Butenafine Hydrochloride – Uses, Dosage, Side Effects

Butenafine hydrochloride is a synthetic benzylamine antifungal agent. Butenafine’s mechanism of action is believed to involve the synthesis inhibition of sterols. In particular, butenafine acts to inhibit the activity of the squalene epoxidase enzyme that is essential in the formation of sterols necessary for fungal cell membranes.

Butenafine is only found in individuals that have used or taken this drug. It is a synthetic benzylamine antifungal agent. Although the mechanism of action has not been fully established, it has been suggested that butenafine, like allylamines, interferes with sterol biosynthesis (especially ergosterol) by inhibiting squalene monooxygenase, an enzyme responsible for converting squalene to 2, 3-oxide squalene. As ergosterol is an essential component of the fungal cell membrane, inhibition of its synthesis results in increased cellular permeability causing leakage of cellular contents. The blockage of squalene monooxygenase also leads to subsequent accumulation of squalene. When a high concentration of squalene is reached, it is thought to have an effect of directly kill fungal cells.

Butenafine Hydrochloride is the hydrochloride salt form of butenafine, a synthetic benzylamine derivative with fungicidal properties. Butenafine hydrochloride interferes with the biosynthesis of ergosterol, an important component of fungal cell membranes, by inhibiting the epoxidation of squalene. This alters fungal membrane permeability and causes growth inhibition. Butenafine hydrochloride is active against a number of dermatophytes, including Trichophyton rubrum, Trichophyton mentagrophytes, Microsporum canis, Sporothrix schenckii, and yeasts, including Candida albicans and C. parapsilosis.

Mechanism of Action of Butenafine

Although the mechanism of action has not been fully established, it has been suggested that butenafine, like allylamines, interferes with sterol biosynthesis (especially ergosterol) by inhibiting squalene monooxygenase, an enzyme responsible for converting squalene to 2,3-oxy do squalene. As ergosterol is an essential component of the fungal cell membrane, inhibition of its synthesis results in increased cellular permeability causing leakage of cellular contents. The blockage of squalene monooxygenase also leads to subsequent accumulation of squalene. When a high concentration of squalene is reached, it is thought to have an effect of directly kill fungal cells.

Butenafine Hydrochloride is the hydrochloride salt form of butenafine, a synthetic benzylamine derivative with fungicidal properties. Butenafine hydrochloride interferes with the biosynthesis of ergosterol, an important component of fungal cell membranes, by inhibiting the epoxidation of squalene. This alters fungal membrane permeability and causes growth inhibition. Butenafine hydrochloride is active against a number of dermatophytes, including Trichophyton rubrum, Trichophyton mentagrophytes, Microsporum canis, Sporothrix schenckii, and yeasts, including Candida albicans and C. parapsilosis. Trimethylamine in which hydrogen atoms attached to different methyl groups are substituted by 1-naphthyl and 4-tert-butyl phenyl groups. It is an inhibitor of squalene epoxidase, an enzyme responsible for the creation of sterols needed in fungal cell membranes, and is used as its hydrochloride salt for treatment of dermatological fungal infections.

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Indications of Butenafine

  • For the topical treatment of the following dermatologic infections – tinea (pityriasis) versicolor due to M. furfur, interdigital tinea pedis (athlete’s foot), tinea corporis (ringworm) and tinea cruris (jock itch) due to E. floccosum. mentagrophytes rubrum and tonsurans.
  • Pityriasis Versicolor
  • Tinea Corporis
  • Tinea Cruris
  • Tinea Pedis
  • Butenafine is indicated for the topical treatment of tinea (pityriasis) versicolor due to Malassezia furfur, as well as athlete’s foot (Tinea pedis), ringworm (Tinea corporis) and jock itch (Tinea cruris) due to Epidermophyton floccosum, Trichophyton mentagrophytes, Trichophyton rubrum, and Trichophyton tonsurans.
  • It also displays superior activity against Candida albicans than terbinafine and naftifine. Butenafine demonstrates low minimum inhibitory concentrations against Cryptococcus and Aspergillus.
  • For the treatment of most jock itch and ringworm; for relief of itching, burning, cracking, and scaling with jock itch and ringworm

Typical usage of Butenafine

For 1% cream

for adults and children 12 years and older:

  • wash the affected skin with soap and water and dry completely before applying
  • apply once a day to the affected skin for 2 weeks or as directed by a doctor
  • wash hands after each use
  • children under 12 years: ask a doctor

