Cutaneous candidiasis: Topical: Cream 1%: Apply sufficient quantity twice daily (morning and evening) for 2 weeks.
Tinea infections:
Tinea corporis/tinea cruris: Topical: Cream 1%: Apply to affected and surrounding area(s) once daily until clinical resolution, typically 1 to 3 weeks (Goldstein 2021; van Zuuren 2015; Weinstein 2002; manufacturer’s labeling).
Tinea pedis (labeled use)/tinea manuum (off-label use): Topical: Cream 1%, foam 1%: Apply to affected and surrounding area(s) once daily until 1 week after clinical resolution, typically for 4 weeks total (Goldstein 2021; Gupta 2008; Weinstein 2002; manufacturer’s labeling).
Tinea versicolor: Topical: Cream 1%: Apply to affected area(s) and immediate surrounding skin once daily for 2 weeks (Vicik 1984; manufacturer’s labeling).
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
(For additional information see "Econazole: Pediatric drug information")
Candidiasis cutaneous (including diaper dermatitis): Limited data available: Infants, Children, and Adolescents: Topical: Cream: Apply sufficient amount to cover affected area twice daily (Bradley 2015; Kliegman 2015)
Tinea corporis, tinea cruris, and tinea versicolor (smaller lesions): Children and Adolescents: Limited data available: Topical: Cream: Apply sufficient amount to cover affected area once daily for 4 weeks (Bradley 2015)
Tinea pedis:
Cream: Children and Adolescents: Limited data available: Topical: Apply sufficient amount to cover affected area once daily for 4 weeks (Bradley 2015)
Foam: Children ≥12 years and Adolescents: Topical: Apply sufficient amount to cover affected area once daily for 4 weeks
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Cream, External, as nitrate:
Generic: 1% (15 g, 30 g, 85 g)
Foam, External, as nitrate:
Ecoza: 1% (70 g) [contains propylene glycol, trolamine (triethanolamine)]
Kit, External, as nitrate:
Econasil: 1% [DSC] [contains benzoic acid]
Zolpak: 1% [contains benzoic acid]
May be product dependent
Topical: For external use only. Not for oral, ophthalmic, or vaginal use. Avoid contact with the eyes.
Topical: For external use only. Not for oral, ophthalmic, or vaginal use. Avoid contact with the eyes. Shake foam canister for ~5 seconds before application.
Fungal infection:
Cream: Treatment of tinea pedis, tinea cruris, and tinea corporis caused by Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton tonsurans, Microsporum canis, Microsporum audouini, Microsporum gypseum, and Epidermophyton floccosum in the treatment of cutaneous candidiasis, and in the treatment of tinea versicolor.
Foam: Treatment of interdigital tinea pedis caused by Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum in patients 12 years and older
Tinea manuum
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
1% to 10%: Dermatologic: Burning sensation of skin (3%), erythema (3%), pruritus (3%), stinging of the skin (3%)
<1%, postmarketing, and/or case reports: Application site reaction, pruritic rash
Cream: Hypersensitivity to econazole or any component of the formulation.
Foam: There are no contraindications listed in the manufacturer's labeling.
Documentation of allergenic cross-reactivity for imidazole antifungals is limited; however, because of similarities in chemical structure and/or pharmacologic actions, the possibility of cross-sensitivity cannot be ruled out with certainty.
Concerns related to adverse effects:
• Irritation: Discontinue if sensitivity or irritation occurs.
Dosage form specific issues:
• Foam: Avoid heat, flame, and smoking during and immediately following application; topical foam is flammable.
Other warnings/precautions:
• Appropriate use: For topical use only; avoid contact with eyes, mouth, nose, or other mucous membranes
Some dosage forms may contain propylene glycol; in neonates large amounts of propylene glycol delivered orally, intravenously (eg, >3,000 mg/day), or topically have been associated with potentially fatal toxicities which can include metabolic acidosis, seizures, renal failure, and CNS depression; toxicities have also been reported in children and adults including hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Shehab 2009).
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Vitamin K Antagonists (eg, warfarin): Econazole may increase the serum concentration of Vitamin K Antagonists. Risk C: Monitor therapy
Information related to econazole use in pregnancy is primarily from use for other indications and route of administration. Until more data are available, it is suggested to avoid use in the first trimester and apply sparingly during the second and third trimesters if needed for topical fungal infections (Patel 2017).
It is not known if econazole is present in breast milk.
According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother.
Reassess diagnosis if no clinical improvement after completion of treatment course.
Alters fungal cell wall membrane permeability; may interfere with RNA and protein synthesis, and lipid metabolism
Absorption: Cream: <10%
Metabolism: Cream: Hepatic to more than 20 metabolites
Time to peak: Foam: 6.8 ± 5.1 hours
Excretion: Cream: Urine (<1%); feces (<1%)
Cream (Econazole Nitrate External)
1% (per gram): $2.00 - $7.25
Foam (Ecoza External)
1% (per gram): $10.47
Kit (Zolpak External)
1% (per each): $3,485.00
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