Version May 2024
Tinea infections:
Tinea corporis/tinea cruris: Topical: Cream 1%: Apply to affected and surrounding area(s) once daily until clinical resolution, typically 1 to 3 weeks (Ref).
Tinea pedis (labeled use)/tinea manuum (off-label use): Topical: Cream 1%: Apply to affected and surrounding area(s) once or twice daily until 1 week after clinical resolution, typically for 2 weeks (twice daily) or 4 weeks (once daily) total (Ref).
Tinea versicolor (pityriasis versicolor): Topical: Cream 1%: Apply to affected area(s) and immediate surrounding skin once daily for 2 weeks (Ref).
There are no dosage adjustments provided in the manufacturer’s labeling. However, dosage adjustment unlikely due to low systemic absorption.
There are no dosage adjustments provided in the manufacturer’s labeling. However, dosage adjustment unlikely due to low systemic absorption.
Refer to adult dosing.
Children ≥12 years and Adolescents: Refer to adult dosing.
There are no dosage adjustments provided in the manufacturer’s labeling. However, dosage adjustment unlikely due to low systemic absorption.
There are no dosage adjustments provided in the manufacturer’s labeling. However, dosage adjustment unlikely due to low systemic absorption.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
≥1%: Dermatologic: Burning sensation of skin, contact dermatitis, erythema, pruritus, skin irritation, stinging of the skin
Hypersensitivity to butenafine or any component of the formulation
OTC labeling: When used for self-medication, do not use on nails or scalp, in or near the mouth or eyes, or for vaginal yeast infections
Concerns related to adverse effects:
• Allylamine antifungal hypersensitivity: Use caution in patients sensitive to allylamine antifungals (eg naftifine, terbinafine); cross sensitivity to butenafine may exist.
• Irritation: Discontinue if sensitivity or irritation occurs.
Special populations:
• Immunocompromised patients: Has not been studied in immunocompromised patients.
Other warnings/precautions:
• Appropriate use: For external use only; avoid contact with eyes, mouth, nose, or other mucous membranes.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Cream, External, as hydrochloride:
Lotrimin Ultra: 1% (12 g, 30 g [DSC]) [contains benzyl alcohol, cetyl alcohol, propylene glycol, sodium benzoate, trolamine (triethanolamine)]
Mentax: 1% (15 g [DSC], 30 g [DSC]) [contains benzyl alcohol, sodium benzoate]
Generic: 1% (12 g, 30 g)
Yes
Cream (Butenafine HCl External)
1% (per gram): $0.67
Cream (Lotrimin Ultra External)
1% (per gram): $0.90
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Topical: For external use only; avoid contact with eyes, mouth, nose, or other mucous membranes. Apply to clean, dry skin. Avoid occlusive dressings.
Tinea pedis: Wear well-fitted, ventilated shoes; change socks and shoes at least once daily.
Topical: For external use only; avoid contact with eyes, mouth, nose, or other mucous membranes. Apply to clean, dry skin. Avoid occlusive dressings. Wash hands after each use.
Topical infections: Topical treatment of tinea (pityriasis) versicolor due to Malassezia furfur
OTC labeling: Topical treatment of tinea pedis (athlete's foot), tinea cruris (jock itch), and tinea corporis (ringworm)
Tinea manuum
Lotrimin may be confused with Lotrisone
None known.
There are no known significant interactions.
Adverse effects were not observed in animal reproduction studies.
It is not known if butenafine is excreted in breast milk. The manufacturer recommends that caution be exercised when administering butenafine to nursing women.
Culture and KOH exam, clinical signs of tinea pedis
Butenafine exerts fungicidal activity against dermatophytes (eg trichophyton, epidermophyton) by blocking squalene epoxidation, resulting in inhibition of ergosterol synthesis and subsequent weakening of fungal cell membranes.
Absorption: Minimal systemic
Metabolism: Hepatic via hydroxylation
Half-life elimination: Biphasic: Alpha: 35 hours; Beta: >150 hours
Time to peak, serum: 6 to 15 hours
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