Last update Jan. 9, 2022

Clotrimazole

Compatible

Safe substance and/or breastfeeding is the best option.

Excretion into breast milk is very unlikely since absorption through skin, vaginal mucosa, and, even intestinal mucosa into plasma is very poor with non-significant plasma levels or below the detection threshold (<10 ng/mL). (MSyC 2014, Butler 2014, Bayer 2013, Lücker 1984)

In addition, because of a high plasma protein binding capacity, excretion into breast milk seems to be less likely.

It is used frequently for treatment of Candida infection, either in skin or mouth mucosa, even in newborn and premature infants without observed side-effects. (Hoeger 2010, Dhondt 1992, Johnstone​​​​​​​ 1990, Sitka​​​​​​​ 1976, Cohen 1974)

In case of use on the nipple, do it after feeding the baby and cleanse thoroughly the surface before the next one. Do not use creams, gels and other locally applied products that contain paraffin (mineral oil) to prevent absorption by the infant. (Concin 2008, Noti 2003)

Alternatives

  • Fluconazole (Safe substance and/or breastfeeding is the best option.)
  • Miconazole (Safe substance and/or breastfeeding is the best option.)
  • Nystatin (Safe substance and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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Other names

Clotrimazole in other languages or writings:

Groups

Clotrimazole belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Clotrimazole in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. ≈ 0. (Vaginal : 3 - 10) %
Molecular weight 345 daltons
Protein Binding 98 %
pKa 4.7 -
Tmax 3 hours
T½ 2 hours

References

  1. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014 Mar;70(3):417.e1-10; quiz 427. Abstract
  2. MSyC-AgEspMed. Clotrimazol. Ficha técnica. 2014 Full text (in our servers)
  3. Bayer. New Zealand Data Sheet. Clotrimazole. Data Sheet. 2013 Full text (in our servers)
  4. Hoeger PH, Stark S, Jost G. Efficacy and safety of two different antifungal pastes in infants with diaper dermatitis: a randomized, controlled study. J Eur Acad Dermatol Venereol. 2010 Abstract
  5. Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010 Jan-Feb;17(1):32-47. Abstract Full text (link to original source) Full text (in our servers)
  6. Concin N, Hofstetter G, Plattner B, Tomovski C, Fiselier K, Gerritzen K, Fessler S, Windbichler G, Zeimet A, Ulmer H, Siegl H, Rieger K, Concin H, Grob K. Mineral oil paraffins in human body fat and milk. Food Chem Toxicol. 2008 Abstract
  7. Noti A, Grob K, Biedermann M, Deiss U, Brüschweiler BJ. Exposure of babies to C15-C45 mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003 Abstract
  8. Mactal-Haaf C, Hoffman M, Kuchta A. Use of anti-infective agents during lactation, Part 3: Antivirals, antifungals, and urinary antiseptics. J Hum Lact. 2001 Abstract
  9. Dhondt F, Ninane J, De Beule K, Dhondt A, Cauwenbergh G. Oral candidosis: treatment with absorbable and non-absorbable antifungal agents in children. Mycoses. 1992 Abstract
  10. Johnstone HA, Marcinak JF. Candidiasis in the breastfeeding mother and infant. J Obstet Gynecol Neonatal Nurs. 1990 Abstract
  11. Lücker PW, Beubler E, Kukovetz WR, Ritter W. Retention time and concentration in human skin of bifonazole and clotrimazole. Dermatologica. 1984 Abstract
  12. Sitka U, Weingärtner L. [Clotrimazol in the treatment of candida infections in premature and newborn children (author's transl)]. Med Klin. 1976 Abstract
  13. Cohen M, Harkness RA, Renz M, Farquhar JW. Trials of the use of clotrimazole in the treatment of oral candidiasis in newborn babies. Postgrad Med J. 1974 Abstract

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