d. Griseofulvin (Gris-Peg). This agent is very effective in the treatment of
superficial fungus infections. It is fungistatic, not fungicidal, and is administered
systemically with the dosage varying with the severity and type of infection. Griseofulvin
may cause nausea and vomiting, which may be avoided by taking the drug with or
shortly after a meal. Headaches are also relatively frequent. This drug is available in
tablets, capsules, and in suspension.
e. Ketoconazole (Nizoral). This drug is a broad-spectrum synthetic
antifungal agent. It is used as a systemic agent in the treatment of candidiasis, oral
thrush, histoplasmosis, and blastomycosis. Ketoconazole may produce nausea and
vomiting. Occasionally, potentially fatal liver disorders may occur unless they are
properly recognized and managed. The agent should be taken with meals; the patient
should be cautioned against using antacids and other drugs that inhibit gastric acid, as
gastric acid is necessary for the absorption of ketoconazole. This drug is available only
in tablet form.
f. Selenium Sulfide (Selsun). This agent is a topical antifungal used in the
treatment of dandruff and seborrheic dermatitis. Oiliness or dryness of the scalp and
hair may occur following use, and there have been reported cases of increased normal
hair loss. This agent may also discolor the hair; thorough rinsing of the hair can
minimize discoloring. Selsun, a prescription drug, is intended for external use only, as
is Selsun Blue, an over the counter product.
g. Clotrimazole (Lotrimin). This drug is a broad spectrum antifungal effective
as a topical agent in the treatment of infections caused by pathogenic fungi and in the
treatment of infections caused by Candida albicans. Side effects associated with the
use of this product include itching, burning, peeling, blisters, and erythema. When used
as a vaginal cream, it may cause staining of undergarments. Clotrimazole is available
in tablets, creams, and in solution.
h. Miconazole Nitrate (Monistat-Derm, Monistat-7). Miconazole is a
synthetic antifungal effective against the common skin fungi and vaginal candidiasis.
The side effects for miconazole are the same as for clotrimazole. This product is
available in cream form for either topical or vaginal application, vaginal suppositories,
lotions for topical application, and in an injectable form.
i. Fluconazole (Diflucan). Fluconazole is a synthetic broad-spectrum
antifungal agent. It is used in the treatment of candidiasis and cryptococcal meningitis.
The side effects include nausea, vomiting, headache, skin rash, abdominal pain, and
diarrhea. Additionally, fluconazole has several significant drug interactions. Diflucan is
available as tablets, powder for suspension, and injection.
j. Econazole (Spectazole). Econazole is a topical antifungal that is used to
treat tinea cruris, T. pedis, T. corporis, T. rubrum and T. versicolor. Side effects include
burning, itching, and stinging. Spectazole is available as a one-percent cream that is
applied once to twice daily.