Usage
Amorolfine + Phenoxyethanol is prescribed for fungal skin and nail infections, including:
- Athlete’s foot (Tinea pedis)
- Jock itch (Tinea cruris)
- Ringworm (Tinea corporis)
- Onychomycosis (fungal nail infections)
- Cutaneous candidiasis
- Pityriasis versicolor
Pharmacological Classification: Antifungal
Mechanism of Action: Amorolfine inhibits ergosterol biosynthesis, a critical component of fungal cell membranes. This disruption alters membrane permeability, affecting fungal metabolic processes and causing fungal cell death. Phenoxyethanol acts as a preservative in the cream formulation.
Alternate Names
Some alternate names include Amrobrut Cream, Amoron Cream, Emrolfin Cream, Fungicros Cream, Amortas Cream, and PAMORIA Cream. Brand names can vary regionally.
How It Works
Pharmacodynamics: Amorolfine exerts its antifungal effect by targeting ergosterol biosynthesis in fungal cell membranes. By inhibiting the enzymes Δ14-reductase and Δ7-Δ8-isomerase, it depletes ergosterol, leading to altered membrane permeability and function. This disruption ultimately results in fungal cell death. Phenoxyethanol acts as a preservative, preventing microbial contamination of the cream.
Pharmacokinetics: Amorolfine applied topically penetrates the stratum corneum and reaches therapeutic concentrations in the target tissues (skin and nails). Systemic absorption is minimal, reducing the risk of systemic side effects. The primary route of elimination for the small amount absorbed systemically is hepatic metabolism followed by renal excretion. The pharmacokinetic profile of Phenoxyethanol following topical application as a preservative in the cream is not clinically significant due to the low concentrations used and minimal systemic absorption.
Dosage
Standard Dosage
Adults: Apply a thin layer of the cream to the affected area(s) once daily, preferably at bedtime, after cleansing and thoroughly drying the area.
Children: Use in children under 12 years of age is generally not recommended unless specifically advised by a pediatrician, as safety and efficacy haven’t been fully established. Some sources recommend avoiding use in children under 3.
Special Cases:
- Elderly Patients: No specific dosage adjustments are typically required.
- Patients with Renal Impairment: Dosage adjustments may be needed depending on the severity of impairment. Monitor renal function.
- Patients with Hepatic Dysfunction: Caution is advised; dosage adjustments may be necessary. Monitor liver function tests.
- Patients with Comorbid Conditions: Consider potential drug interactions and adjust treatment accordingly.
Clinical Use Cases
Amorolfine + Phenoxyethanol cream is intended for topical use only and is not suitable for intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations.
Dosage Adjustments
Dosage adjustments may be required in cases of renal or hepatic impairment, metabolic disorders, or genetic polymorphisms affecting drug metabolism. Consult specialized resources for specific recommendations.
Side Effects
Common Side Effects:
- Local skin irritation (e.g., burning, itching, redness)
- Dryness
- Contact dermatitis (rarely)
Rare but Serious Side Effects:
- Allergic reactions (e.g., rash, hives, angioedema) - discontinue use immediately and seek medical attention.
Contraindications
- Hypersensitivity to amorolfine, phenoxyethanol, or any component of the formulation.
Drug Interactions
Clinically significant drug interactions with topical Amorolfine + Phenoxyethanol cream are unlikely due to minimal systemic absorption. No specific studies have investigated drug interactions with topical Amorolfine + Phenoxyethanol cream. It is advisable to inform the physician about all concomitant medications, including topical and systemic drugs.
Pregnancy and Breastfeeding
Use during pregnancy and breastfeeding should be avoided unless the potential benefit outweighs the risk to the fetus or infant. Limited data is available on the safety of amorolfine and phenoxyethanol in pregnancy and lactation. Consult specialist resources or maternal-fetal medicine experts for guidance.
Drug Profile Summary
- Mechanism of Action: Inhibits ergosterol biosynthesis, disrupting fungal cell membrane integrity.
- Side Effects: Local skin irritation, dryness, rarely contact dermatitis or allergic reaction.
- Contraindications: Hypersensitivity to components.
- Drug Interactions: Clinically significant interactions with topical application are unlikely.
- Pregnancy & Breastfeeding: Avoid unless potential benefit outweighs risk. Consult specialist resources.
- Dosage: Apply a thin layer to affected area once daily.
- Monitoring Parameters: Observe for local skin reactions and treatment efficacy.
Popular Combinations
Topical Amorolfine + Phenoxyethanol is typically used as a monotherapy. Combination therapy is not commonly practiced.
Precautions
- Avoid contact with eyes, mucous membranes, and open wounds.
- If irritation occurs, discontinue use and consult a doctor.
- Wash hands thoroughly after application.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Amorolfine + Phenoxyethanol?
A: Apply a thin layer to the affected area once daily after cleansing and drying the area.
Q2: How long does it take to see results?
A: Improvement may be noticed within a few days or weeks, but complete resolution of nail infections can take 6 months (fingernails) or 9-12 months (toenails).
Q3: Can I stop using the cream once the symptoms disappear?
A: No, complete the prescribed course even if symptoms resolve to prevent recurrence.
Q4: What should I do if the infection doesn’t improve?
A: Consult your doctor for further evaluation and possible alternative treatment.
Q5: Can I use this cream on my face?
A: Use with caution on the face and avoid contact with the eyes. Consult a doctor if treating facial fungal infections.
Q6: Can I use cosmetics or nail polish on the treated area?
A: Avoid using cosmetics, nail polish, or artificial nails on the treated area during treatment unless specifically advised by your doctor.
Q7: Is it safe to use this cream if I am pregnant or breastfeeding?
A: Consult your doctor or a specialist before using this cream if you are pregnant or breastfeeding.
Q8: What are the signs of an allergic reaction to this cream?
A: Signs of an allergic reaction can include rash, hives, itching, swelling, and difficulty breathing. Seek immediate medical attention if you experience these symptoms.
Q9: Can I use this cream with other topical medications?
A: Inform your physician of all other topical medications you are using to avoid potential interactions.
