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 Zambia HIV National Guidelines
 


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Cotrimoxazole Prophylaxis  

WHO Staging in Adults and Adolescents  

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Palliative Care in HIV and AIDS  

 Guide Editors
 Editor In Chief
    Joel E. Gallant, MD, MPH

Pharmacology Editor
    Paul Pham, PharmD, BCPS

Zambia Guideline Team
   Peter Mwaba MMed PhD FRCP
   Alywn Mwinga MMed
   Isaac Zulu MMed MPH
   Velepie Mtonga MMed
   Albert Mwango MBChB
   Jabbin Mulwanda MMed FCS
 

 

 

Drugs>Antimicrobial Agents>
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Clotrimazole

Paul A. Pham, Pharm.D. and John G. Bartlett, M.D.
11-23-2010

Zambia Specific Information

  • Available formulation in Zambia: Vaginal cream: 1%; 10%. Vaginal tablet: 100 mg; 500 mg.
  • Oral candidiasis: one oral lozenge (troche) dissolve in mouth q6h x 5 days.
  • Vaginal candidiasis: 200 mg intra-vaginally once-daily x 3d.

REFERENCES

Zambia Information Author: Paul A. Pham, Pharm. D.

INDICATIONS

FDA

FORMS

brand 
name
 
generic 
Mfg 
brand 
forms
 
cost* 
Mycelex ClotrimazoleGeneric manufacturers oral
troche
10 mg
$1.60
Ivax (non-US brands)ClotrimazoleGeneric manufacturersvaginal
vaginal cream
1% (45g)
$12.00
      vaginal
vaginal tablet
200 mg (3)
$9.00
      vaginal
vaginal tablet
500 mg (1)
$13.88
      topical
topical cream (1%)
15 g and 30 g tube
$8.29/15 g
      topical
solution/lotion (1%)
10 mL and 30 mL
$7.40 /10 mL

*Prices represent cost per unit specified and are representative of "Average Wholesale Price" (AWP). AWP Prices were obtained and gathered by Lakshmi Vasist Pharm D using the Red Book, manufacturer's information, and the McKesson database.

^Dosage is indicated in mg unless otherwise noted.

USUAL ADULT DOSING

  • Thrush: 10mg troche 5x/d (dissolved in mouth).
  • Candida vaginitis: 100 mg intravaginal tab twice-daily x 3 days (preferred) or 100 mg once-daily x 7days or 500mg x1.
  • Cutaneous candidiasis: apply cream, solution, or lotion to affected areas twice-daily x 2-8 wks.

RENAL DOSING

DOSING FOR GLOMERULAR FILTRATION OF 50-80

Usual dose.

DOSING FOR GLOMERULAR FILTRATION OF 10-50

Usual dose.

DOSING FOR GLOMERULAR FILTRATION OF <10 ML/MIN

Usual dose.

DOSING IN HEMODIALYSIS

Usual dose.

DOSING IN PERITONEAL DIALYSIS

Usual dose.

DOSING IN HEMOFILTRATION

Usual dose.

ADVERSE DRUG REACTIONS

OCCASIONAL

  • Burning; itching; erythema (intravaginal and topical administration).
  • Nausea and vomiting (lozenge).
  • Elevated transaminases.

DRUG INTERACTIONS

No known drug interactions.

SPECTRUM

Candida albicans and dermatophytes.

PHARMACOLOGY

Pharmacology

COMMENTS

Slightly less effective (measured as disease free period post-therapy) than fluconazole but preferred as 1st line due to the concern over azole-resistant candidiasis with long-term use of fluconazole.

REFERENCES

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