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Pronunciation:

(byoo TEN a feen)

U.S. Brand Names:

Lotrimin® Ultra™ [OTC]; Mentax®

Synonyms:

Butenafine Hydrochloride

Generic Available:

Use:

Topical treatment of tinea pedis (athlete's foot), tinea cruris (jock itch), tinea corporis (ringworm), and tinea versicolor

Pregnancy Risk Factor:

Lactation:

Excretion in breast milk unknown/do not apply to breast if breast-feeding

Contraindications:

Hypersensitivity to butenafine or any component of the formulation

Warnings/Precautions:

Only for topical use (not ophthalmic, vaginal, or internal routes); patients sensitive to other allylamine antifungals may cross-react with butenafine; has not been studied in immunocompromised patients

Adverse Reactions:

>1%: Dermatologic: Burning, stinging, irritation, erythema, pruritus (2%)

<1%: Contact dermatitis

Stability:

Store at 5°C to 30°C (41°F to 86°F).

Mechanism of Action:

Butenafine exerts antifungal activity by blocking squalene epoxidation, resulting in inhibition of ergosterol synthesis (antidermatophyte and Sporothrix schenckii activity). In higher concentrations, the drug disrupts fungal cell membranes (anticandidal activity).

Pharmacodynamics/Kinetics:

Absorption: Minimal systemic

Metabolism: Hepatic via hydroxylation

Half-life elimination: 35 hours

Time to peak, serum: 6 hours

Dosage:

Children >12 years and Adults: Topical:

Tinea corporis, tinea cruris, or tinea versicolor: Apply once daily for 2 weeks to affected area and surrounding skin

Tinea pedis: Apply once daily for 4 weeks or twice daily for 7 days to affected area and surrounding skin (7-day regimen may have lower efficacy)

Monitoring Parameters:

Culture and KOH exam, clinical signs of tinea pedis

Patient Education:

Report any signs of rash or allergy to your physician immediately; do not apply other topical medications on the same area as butenafine unless directed by your physician

Dental Health: Effects on Dental Treatment:

No significant effects or complications reported

Dental Health: Vasoconstrictor/Local Anesthetic Precautions:

No information available to require special precautions

Mental Health: Effects on Mental Status:

None reported

Mental Health: Effects on Psychiatric Treatment:

None reported

Dosage Forms:

Cream, as hydrochloride:

Lotrimin® Ultra™: 1% (12 g, 24 g) [contains benzyl alcohol and sodium benzoate]

Mentax®: 1% (15 g, 30 g) [contains benzyl alcohol and sodium benzoate]

International Brand Names:

Dermax® (ID); Mentax® (IL, JP); Volley® (JP)

References

Greer DL, Weiss J, Rodriguez DA, et al, "A Randomized Trial to Assess Once-Daily Topical Treatment of Tinea Corporis With Butenafine, a New Antifungal Agent,"J Am Acad Dermatol, 1997, 37(2 Pt 1):231-5.

McNeely W and Spencer CM, "Butenafine,"Drugs, 1998, 55(3):405-12.

Reyes BA, Beutner KR, Cullen SI, et al, "Butenafine, a Fungicidal Benzylamine Derivative, Used Once Daily for the Treatment of Interdigital Tinea Pedis,"Int J Dermatol, 1998, 37(6):450-3.

Syed TA, Ahmadpour OA, Ahmad SA, et al, "Management of Toenail Onychomycosis With 2% Butenafine and 20% Urea Cream: A Placebo-Controlled, Double-Blind Study,"J Dermatol, 1998, 25(10):648-52.

"Topical Butenafine for Tinea Pedis,"Med Lett Drugs Ther, 1997, 39(1004):63-4.

Tschen E, Elewski B, Gorsulowsky DC, et al, "Treatment of Interdigital Tinea Pedis With a 4-Week Once-Daily Regimen of Butenafine Hydrochloride 1% Cream,"J Am Acad Dermatol, 1997, 36(2 Pt 1):S9-14.

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