Sertaconazole

D01A - Antifungals for topical use ATC D01AC14 Small molecule approved 2003 Topical Natural product

JFDA label: Dermofix solution

Mechanism of Action

Alters fungal cell wall membrane permeability; inhibits the CYP450-dependent synthesis of ergosterol

Indications

Approved

Tinea pedis

Off-label

Cutaneous candidiasis
Seborrheic dermatitis
Tinea versicolor

Antimicrobial Spectrum

Expected / intrinsic spectrum (EUCAST breakpoints & labels) — not local resistance. Source: openfda-label.

Fungi

Organism	Activity	MIC
Epidermophyton floccosum	Active	—
Trichophyton mentagrophytes	Active	—
Trichophyton rubrum	Active	—

Contraindications

Source: Lexicomp

There are no contraindications listed in the manufacturer's labeling Absolute

Adverse Reactions

Very Common >10%Common 1–10%Uncommon 0.1–1% Rare 0.01–0.1%Very Rare <0.01%Not Known

Other (4)

Common contact dermatitis · Dermatologic: Burning sensation of skin · skin tenderness · xeroderma

Dosing

Source: Lexicomp

Tinea pedis: Topical: Apply between toes and to surrounding healthy skin twice daily for 4 weeks Cutaneous candidiasis (off-label use): Topical: Apply to affected area(s) twice daily for 4 weeks (Alomar 1992) Seborrheic dermatitis (off-label use): Topical: Apply to affected area(s) twice daily for 4 weeks (Goldust 2013) Tinea versicolor (off-label use): Topical: Apply to affected area(s) twice daily for 4 weeks (Nasarre 1992). Additional data may be necessary to further define the role of sertaconazole in this condition.

(For additional information see "Sertaconazole: Pediatric drug information") Tinea pedis: Topical: Children ≥12 years and Adolescents: Refer to adult dosing.

Refer to adult dosing.

There are no dosage adjustments provided in the manufacturer's labeling. However, dosage adjustment unlikely due to low systemic absorption.

Warnings & Precautions

Source: Lexicomp

Irritation

Discontinue drug if sensitivity or irritation occurs. Other warnings/precautions:

Appropriate use

For topical use only; avoid ophthalmologic, oral, or intravaginal use. Re-evaluate use if no response within 2 weeks.

Pregnancy & Lactation

Pregnancy

FDA category C

Adverse events were not observed in animal reproduction studies following oral administration.

Lactation

It is not known if sertaconazole is excreted in breast milk. The manufacturer recommends that caution be exercised when administering sertaconazole to nursing women.

Monitoring

Clinical pearl	Reassess diagnosis if no clinical improvement after 2 weeks.

Chemistry & Properties

Formula	C20H15Cl3N2OS
Molecular weight	437.78 g/mol
IUPAC name	1-[2-[(7-chloro-1-benzothiophen-3-yl)methoxy]-2-(2,4-dichlorophenyl)ethyl]imidazole
CAS	99592-32-2
PubChem CID	65863
InChIKey	`JLGKQTAYUIMGRK-UHFFFAOYSA-N`
logP	7.02 (XLogP 6.3)
Polar surface area	27.05 Å²
H-bond acceptors / donors	4 / 0
Drug-likeness (QED)	0.32
Lipinski violations	1

SMILES

Clc1ccc(C(Cn2ccnc2)OCc2csc3c(Cl)cccc23)c(Cl)c1

Biology & Pharmacokinetics

Pharmacokinetics

BBB penetrant	No

Enzyme interactions

Enzyme	Role	Detail
CYP1A2	Inhibitor	—
CYP1A2	Substrate	—
CYP2B6	Inhibitor	—
CYP2C19	Inhibitor	—
CYP2C8	Inhibitor	—
CYP2C9	Inhibitor	—
CYP2D6	Inhibitor	—
CYP3A4	Inhibitor	—
CYP3A4	Substrate	—

Transporters

BCRP (Inhibitor)BSEP (Inhibitor)MRP1 (Inhibitor)OATP1B1 (Inhibitor)OATP1B3 (Inhibitor)P-gp (Inhibitor)P-gp (Substrate)

Registered Products (3)

Brand	Form / strength	Pack	Agent	Citizen (JOD)
Dermofix Cream	Cream 2 %	20 g tube pack varies	Ibn Rushd Drug Store	2.900
Dermofix Powder	Powder 2 %	30 g pack varies	Ibn Rushd Drug Store	3.690
Dermofix solution	Solution 2 %	30 ml pack varies	Ibn Rushd Drug Store	4.340