Butenafine hydrochloride:Mechanism, Uses, Risks and Side effects

Butenafine hydrochloride(Mentax, Lotrimin Ultra) is the first and only in the benzylamine class of antifungals. Butenafine hydrochloride is structurally similar to the various allylamines with a butylbenzyl group in the place of the allylamine group.

Mechanism

Like allylamines, butenafine hydrochloride inhibits the membrane-bound squalene epoxidase, interrupting the conversion of squalene to squalene oxide, which results in intracellular accumulation of squalene. It blocks the biosynthesis of ergosterol, resulting in increased cellular permeability, leakage of cellular contents, and fungal cell death.^[1]

Uses

Butenafine hydrochloride has demonstrated fungicidal activity in vitro, and in animal models against dermatophytes, Aspergillus, and dimorphic fungi with inhibitory activity equal to, or greater than, that of naftifine and terbinafine. Butenafine hydrochloride has been the treatment of choice for tinea pedis, tinea corporis, tinea cruris, tinea versicolor, and cutaneous candida infections in Japan since its introduction in 1992, but like terbinafine, is not indicated for candida. ^[2]

Side effects

Common side effects of Butenafine hydrochloride include:

burning

stinging

irritation

redness

itching at the application site

worsening of the skin condition

Serious side effects of Butenafine include:

severe burning/stinging and itching at the site of application

Risks and warnings

Butenafine (Lotrimin Ultra) can cause some serious health issues.

Use only on the skin

Only use butenafine (Lotrimin Ultra) on the skin. Don't use this medication in the eye, nose, mouth, or vagina. If it gets into those areas, rinse it out with water.

Skin reaction or irritation

Risk factors: History of allergy to other antifungals

Skin reactions from butenafine hydrochloride(Lotrimin Ultra) are uncommon, but can include burning, itching, stinging, redness, or signs of allergic reaction such as rash. If this happens, stop using the medication and contact your HCP.

References

[1] ALEXANDRA Y. ZHANG MD  William L C M, MPH  Boni E E M. Advances in Topical and Systemic Antifungals[J]. Dermatologic Clinics, 2007, 25 2: Pages 165-183. DOI:10.1016/j.det.2007.01.002.

[2] GUPTA A K, MAYS R R, FOLEY K. Topical Antifungal Agents[J]. Comprehensive Dermatologic Drug Therapy, 1900, 67 1: 0. DOI:10.1016/b978-0-323-61211-1.00042-5.

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