Usage
Clotrimazole + Selenium is a topical antifungal medication prescribed for fungal skin infections like tinea versicolor (a skin discoloration caused by a fungal infection), seborrheic dermatitis (dandruff), and other superficial mycoses. It is categorized as an antifungal and anti-infective agent. The combination works by inhibiting fungal cell membrane synthesis, causing fungal cell death (Clotrimazole), and reducing scaling and itching while promoting skin regeneration (Selenium sulfide).
Alternate Names
While no official alternate names exist for this combination drug itself, it’s important to be aware that “Clotrimazole + Selenium Sulfide” is also sometimes used. Some brand names under which this medication may be marketed include Candid TV, Kansel DS and others.
How It Works
- Pharmacodynamics: Clotrimazole inhibits the biosynthesis of ergosterol, a crucial component of fungal cell membranes. This leads to increased membrane permeability, cell leakage, and ultimately, fungal cell death. Selenium sulfide possesses antifungal, keratolytic (exfoliating), and anti-inflammatory properties. It works by slowing down the growth of yeast cells, removing scales, and controlling inflammation associated with the infection.
- Pharmacokinetics: Topical absorption of both clotrimazole and selenium sulfide is minimal, resulting in low systemic exposure and reducing the risk of systemic side effects.
- Mode of Action: Clotrimazole alters the permeability of the fungal cell wall, leading to fungal cell death. Selenium sulfide exfoliates the stratum corneum (outermost layer of the skin), reduces scaling and itching, and facilitates healthy skin regeneration.
- Elimination Pathways: Due to minimal systemic absorption, most of the drug is eliminated through washing off the application site. A small amount that may be absorbed is metabolized in the liver and eliminated through renal or fecal routes.
Dosage
Standard Dosage
Adults: Apply a thin layer of the cream, lotion, or solution to the affected area twice daily. The duration of treatment depends on the infection type and severity, generally ranging from two to four weeks for tinea infections and at least 15 days for Candida infections. For seborrheic dermatitis (dandruff), apply twice weekly until symptoms are controlled, and then use weekly or less frequently as maintenance.
Children: The dosage and frequency should be determined by a physician, based on the child’s age, weight, and the specific condition being treated. Use in children younger than 2 years is generally not recommended without physician consultation.
Special Cases:
- Elderly Patients: No specific dosage adjustments are usually needed, but monitor for skin irritation.
- Patients with Renal Impairment: No specific dosage adjustments are indicated.
- Patients with Hepatic Dysfunction: No specific dosage adjustments are indicated.
- Patients with Comorbid Conditions: Consider patient-specific factors and concomitant medications. Consult a physician if other skin conditions or systemic illnesses are present.
Clinical Use Cases
Clotrimazole + Selenium is not typically used in intubation, surgical procedures, mechanical ventilation, ICU, or emergency situations. It is primarily indicated for topical treatment of specific skin conditions.
Dosage Adjustments
Dosage adjustments are usually not necessary. Modifications are at the physician’s discretion based on individual patient factors.
Side Effects
Common Side Effects:
- Itching, dryness, redness, swelling, and burning sensation at the application site.
- Temporary hair loss (when used on the scalp).
- Hair discoloration (can be minimized by thorough rinsing).
- Oiliness or dryness of scalp and hair.
Rare but Serious Side Effects:
- Allergic reactions (rash, hives, swelling, difficulty breathing).
- Blistering or oozing at the application site.
Long-Term Effects:
No significant long-term effects are observed with recommended usage.
Adverse Drug Reactions (ADR):
- Severe allergic reactions.
- Severe skin irritation or ulceration.
Contraindications
- Hypersensitivity to clotrimazole, selenium sulfide, or any component of the formulation.
- Broken or irritated skin at the application site.
Drug Interactions
No significant drug interactions have been reported. However, the combination may damage metallic jewelry upon contact.
Pregnancy and Breastfeeding
- Pregnancy: Consult a physician before use. Topical clotrimazole is generally considered safe, but limited data is available on selenium sulfide during pregnancy.
- Breastfeeding: Consult a physician before use. Limited data is available on the excretion of both components in breast milk. Exercise caution and avoid applying to areas that may come in contact with the infant. If applying to the nipples, wash thoroughly before breastfeeding.
Drug Profile Summary
- Mechanism of Action: Clotrimazole inhibits fungal cell growth; Selenium sulfide reduces scaling and itching.
- Side Effects: Itching, dryness, redness, burning at the application site, hair discoloration, temporary hair loss.
- Contraindications: Hypersensitivity, open wounds.
- Drug Interactions: Minimal known drug interactions. May damage metallic jewelry.
- Pregnancy & Breastfeeding: Consult a physician before use.
- Dosage: See Dosage section above.
- Monitoring Parameters: Observe for skin irritation or allergic reactions.
Popular Combinations
Clotrimazole + Selenium Sulfide is already a combination product. Adding other topical medications is not recommended unless advised by a doctor.
Precautions
- Avoid contact with eyes, nose, and mouth.
- Remove jewelry before application.
- Inform the doctor about any pre-existing skin conditions or allergies.
- For pregnant or breastfeeding women, consult a physician.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Clotrimazole + Selenium?
A: Apply a thin layer to the affected skin twice daily. Duration varies based on the condition but is typically 2-4 weeks.
Q2: Can I use this combination on my face?
A: No, avoid applying Clotrimazole + Selenium to the face, genitals, or any broken or irritated skin.
Q3: What should I do if I accidentally get it in my eyes?
A: Rinse thoroughly with plenty of water and seek medical advice if irritation persists.
Q4: Can I cover the treated area with a bandage?
A: No, do not cover the treated area unless specifically instructed by your physician. Covering the area may increase the risk of side effects.
Q5: Is it safe to use this combination during pregnancy or while breastfeeding?
A: Consult a physician before use during pregnancy or while breastfeeding. While generally considered safe, limited safety data is available.
Q6: How long should I use Clotrimazole + Selenium before seeing improvement?
A: You should notice improvement in a few days. However, continue the treatment for the prescribed duration to ensure complete eradication of the infection.
Q7: What are the common side effects of this medication?
A: Common side effects include local irritation such as itching, dryness, redness, and burning at the application site.
Q8: What should I do if I experience an allergic reaction?
A: Discontinue use immediately and seek medical attention. Allergic reactions can manifest as rash, hives, swelling, or difficulty breathing.
Q9: Can I use other topical medications along with Clotrimazole + Selenium?
A: Generally, it’s best to avoid combining this product with other topical medications unless advised by a doctor.
Q10: What is the storage recommendation for Clotrimazole + Selenium?
A: Store at room temperature, away from direct sunlight and moisture. Keep out of reach of children.
