Oxiconazole Nitrate
The drug sold as Oxitry is oxiconazole nitrate, a 1% topical imidazole antifungal cream used for treating tinea corporis, tinea cruris, tinea pedis, and tinea versicolor.
Drug Classification and Mechanism
Oxiconazole nitrate is an imidazole antifungal agent that demonstrates broad-spectrum activity against common dermatophytes including Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton tonsurans, and Epidermophyton floccosum 1. The drug achieves rapid absorption into the stratum corneum with maximum concentrations within 100 minutes of application, maintaining fungicidal concentrations in the epidermis and upper corium for at least five hours 1.
FDA-Approved Dosing Regimen
For tinea corporis, tinea cruris, and tinea versicolor: Apply once daily for 2 weeks 2.
For tinea pedis: Apply once daily for 1 month 2.
The medication should be applied to affected areas and immediately surrounding skin 2. Once-daily application is the standard regimen, though twice-daily dosing may be used for tinea pedis, tinea corporis, or tinea cruris 2.
Clinical Efficacy
Oxiconazole 1% cream produces mycologic and clinical cures in at least 80% of patients when applied once daily for the recommended duration 1. In plantar-type tinea pedis caused primarily by T. rubrum, once-daily oxiconazole achieved a 76% mycologic cure rate 1. Comparative trials demonstrate that oxiconazole is as effective as or more effective than miconazole, clotrimazole, and tolnaftate creams 1.
Important Clinical Considerations
For tinea versicolor, pigment normalization may take months after successful treatment, as the causative organism is part of normal skin flora and pigment restoration varies with individual skin type and sun exposure 2. The infection may recur despite successful treatment 2.
If no clinical improvement occurs after the recommended treatment period, the diagnosis should be reconsidered 2. The medication demonstrates excellent tolerability with negligible systemic absorption 1.
Alternative Approaches for Treatment Failure
For patients who fail topical therapy after 2-4 weeks, oral antifungal agents should be considered 3. Oral options include fluconazole 50-100 mg daily or 150 mg once weekly for 2-3 weeks, itraconazole 100 mg daily for 2 weeks or 200 mg daily for 7 days, or terbinafine 250 mg daily for 1-2 weeks 4. Note that terbinafine is ineffective for tinea versicolor 4.