TOLNAFTATE
(tole-naf'tate)
Aftate, Pitrex

, Tinactin
Classifications: antiinfective; antifungal antibiotic
Pregnancy Category: C

Availability

1% cream, solution, gel, powder, spray

Actions

Synthetic topical antifungal agent. Action mechanism not clear, but has been shown that tolnaftate distorts hyphae and stunts mycelial growth on susceptible fungi.

Therapeutic Effects

Fungistatic or fungicidal to Microsporum, specifically M. gypseum, M. canis, M. audouinii, M. japonicum, Trichophyton, T. rubrum, T. schoenleinii, T. tonsurans, and Epidermophyton floccosum, but ineffective against Candida albicans, Cryptococcus neoformans, Aspergillus fumigatus, bacteria, protozoa, and viruses.

Uses

Tinea pedis (athlete's foot), tinea cruris (jock itch), tinea corporis (body ringworm); also tinea capitis and tinea unguium if infection is superficial, plantar or palmar lesions adjunctively with keratolytic agents, and tinea versicolor (caused by Malassezia furfur).

Contraindications

Skin irritations prior to therapy, nail and scalp infections. Safety during pregnancy (category C), lactation, or by children <2 y is not established.

Cautious Use

Excoriated skin.

Route & Dosage

Tinea Infestations
Adult/Child: Topical Apply 0.5–1 cm (1/4–½ in) of cream or 3 drops of solution b.i.d. in morning and evening; powder may be used prophylactically in normally moist areas

Administration

Topical

Cleanse site thoroughly with water and dry completely before applying. Massage thin layer gently into skin. Make sure area is not wet from excess drug after application.
Shake aerosol powder container well before use.
Note: Cream and powder are not recommended for nail or scalp infection.
Use liquids (solutions) for scalp infection or to treat hairy areas.
Store cream, gel, powder, and topical solution in light-resistant containers at 15°–30° C (59°–86° F); store aerosol container at 2°–30° C (38°–86° F). Avoid freezing and exposure to light.

Adverse Effects (1%)

Skin: Local irritation, stinging of skin from aerosol formulation.

Interactions

Drug: No clinically significant interactions established.

Pharmacokinetics

Not studied.

Nursing Implications

Patient & Family Education

Expect relief from pruritus, soreness, and burning within 24–72 h after start of treatment.
Continue treatment for 2–3 wk after disappearance of all symptoms to prevent recurrence.
Return to physician for reevaluation in absence of improvement within 4 wk.
Note: If skin has thickened as a result of the infection, desired clinical response may be delayed for 4–6 wk.
Avoid contact with eyes of all drug forms.
Place container in warm water to liquefy contents if solution solidifies. Potency is unaffected.
Do not breast feed while using this drug without consulting physician.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug