses current knowledge on the main mechanisms involved in nanomaterials-fungi interactions, with an emphasis on cell damage processes, while providing relevant hints for the prospective design of innovative antifungal nanomedicines.
Due to the adverse effects associated with long-term administration of antifungal drugs used for treating dermatophytic lesions like tinea unguium, there is a critical need for novel antifungal therapies that exhibit improved absorption and minimal adverse effects. Nanoformulations offer a promising solution in this regard. Topical formulations may penetrate the upper layers of the skin, such as the stratum corneum, and release an appropriate amount of drugs in therapeutic quantities. Liposomes, particularly nanosized ones, used as topical medication delivery systems for the skin, may have various roles depending on their size, lipid and cholesterol content, ingredient percentage, lamellarity, and surface charge. Liposomes can enhance permeability through the stratum corneum, minimize systemic effects due to their localizing properties, and overcome various challenges in cutaneous drug delivery. Antifungal medications encapsulated in liposomes, including fluconazole, ketoconazole, croconazole, econazole, terbinafine hydrochloride, tolnaftate, and miconazole, have demonstrated improved skin penetration and localization. This review discusses the traditional treatment of dermatophytes and liposomal formulations. Additionally, promising liposomal formulations that may soon be available in the market are introduced. The objective of this review is to provide a comprehensive understanding of dermatophyte infections and the role of liposomes in enhancing treatment.
Among the various prominent fungal infections, superficial ones are widespread. A large number of antifungal agents and their formulations for topical use are commercially available. They have some pharmacokinetic limitations which cannot be retracted by conventional delivery systems. While nanoformulations composed of lipidic and polymeric nanoparticles have the potential to overcome the limitations of conventional systems. The broad spectrum category of antifungals i.e. azoles (ketoconazole, voriconazole, econazole, miconazole, etc.) nanoparticles have been designed, prepared and their pharmacokinetic and pharmacodynamic profile was established. This review briefly elaborates on the types of nano-based topical drug delivery systems and portrays their advantages for researchers in the related field to benefit the available antifungal therapeutics.