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.
<1% absorbed following topical administration.
Half-life: 1-2 hours
Burning, irritation, itching sensations and redness at the site of application
Allergy or hypersensitivity to bifonazoles.
Applied once daily (advantage over other anti-fungal drugs that need to be applied twice or more a day; increases compliance).
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
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:
|Allylamines:||Terbinafine (oral)||Terbinafine (topical)|
|Other topical agents:||Tolnaftate||Benzoic acid||Butenafine||Sodium thiosulfate||Quiniodochlor|
|Undecylenic acid||Ciclopirox olamine|
In Australia, bifonazole is on the National Podiatry Scheduled Medicines List.
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