Bifonazole

bidonazole canesten
Bifonazole is a broad spectrum imidazole antifungal drug that has been in use since 1983 for topical fungal infections and in particular tinea pedis. It is available under several brand names as a 1% topical ointment.

Mechanism of action:
Inhibits the fungal ergosterol biosynthesis via the transformation of 24-methylendihydrolanosterol to desmethylsterol. Ergosterol is an essential component of fungal cell membranes. The uptake of bifonazole into the fungal cells peaks after 20 – 30 mins and remains there for up to 120 hours so it can continuously inhibit the ergosterol biosynthesis.
Also inhibits HMG-CoA.

Pharmacokinetics:
<1% absorbed following topical administration.
Half-life: 1-2 hours
Bioavailability: unknown
Metabolism: unknown
Excretion: unknown

Adverse effects:
Burning, irritation, itching sensations and redness at the site of application

Contraindications:
Allergy or hypersensitivity to bifonazoles.

bidonazole canesten tube label

Tube label of Canesten (Bifonazole) used in Australia

Dosage:
Applied once daily (advantage over other anti-fungal drugs that need to be applied twice or more a day; increases compliance).

Precautions:
Pregnancy: there is no clinical data. High oral doses in animals have shown reproductive toxicity.
Bayer use these cautions on their packaging for the Canesten brand of bifonazole:

Do not use in the eyes
Not recommended for babies except under medical supervision
Consult your pharmacist or doctor for advice before treating yourself if you are pregnant or breastfeeding

Interactions:
Limited data suggests that the warfarin serum concentration may increase with use of bifonazole, so use with careful monitoring (especially if bifonazole is used under occlusion).

Brand names: Canespor (Bayer); Amycor (Merck); Canesten (Bayer); Amycor (Lipha); Azolmen (Menarini); Bedriol (Andromaco); and others
Chemical formula: C22H18N2
Systematic name: 1-[phenyl-(4-phenylphenyl)methyl]imidazole

Other anti-fungal drugs:

AntibioticsPolyenes:NystatinAmphotericin BHamycin
Heterocyclic benzofuran:Griseofulvin
Echinocandins:CaspofunginMicafunginAnidulafungin
Azoles:Imidazoles:Topical:ClotrimazoleEconazoleMiconazole
Bifonazole
Systemic:Ketoconazole
Triazoles:FluconazoleItraconazoleVoriconazolePosaconazole
Morpholines:Amorolfine
Allylamines:Terbinafine (oral)Terbinafine (topical)
Other topical agents:TolnaftateBenzoic acidButenafineSodium thiosulfateQuiniodochlor
Undecylenic acidCiclopirox olamine

In Australia, bifonazole is on the National Podiatry Scheduled Medicines List.

Page last updated: Oct 1, 2022 @ 4:51 am

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