Usage
Clotrimazole + Mometasone is prescribed for fungal skin infections such as ringworm, athlete’s foot, jock itch, and other types of dermatophytoses. It’s also used for inflammatory skin conditions like eczema and psoriasis.
- Pharmacological Classification: This is a combination product containing a corticosteroid (Mometasone) and an antifungal (Clotrimazole). Thus, it is classified as a combination corticosteroid/antifungal.
- Mechanism of Action: Mometasone, the corticosteroid, provides anti-inflammatory, antipruritic (anti-itch), and vasoconstrictive actions. Clotrimazole exerts its antifungal effect by inhibiting ergosterol synthesis, a crucial component of fungal cell membranes, thus disrupting membrane integrity and leading to fungal cell death.
Alternate Names
No commonly used alternate names or international variations exist for the combination product “Clotrimazole + Mometasone” itself. However, each component has other names: mometasone furoate and clotrimazole. Brand names vary depending on the region and manufacturer.
- Brand Names: Examples of brand names include Momate-C, Clobetasone-M, and others depending on the manufacturer and country.
How It Works
- Pharmacodynamics: Mometasone reduces inflammation by binding to glucocorticoid receptors, inhibiting inflammatory mediators like prostaglandins and leukotrienes. Clotrimazole affects the synthesis of ergosterol in fungal cell membranes.
- Pharmacokinetics: Primarily topical application. Systemic absorption is minimal for both drugs when applied to intact skin. Mometasone, if absorbed, is metabolized primarily in the liver, with renal excretion. Clotrimazole is metabolized in the liver to inactive compounds and excreted in bile and feces.
- Mode of Action: Mometasone binds to glucocorticoid receptors in the cytoplasm, translocates to the nucleus, and modulates gene expression related to inflammation. Clotrimazole inhibits the enzyme 14α-demethylase, which is involved in ergosterol synthesis.
- Receptor Binding/Enzyme Inhibition: Mometasone binds to glucocorticoid receptors. Clotrimazole inhibits 14α-demethylase.
- Elimination Pathways: Mometasone is primarily metabolized in the liver, with renal excretion of metabolites. Clotrimazole is metabolized in the liver and excreted mainly through bile and feces.
Dosage
Standard Dosage
Adults: Apply a thin layer to the affected area once or twice daily for 2-4 weeks, depending on the condition.
Children: Dosage should be determined by a pediatrician, considering age, weight, and specific condition.
Special Cases:
- Elderly Patients: No specific dosage adjustments are typically needed.
- Patients with Renal Impairment: No specific dosage adjustments are generally needed.
- Patients with Hepatic Dysfunction: No specific dosage adjustments are usually required due to minimal systemic absorption.
- Patients with Comorbid Conditions: Patients with diabetes or other conditions affecting skin integrity should be monitored closely.
Clinical Use Cases The combination is not used systemically, hence the following clinical use cases are inapplicable:
- Intubation
- Surgical Procedures
- Mechanical Ventilation
- Intensive Care Unit (ICU) Use
- Emergency Situations
Dosage Adjustments Dosage adjustments are based on the severity and response to treatment and are best determined by the physician.
Side Effects
Common Side Effects
Burning, stinging, itching, irritation, dryness, and skin atrophy (thinning) at the application site.
Rare but Serious Side Effects
Allergic contact dermatitis, hypopigmentation, hypertrichosis (increased hair growth), telangiectasia (spider veins), and secondary infections.
Long-Term Effects
Skin atrophy, striae (stretch marks), and Cushing’s syndrome (with extensive or prolonged use on large areas of the body).
Adverse Drug Reactions (ADR)
Severe allergic reactions are rare but require immediate medical attention.
Contraindications
Hypersensitivity to clotrimazole, mometasone, or any other components of the formulation. Rosacea, acne, perioral dermatitis, primary cutaneous viral infections (e.g., herpes simplex, chickenpox), and open wounds or ulcerated lesions.
Drug Interactions
No significant drug interactions are typically reported with topical application.
Pregnancy and Breastfeeding
- Pregnancy Safety Category: Data on use during pregnancy are limited. Use only if clearly needed and under the guidance of a physician.
- Breastfeeding: Use with caution during breastfeeding. Avoid applying to the breast area before nursing.
Drug Profile Summary
- Mechanism of Action: Mometasone: Anti-inflammatory and antipruritic. Clotrimazole: Inhibits ergosterol synthesis in fungal cell membranes.
- Side Effects: Local skin reactions (burning, stinging, itching). Rarely: allergic contact dermatitis, skin atrophy.
- Contraindications: Hypersensitivity, rosacea, acne, viral skin infections.
- Drug Interactions: No significant interactions expected with topical use.
- Pregnancy & Breastfeeding: Use with caution if benefits outweigh potential risks.
- Dosage: Apply a thin layer to affected area 1-2 times daily.
- Monitoring Parameters: Monitor the affected skin for improvement and signs of adverse reactions.
Popular Combinations
Clotrimazole and mometasone are already combined in a single topical formulation. No additional drugs are typically combined within the same formulation, but physicians can recommend additional medications if necessary.
Precautions
Avoid application near the eyes, mouth, or other mucous membranes. Do not use occlusive dressings unless specifically directed by a physician. Monitor for signs of allergic reactions or worsening skin infection.
FAQs (Frequently Asked Questions)
A: Apply a thin layer to the affected area once or twice daily. Duration of treatment varies depending on the condition and response, usually 2-4 weeks.
Q2: Can it be used on the face?
A: Use on the face with caution and only under the direction of a physician, as facial skin is more sensitive to potential side effects like atrophy.
Q3: Is it safe to use during pregnancy?
A: Safety during pregnancy has not been fully established. Use only if clearly needed and under the guidance of a physician.
Q4: What should I do if my symptoms don’t improve?
A: Consult a physician if no improvement is observed after the recommended treatment period.
Q5: Can I use it for diaper rash?
A: No, this combination is not recommended for diaper rash.
Q6: What if I miss a dose?
A: Apply the missed dose as soon as you remember. Do not double the dose to catch up.
Q7: Can I use it for other fungal infections like nail fungus?
A: The cream formulation is not effective for nail fungus. Oral or specific topical formulations are recommended for nail infections.
Q8: What are the signs of an allergic reaction?
A: Signs include rash, itching, swelling, difficulty breathing, and dizziness. Seek immediate medical attention if these occur.
Q9: Can I use it with other topical medications?
A: Inform your physician about all other medications, including topical products, that you are using. Concomitant use of other topical corticosteroids should generally be avoided.
A: Store at room temperature away from excessive heat and moisture. Keep out of reach of children.
