What is diflucortolone (Nerisona) and isoconazole (Imazol)?

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Last updated: April 14, 2025View editorial policy

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From the Guidelines

Diflucortolone isoconazole is a combination medication used to treat inflammatory skin conditions that are complicated by fungal infections, containing diflucortolone valerate, a potent corticosteroid, and isoconazole nitrate, an antifungal agent. This combination is typically available as a cream or ointment and is prescribed for conditions like infected eczema, dermatitis, or fungal skin infections with inflammatory components. The medication is usually applied thinly to affected areas once or twice daily for 1-2 weeks, though treatment should not exceed 4 weeks due to potential side effects from the steroid component. It should not be used on large body areas, under occlusive dressings, or for extended periods without medical supervision. Common side effects may include skin thinning, stretch marks, or increased susceptibility to skin infections if used improperly. This medication requires a prescription and should only be used under medical guidance, as noted in various studies 1. Key points to consider when prescribing diflucortolone isoconazole include:

  • The importance of using the medication as directed to minimize side effects and maximize efficacy
  • The need for medical supervision to monitor for potential side effects and adjust treatment as necessary
  • The availability of alternative treatments for fungal infections, as discussed in guidelines for the management of candidiasis 1 and mucormycosis 1
  • The potential for drug interactions, particularly with other antifungal agents, as noted in studies on posaconazole 1 and itraconazole 1.

From the Research

Definition and Composition

  • Diflucortolone isoconazole is a combination therapy consisting of isoconazole, an antimycotic agent, and diflucortolone, a topical corticosteroid 2, 3, 4.
  • The combination of 1% isoconazole nitrate and 0.1% diflucortolone valerate is used to treat various fungal infections, including tinea inguinalis and tinea corporis 2, 3.

Therapeutic Uses

  • Diflucortolone isoconazole is used to treat inflammatory dermatomycoses, such as tinea inguinalis and tinea corporis, by reducing inflammatory symptoms and eradicating the fungal infection 2, 3, 4.
  • The combination therapy has been shown to be effective in treating pediatric tinea corporis, particularly in cases with Staphylococcus aureus superinfections 3.

Mechanism of Action

  • Isoconazole works by inhibiting the growth of fungi, while diflucortolone valerate reduces inflammation and pruritus 2, 4.
  • The combination of isoconazole and diflucortolone valerate has been shown to increase the bioavailability and prolong the activity of the antimycotic, while rapidly reducing inflammatory symptoms 4.

Efficacy and Safety

  • Studies have demonstrated that the combination of isoconazole and diflucortolone valerate is effective and well-tolerated in the treatment of tinea inguinalis and tinea corporis 2, 3, 4.
  • The therapy has been shown to provide rapid relief of itch and other inflammatory symptoms, improved overall therapeutic benefits, and better mycological cure rates compared to isoconazole monotherapy 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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