Contraindications Of Butenafine

  • are allergic to betamethasone, or any ingredients of this medication
  • are allergic to other corticosteroids (e.g., hydrocortisone, clobetasol)
  • have untreated infections of the skin caused by fungi or bacteria
  • have an internal fungal infection
  • have tuberculosis skin lesions or skin infections related to syphilis
  • have rosacea
  • have irritated skin around the mouth (perioral dermatitis)
  • have skin reactions after receiving vaccinations
  • have a viral disease such as herpes simplex, varicella (chickenpox), or vaccinia
  • Liver problems
  • Systemic lupus erythematosus
  • An autoimmune disease
  • Abnormal liver function tests
  • A significant drop in a certain type of white blood cell called a neutrophil
  • Allergies to Butenafine

Dosage of Butenafine

  • Liver problems
  • Systemic lupus erythematosus
  • An autoimmune disease
  • Abnormal liver function tests
  • A significant drop in a certain type of white blood cell called a neutrophil
  • Allergies to Terbinafine Terbinafine/Butenafine
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Strengths: 1% topical cream.

Tinea Versicolor

  • Apply to the affected and immediately surrounding skin once a day for 2 weeks.

Tinea Pedis

  • Apply to affected skin between and around the toes twice a day (morning and night) for 1 week or once a day for 4 weeks.

Tinea Corporis

  • Apply to the affected skin once a day for 2 weeks.

Tinea Cruris

  • Apply to the affected skin once a day for 2 weeks.

Pediatric Dose

Tinea Versicolor

  • 12 years or older: Apply to the affected and immediately surrounding skin once a day for 2 weeks.

Tinea Pedis

  • 12 years or older: Apply to affected skin between and around the toes twice a day (morning and night) for 1 week or once a day for 4 weeks.

Tinea Corporis

  • 12 years or older: Apply to the affected skin once a day for 2 weeks.

Tinea Cruris

  • 12 years or older: Apply to the affected skin once a day for 2 weeks.

Side Effects Of Butenafine

More common

  • Blistering, burning, itching, oozing, stinging, swelling, or other signs of skin irritation not present before use of this medicine)
  • the allergic reaction at the site of application, including redness, hives, swelling, rash, and/or itching
  • mild irritation at area of application
  • pain (only when medication is applied to deep leg ulcers)
  • skin blistering
  • symptoms of an eye infection (e.g., pink or red eyes, itchy eyes, eye discharge, crusts on the eyelids or lashes)
  • signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort
  • frequent urination
  • headache
  • itching, skin rash
  • loss of appetite
  • loss of energy or weakness
  • mental depression
  • muscle aches and pains
  • muscle trembling or twitching
  • seeing or hearing things that are not there
  • seizures
  • sore throat
  • stomach pain

Common

  • signs of kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine)
  • signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
  • signs of progressive multifocal leukoencephalopathy (e.g., personality changes, progressive weakness on one side of the body, changes in memory, confusion)
  • any mouth sores
  • changes in memory and orientation
  • cold or flu-like symptoms (such as fever or sore throat)
  • confusion
  • changes in mood or emotions
  • difficulty sleeping or nightmares
  • headache
  • loss of appetite
  • stomach pain
  • tiredness or fatigue
  • vomiting
  • weakness
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Rare

  • signs of posterior encephalopathy syndrome (e.g., headache, seizures, visual disturbances, altered mental state)
  • signs of reduced red blood cells (e.g., fatigue, a general feeling of being unwell, weakness, dizziness, fainting, pale skin, pale stool)
  • swelling or tingling in your hands or feet
  • symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odor)
  • symptoms of a urinary tract infection (e.g., pain when urinating, urinating more often than usual, low back or flank pain)
  • Blurred vision
  • muscle cramps
  • numbness or pain in the legs
  • ringing in the ears
  • sweating

Drug Interactions of Butenafine Hydrochloride

This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.


Pregnancy Category of Butenafine Hydrochloride

US FDA Pregnancy Category – C

Pregnancy

Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant the use of the drug in pregnant women despite potential risks.

Breast-feeding

Using butenafine Cream topically and breastfeeding is unlikely to harm your baby. Butenafine cream may be used during breast-feeding but you should avoid applying it on your breast. You should only breast-feed your baby while using this medicine on the advice of your doctor. There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

References

Butenafine