Drug Guide
Tioconazole
Classification
Therapeutic: Antifungal
Pharmacological: Imidazole antifungal
FDA Approved Indications
- Vaginal candidiasis (yeast infection)
Mechanism of Action
Tioconazole inhibits fungal cytochrome P450 enzymes, disrupting the synthesis of ergosterol, a vital component of the fungal cell membrane, leading to increased membrane permeability and cell death.
Dosage and Administration
Adult: One applicator (estradiol 6.5 g of ointment) intravaginally at bedtime for 1 day.
Pediatric: Not generally used in pediatric patients.
Geriatric: No specific dosage adjustments; consider renal and hepatic function.
Renal Impairment: Use with caution, as data are limited.
Hepatic Impairment: Use with caution; no specific dosage guidelines available.
Pharmacokinetics
Absorption: Minimal systemic absorption when used vaginally.
Distribution: Localized in vaginal tissues; minimal systemic distribution.
Metabolism: Largely unabsorbed; if systemic, metabolized in the liver.
Excretion: Mostly unchanged in vaginal secretions and feces.
Half Life: Not well defined due to minimal systemic absorption.
Contraindications
- Hypersensitivity to imidazole antifungals.
Precautions
- Use during pregnancy only if clearly needed; consult healthcare provider. Use with caution in patients with hepatic impairment.
Adverse Reactions - Common
- Vaginal burning or itching (Common)
- Vaginal irritation or redness (Common)
Adverse Reactions - Serious
- Allergic reactions (rash, hives, swelling) (Rare)
- Severe allergic reactions (anaphylaxis) (Rare)
Drug-Drug Interactions
- Potential interactions with other CYP450 substrates or inhibitors; consult current resources.
Drug-Food Interactions
- No significant interactions reported.
Drug-Herb Interactions
- Limited data; caution advised with herbal products affecting CYP450 enzymes.
Nursing Implications
Assessment: Assess for allergy to azole antifungals and any signs of vaginal infection.
Diagnoses:
- Risk for allergic reaction
- Altered comfort r/t medication side effects
Implementation: Administer intravaginally as prescribed; instruct patient in proper application technique.
Evaluation: Monitor symptom relief and any adverse reactions.
Patient/Family Teaching
- Use as directed for single-dose therapy.
- Report any unusual or severe reactions.
- Maintain vaginal hygiene and avoid irritants during treatment.
Special Considerations
Black Box Warnings:
- None for tioconazole.
Genetic Factors: None known.
Lab Test Interference: Minimal systemic absorption; unlikely to affect lab tests.
Overdose Management
Signs/Symptoms: Local irritation or systemic allergic reactions.
Treatment: Discontinue medication; provide symptomatic relief; seek emergency care if severe reactions occur.
Storage and Handling
Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).
Stability: Stable in original packaging for up to the expiration date.