Usage
Mometasone + Sertaconazole is prescribed for the topical treatment of inflammatory dermatophytosis and superficial fungal infections of the skin, such as athlete’s foot (tinea pedis), jock itch (tinea cruris), and ringworm (tinea corporis).
Pharmacological Classification:
- Sertaconazole: Antifungal (Imidazole)
- Mometasone: Corticosteroid
Mechanism of Action:
Sertaconazole inhibits ergosterol synthesis, a vital component of fungal cell membranes, leading to fungal cell death. Mometasone furoate exerts anti-inflammatory and antipruritic effects by inhibiting the release of inflammatory mediators. The combination provides dual action against fungal infection and associated inflammation.
Alternate Names
Onabet SD is one of the common names for this combination. There may be other regional or international variations.
How It Works
Pharmacodynamics:
Sertaconazole exerts its antifungal activity by interfering with the synthesis of ergosterol, a major component of the fungal cell membrane. This disruption leads to altered cell membrane permeability and ultimately fungal cell death. Mometasone, a potent corticosteroid, binds to glucocorticoid receptors in the skin, leading to decreased production and release of inflammatory mediators, such as prostaglandins, leukotrienes, and cytokines. This reduces inflammation, itching, and redness.
Pharmacokinetics:
Topical application leads to minimal systemic absorption of both drugs. What little is absorbed gets metabolized in the liver and excreted through urine and bile.
Mode of Action:
Sertaconazole’s mode of action is at the cellular level, targeting the fungal cell membrane. Mometasone acts at the molecular level, modulating gene expression related to inflammation by binding to glucocorticoid receptors.
Elimination Pathways:
Both drugs are primarily metabolized by the liver (hepatic metabolism) and excreted mainly through the kidneys (renal excretion) and to a lesser extent in the bile (biliary excretion).
Dosage
Standard Dosage
Adults and Children over 12 years:
Apply a thin layer to the affected skin and surrounding area once or twice daily, as directed by the physician.
Children under 12 years:
Not recommended unless under strict medical supervision. Pediatric skin is more susceptible to corticosteroid side effects.
Special Cases:
- Elderly Patients: Use with caution. Monitor for adverse effects.
- Patients with Renal Impairment: Use with caution. Close monitoring is recommended due to the potential, though minimal, for systemic absorption.
- Patients with Hepatic Dysfunction: Use with caution and monitor closely, as with renal impairment.
- Patients with Comorbid Conditions (like Diabetes): Monitor blood glucose levels. Corticosteroids can impact glucose metabolism.
Clinical Use Cases
This medication is intended for topical use only and is not indicated for:
- Intubation
- Surgical Procedures
- Mechanical Ventilation
- Intensive Care Unit (ICU) Use
- Emergency Situations (e.g., status epilepticus, cardiac arrest)
Dosage Adjustments
Dosage adjustments may be necessary depending on the severity of the infection and the patient’s response to treatment. Consult a specialist if the condition doesn’t improve within the expected timeframe.
Side Effects
Common Side Effects:
- Burning sensation
- Itching
- Irritation
- Dryness
- Redness at the application site
Rare but Serious Side Effects:
- Skin atrophy
- Telangiectasia
- Hypopigmentation
- Allergic contact dermatitis
Long-Term Effects:
Prolonged use, especially under occlusion, can increase the risk of local and systemic side effects of corticosteroids.
Adverse Drug Reactions (ADR):
Severe allergic reactions (though rare) can occur.
Contraindications
- Hypersensitivity to mometasone, sertaconazole, or any component of the formulation.
- Viral skin infections (e.g., herpes simplex, varicella zoster)
- Tuberculosis or syphilitic skin infections
- Rosacea
- Acne
Drug Interactions
No significant drug interactions have been specifically reported for topical mometasone + sertaconazole. However, always review the patient’s medication list for potential interactions, especially with other topical agents.
Pregnancy and Breastfeeding
Use with caution during pregnancy and breastfeeding. Consult a physician to weigh the potential benefits against the potential risks to the fetus or infant. The safety profile during pregnancy and lactation isn’t fully established.
Drug Profile Summary
- Mechanism of Action: Sertaconazole: Inhibits ergosterol synthesis, disrupting fungal cell membranes. Mometasone: Binds to glucocorticoid receptors, inhibiting inflammatory mediators.
- Side Effects: Burning, itching, irritation, dryness, redness. Rarely: skin atrophy, telangiectasia, hypopigmentation.
- Contraindications: Hypersensitivity, viral skin infections, tuberculosis, syphilitic skin lesions, rosacea, acne.
- Drug Interactions: Limited information available, consult medication list.
- Pregnancy & Breastfeeding: Use with caution, consult physician.
- Dosage: Apply thinly once or twice daily to affected area. Not recommended for children under 12.
- Monitoring Parameters: Monitor for treatment response and local/systemic side effects, particularly with prolonged use.
Popular Combinations
This drug is typically not combined with other active ingredients in a single formulation.
Precautions
- Avoid contact with eyes, nose, and mouth.
- Do not use occlusive dressings unless directed by a physician.
- Use cautiously in patients with diabetes, glaucoma, adrenal gland disorders, liver or kidney disease.
- Discontinue if severe irritation or allergic reaction occurs.
- Advise patients on proper hygiene to prevent reinfection.
FAQs (Frequently Asked Questions)
A: Apply a thin layer to affected area once or twice daily for adults and children over 12. Not recommended for children under 12.
A: Use with caution on the face, as skin in this area is thinner and more susceptible to side effects like atrophy.
A: Improvement is usually seen within a few days, but treatment should continue for the prescribed duration, even if symptoms resolve earlier, to prevent recurrence.
A: Consult a physician. Use cautiously if benefits outweigh risks, as the safety profile isn’t fully established.
Q5: What should I do if I miss a dose?
A: Apply the missed dose as soon as remembered, unless it’s close to the next scheduled dose. Do not double the dose.
A: No, this medication is specifically for fungal skin infections. It’s not effective for eczema or psoriasis.
A: Watch for rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
A: Consult a physician before using other topical products on the same area to avoid potential interactions.
A: Store at room temperature away from direct sunlight and moisture. Keep out of reach of children.
