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Clotrimazole vs Miconazole – Which Is Better For Yeast Infection?

Clotrimazole vs Miconazole – Which Is Better For Yeast Infection

Candida albicans is a yeast-like fungus which is usually found in the vagina, mouth, and intestinal tract.

Yeast infections are caused by an overgrowth of these fungi.

Typical areas affected are the lining of the mouth, the armpits, the groin, the spaces between toes and fingers, on an uncircumcised penis, the nails, the skin fold under the breasts, and the skinfolds of the stomach.

There are some factors which can contribute to the fungi growing more than they should:

  • HIV/AIDS;
  • hormonal contraceptives;
  • diabetes;
  • pregnancy;
  • weakened immune system;
  • antibiotic treatment – antibiotics kill a lot of the good bacteria in the body making you more vulnerable to yeast infection.

How Is It Treated?

You can use an antifungal cream, or a suppository which you put into your vagina, or antifungal tablets which you swallow.

Yeast infections in the skin folds can be treated with anti-yeast powders.

Here is a comparison of two common antifungal medicines:

Clotrimazole

It is an anti-fungal medication that can be either applied as an ointment to the skin or can be taken orally. It was discovered in 1969.

Miconazole

It is a man-made imidazole antifungal which has a broad spectrum of activity against non-albicans Candida species and Candida albicans.

Uses

Clotrimazole

Image credit – https://commons.wikimedia.org/wiki/File:Athlete%27s_foot.JPG

It is commonly used to treat yeast infections of the skin (like – jock itch, athlete’s foot), mouth (the most common human fungal infection of the oral cavity), and body (ringworm).

Also, it is used for vulvovaginal candidiasis (a condition that affects up to 75 percent of women of child-bearing age at least once in their lifetime).

Moreover, this antifungal has proved to be useful as an intranasal infusion in the treatment of nasal aspergillosis.

Miconazole

It has been used successfully in the treatment of onychomycosis (also known as tinea unguium), pityriasis versicolor, vaginal candidiasis, tinea pedis, and systemic mycoses.

Note – its resistance in chronically treated sufferers is rarely reported. Also, this medicine can cross the blood-brain barrier to some extent.

Mechanism of Action

These antifungals work by stopping the fungi from producing a substance that is a crucial component of fungal cell membranes, called ergosterol.

Absorption of these agents from the gastrointestinal tract is low.

Side Effects

Clotrimazole

Common side effects associated with this medicine include:

  • a burning sensation at the time of application;
  • nausea;
  • itching of the skin;
  • vomiting;
  • tightness in the chest;
  • stomach pain;
  • breathing difficulty;
  • foul-smelling vaginal discharge;
  • urticaria.

Call your healthcare provider at once if you have a serious side effect like:

  • severe burning;
  • oozing;
  • severe blistering of the treated skin.

Miconazole

The most common adverse events associated with this antifungal include:

  • headache;
  • change in taste;
  • flushes;
  • rash;
  • diarrhea.

Call your healthcare professional right away if you have a serious side effect like:

  • hives;
  • difficult breathing;
  • vulvovaginal burning, itching or irritation;
  • swelling of the lips, face, tongue,  or throat;

Note – severe gastrointestinal disturbances and other side effects could occur in case of acute overdosage.

No serious systemic toxicity resulted from intrathecal or intravenous miconazole treatment, according to studies.

No pharmacokinetic studies on this antifungal have been done in neonates and young infants.

Dosage

Clotrimazole – apply to affected and surrounding area twice a day. Discontinue if irritation or sensitivity occurs.

Miconazole – apply once or twice a day as a 2 percent cream, lotion or powder. The duration depends on the severity and nature of the infection.

Warnings & Precautions

Clotrimazole

This antifungal medicine should not be used if you are allergic to one or any of its ingredients.

Wash your hands before and after using it. Avoid getting this antifungal in your nose, eyes, or mouth.

Miconazole

Do not take this antifungal by mouth.

Before using this medicine, tell your doctor if you are allergic to it.

Alcohol

These medicines are typically used topically and vaginally, meaning that the medication does not get properly absorbed into the body.

Hence, drinking any type of alcoholic beverages will not interfere with these agents.

Drug Interactions

These antifungals may interact in a negative way with the following medications:

  • dicumarol (a naturally occurring anticoagulant);
  • Jantoven;
  • phenytoin (sold under the brand name Dilantin);
  • Coumadin (a medication that is used as an anticoagulant);
  • warfarin;
  • clomipramine (brand name Anafranil);
  • Miradon (anisindione);
  • carbamazepine;
  • anisindione.

Pregnancy & Breastfeeding

Clotrimazole

It is not known whether this medicine passes into breast milk or if it could negatively affect a nursing infant.

Also, it is not expected to harm an unborn baby.

However, it is recommended to tell your doctor if you are pregnant before starting treatment with this antifungal.

Miconazole

It is not known if the medicine passes into breast milk and negatively affects the breastfed baby.

But, it is recommended to tell your healthcare provider if you are breastfeeding a baby before starting treatment with this antifungal.

It should not be used during pregnancy (especially in the third trimester) unless the potential benefit to the mother substantially outweighs the potential health risks to the developing fetus.

Conclusion – Clotrimazole vs Miconazole – Which Is More Effective For Yeast Infection?

Clotrimazole is used to treat jock itch, athlete’s foot, ringworm, and vulvovaginal candidiasis. It is available as a spray, as a cream, and as a topical solution.

Miconazole is commonly used to treat jock itch (an itch around the genital and buttock areas), pityriasis (tinea versicolor), athlete’s foot, ringworm, and vulvovaginal candidiasis.

This antifungal works by inhibiting the synthesis of an essential component of the fungal cell membrane.

Both medicines are antimycotics which belong to the family of imidazole derivatives. Both agents have potent and broad antifungal activity.

According to a 1978 study that compared miconazole nitrate 2 percent vaginal cream administered daily over a 14 day period with clotrimazole 1 percent vaginal cream administered daily over a 7-day period, people treated with clotrimazole showed a slightly, but not substantial, better efficacy than the miconazole group.

As per a 1989 study that was conducted on 200 patients with superficial mycosis during a period of 12 weeks, both medicines were found to be an effective cure, however, clotrimazole showed slightly earlier response than miconazole.

Sources

http://annals.org/aim/article-abstract/694241/cardiorespiratory-toxicity-due-miconazole
http://aac.asm.org/content/16/6/792.full.pdf
http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Scientific_Discussion/veterinary/000140/WC500063875.pdf
http://journalssc.portal.tools/?page=article&article_id=23330

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