butenafine

[bu-ten´ah-fēn] a topical antifungal agent used as the hydrochloride salt in the treatment of athlete's foot, jock itch, and ringworm.

butenafine

(byoo-ten-a-feen) butenafine,

Lotrimin Ultra

(trade name),

Mentax

(trade name)

Classification

Therapeutic: antifungals
Pregnancy Category: B

Indications

Treatment of a variety of cutaneous fungal infections, including tinea pedis (athlete’s foot), tinea cruris (jock itch), tinea corporis (ringworm), and tinea versicolor.

Action

Affects the synthesis of the fungal cell wall.

Therapeutic effects

Decrease in symptoms of fungal infection.

Pharmacokinetics

Absorption: Absorption through intact skin is minimal.Distribution: Distribution after topical administration is primarily local.Metabolism and Excretion: Hepatic via hydroxylation.Half-life: 35 hr.

Time/action profile

ROUTE	ONSET	PEAK	DURATION
Top	unknown	up to 4 wk	unknown

Contraindications/Precautions

Contraindicated in: Hypersensitivity to active ingredients, additives, preservatives, or bases; Some products contain alcohol or bisulfites and should be avoided in patients with known intolerance.Use Cautiously in: Nail and scalp infections (may require additional systemic therapy); Obstetric / Lactation: Safety not established.

Adverse Reactions/Side Effects

Local

burning
itching
local hypersensitivity reactions
redness
stinging

Interactions

Drug-Drug interaction

None significant.

Route/Dosage

Topical (Adults and Children > 12 yr) Apply once daily for 2 wk for patients with tinea corporis, tinea cruris, or tinea versicolor. Apply once daily for 4 wk or twice daily for 7 days for patients with tinea pedis.

Availability

Cream: 1%Rx, OTC

Nursing implications

Nursing assessment

Inspect involved areas of skin and mucous membranes before and frequently during therapy. Increased skin irritation may indicate need to discontinue medication.

Potential Nursing Diagnoses

Risk for impaired skin integrity (Indications)
Risk for infection (Indications)

Implementation

Consult physician or other health care professional for proper cleansing technique before applying medication.
Topical: Apply small amount to cover affected area completely. Avoid the use of occlusive wrappings or dressings unless directed by physician or other health care professional.

Patient/Family Teaching

Instruct patient to apply medication as directed for full course of therapy, even if feeling better. Emphasize the importance of avoiding the eyes or vaginal area.
Caution patient that some products may stain fabric, skin, or hair. Check label information. Fabrics stained from cream can usually be cleaned by handwashing with soap and warm water.
Patients with athlete’s foot should be taught to wear well-fitting, ventilated shoes, to wash affected areas thoroughly, and to change shoes and socks at least once a day.
Advise patient to report increased skin irritation or lack of response to therapy to health care professional.
Early relief of symptoms may be seen in 2–3 days. For tinea cruris, tinea corporis, and tinea versicolor, 2 wk are needed, and for tinea pedis, therapeutic response may take 4 wk. Recurrent fungal infections may be a sign of systemic illness.

Evaluation/Desired Outcomes

Decrease in skin irritation and.
Resolution of infection.