Tinactin

tolnaftate

(tol-naff-tate) ,

Lamisil AF

(trade name),

Pitrex

(trade name),

Podactin

(trade name),

Tinactin

(trade name),

Ting

(trade name),

Tolnaftate-D

(trade name)

Classification

Therapeutic: antifungals

Pregnancy Category: C

Indications

Treatment of a variety of cutaneous fungal infections, including tinea pedis (athlete’s foot), tinea cruris (jock itch), and tinea corporis (ringworm).

Action

Distorts the hyphae and stunts mycelial growth in fungi.

Therapeutic effects

Decrease in symptoms of fungal infection.

Pharmacokinetics

Absorption: Absorption through intact skin is minimal.

Distribution: Distribution after topical administration is primarily local.

Metabolism and Excretion: Systemic metabolism and excretion not known following local application.

Half-life: Not applicable.

Time/action profile

ROUTE	ONSET	PEAK	DURATION
Topical	24–72 hr	unknown	unknown

Contraindications/Precautions

Contraindicated in: Hypersensitivity to active ingredients, additives, preservatives, or bases; Some products contain alcohol and should be avoided in patients with known intolerance.

Use Cautiously in: Nail and scalp infections (may require additional systemic therapy); Obstetric / Lactation: Safety not established.

Adverse Reactions/Side Effects

Local

• burning
• itching
• local hypersensitivity reactions
• redness
• stinging

Interactions

Drug-Drug interaction

Not known.

Route/Dosage

Topical (Adults and Children ≥2 yr) Apply twice daily for up to 2 wk for tinea cruris and for up to 4 wk for tinea pedis or tinea corporis.

Availability (generic available)

Cream: 1%^OTC

Powder: 1%^OTC

Solution: 1%^OTC

Spray liquid: 1%^OTC

Spray powder: 1%^OTC

Nursing implications

Nursing assessment

• Inspect involved areas of skin and mucous membranes before and frequently during therapy. Increased skin irritation may indicate need to discontinue medication.

Potential Nursing Diagnoses

Risk for impaired skin integrity (Indications)
Risk for infection (Indications)

Implementation

• Consult health care professional for proper cleansing technique before applying medication.
• Topical: Apply small amount to cover affected area completely. Avoid the use of occlusive wrappings or dressings unless directed by health care professional.

Patient/Family Teaching

• Instruct patient to apply medication as directed for full course of therapy, even if feeling better. Emphasize the importance of avoiding the eyes.
• Caution patient that some products may stain fabric, skin, or hair. Check label information. Fabrics stained from cream can usually be cleaned by handwashing with soap and warm water.
• Patients with athlete’s foot should be taught to wear well-fitting, ventilated shoes, to wash affected areas thoroughly, and to change shoes and socks at least once a day.
• Advise patient to report increased skin irritation or lack of response to therapy to health care professional.

Evaluation/Desired Outcomes

• Decrease in skin irritation and resolution of infection. Early relief of symptoms may be seen in 2–3 days. For tinea cruris and tinea corporis, 2 wk are needed, and for tinea pedis, therapeutic response may take 4 wk. Recurrent fungal infections may be a sign of systemic illness.