Generic Name for Adaptic
The generic name for Adaptic is clotrimazole, a synthetic imidazole antifungal medication used primarily for topical treatment of fungal infections.
Medication Classification and Properties
Clotrimazole belongs to the azole antifungal class and is available in various formulations:
- Topical creams (1% and 2%)
- Vaginal tablets/suppositories
- Vaginal creams
- Oral troches (for oropharyngeal candidiasis)
Mechanism of Action
Clotrimazole works by inhibiting the biosynthesis of ergosterol, an essential component of fungal cell membranes, thereby disrupting membrane integrity and inhibiting fungal growth 1. It displays primarily fungistatic activity against a wide range of fungi.
Spectrum of Activity
Clotrimazole demonstrates broad-spectrum antifungal activity against:
- Candida species (particularly C. albicans)
- Dermatophytes (including Trichophyton species, Microsporum species)
- Malassezia furfur (formerly Pityrosporum orbiculare)
- Some activity against certain Gram-positive bacteria at higher concentrations 2
Clinical Applications
Clotrimazole is FDA-approved for treating:
- Vulvovaginal candidiasis
- Tinea pedis (athlete's foot)
- Tinea cruris (jock itch)
- Tinea corporis (ringworm)
- Cutaneous candidiasis
- Oropharyngeal candidiasis (thrush)
Typical Dosing Regimens
For Vulvovaginal Candidiasis:
- 1% cream: 5g intravaginally for 7-14 days
- 2% cream: 5g intravaginally for 3 days
- 100mg vaginal tablets: one tablet daily for 7 days
- 500mg vaginal tablet: single application 3
For Dermatophyte Infections:
- 1% cream applied topically to affected areas 2-3 times daily for 2-4 weeks 4
Efficacy Comparison
Clotrimazole has demonstrated comparable efficacy to:
- Nystatin in treating cutaneous candidiasis
- Whitfield's ointment and tolnaftate in treating dermatophytoses 2
- Other azole antifungals like miconazole for most mycotic infections 5
Important Considerations and Precautions
Drug Interactions: Topical clotrimazole has minimal systemic absorption and few drug interactions.
Adverse Effects: Generally well-tolerated with occasional local irritation, burning, or itching at application sites 2.
Pregnancy: Topical clotrimazole is considered safe during pregnancy.
Oil-Based Formulations: Creams and suppositories are oil-based and may weaken latex condoms and diaphragms 3.
Combination Products: Clotrimazole is sometimes combined with betamethasone diproprionate (a high-potency corticosteroid), but this combination (Lotrisone) should be used judiciously due to potential steroid-related side effects 6.
Treatment Failure Considerations
If treatment with clotrimazole fails, consider:
- Incorrect diagnosis
- Non-compliance with treatment regimen
- Resistant fungal species (particularly non-albicans Candida species)
- Underlying immunosuppression
- Need for systemic antifungal therapy 3
Clotrimazole remains one of the most widely used topical antifungal medications due to its broad spectrum of activity, good safety profile, and availability in multiple formulations, including over-the-counter preparations.