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Chemical Name:
1-Acetyl-4-[4-[[(2RS,4SR)-2-(2,4-dichlorophenyl)-2-(1H-imidazol-1-ylmethyl)-1,3-dioxolan-4-yl]methoxy]phenyl]piperazine
Molecular Weight: 531.43 g/mol
Class: Imidazole antifungal agent
Mechanism: Inhibits fungal ergosterol biosynthesis by blocking cytochrome P450-dependent 14α-demethylase, disrupting cell membrane integrity and inhibiting fungal growth
Also acts as a CYP3A4 inhibitor, affecting steroid hormone metabolism
Fungal Infections:
Superficial: Tinea (ringworm), cutaneous candidiasis, seborrheic dermatitis, pityriasis versicolor
Systemic: Oral treatment for Cushing's syndrome (off-label, due to adrenal steroid inhibition)
Formulations:
Oral tablets (e.g., 200-400 mg/day for systemic infections)
Topical spray (2%), shampoo (for dermal infections)
Adults: 200-400 mg/day (oral), adjusted based on infection severity
Children: 3.3-6.6 mg/kg/day (oral)
Topical use: Apply 1-2 times daily to affected areas
Common: Nausea, vomiting, headache, rash, pruritus
Serious:
Hepatotoxicity (risk of severe liver damage)
Adrenal suppression (with prolonged use)
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