OXISTAT® (oxiconazole nitrate) Lotion, 1%*

OXISTAT® (oxiconazole nitrate) Lotion, 1%*

*Potency expressed as oxiconazole

Rx only

FOR TOPICAL DERMATOLOGIC USE ONLY—

NOT FOR ORAL, OPHTHALMIC OR INTRAVAGINAL USE

OXISTAT® (oxiconazole nitrate) Lotion, 1%*

OXISTAT® (oxiconazole nitrate) Lotion, 1% contains the antifungal active compound oxiconazole nitrate. This formulation is for topical dermatologic use only. Chemically, oxiconazole nitrate is 2′,4′-dichloro-2-imidazol-1-ylacetophenone (Z)-[0-(2,4- dichlorobenzyl)oxime], mononitrate. The compound has the molecular formula C18H13ON3Cl4·HNO3, a molecular weight of 492.15.

Oxiconazole nitrate is a nearly white crystalline powder, soluble in methanol; sparingly soluble in ethanol, chloroform, and acetone; and very slightly soluble in water.

OXISTAT Lotion contains 10 mg of oxiconazole per gram of lotion in a white to off-white, opaque lotion base of purified water, white petrolatum, stearyl alcohol, propylene glycol, polysorbate 60, cetyl alcohol, and benzoic acid 0.2% as a preservative.

Microbiology

Oxiconazole nitrate is an imidazole derivative whose antifungal activity is derived primarily from the inhibition of ergosterol biosynthesis, which is critical for cellular membrane integrity. It has in vitro activity against a wide range of pathogenic fungi.

Oxiconazole has been shown to be active against most strains of the following organisms both in vitro and in clinical infections at indicated body sites:

Epidermophyton floccosum

Trichophyton mentagrophytes

Trichophyton rubrum

Malassezia furfur

The following in vitro data are available; however, their clinical significance is unknown. Oxiconazole exhibits satisfactory in vitro minimum inhibitory concentrations (MICs) against most strains of the following organisms; however, the safety and efficacy of oxiconazole in treating clinical infections due to these organisms have not been established in adequate and well-controlled clinical trials:

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Candida albicans

Microsporum audouini

Microsporum canis

Microsporum gypseum

Trichophyton tonsurans

Trichophyton violaceum

INDICATIONS AND USAGE

OXISTAT Lotion is indicated for the topical treatment of the following dermal infections: tinea pedis, tinea cruris, and tinea corporis due to Trichophyton rubrum, Trichophyton mentagrophytes, or Epidermophyton floccosum.

CONTRAINDICATIONS

OXISTAT Lotion is contraindicated in individuals who have shown hypersensitivity to any of their components.

WARNINGS

OXISTAT (oxiconazole nitrate) Lotion, 1% is for topical use only and not for oral, ophthalmic or intravaginal use.

PRECAUTIONS

OXISTAT Lotion is for external dermal use only. Avoid introduction of OXISTAT Lotion into the mouth, eyes, or vagina. If a reaction suggesting sensitivity or chemical irritation should occur with the use of OXISTAT Lotion, treatment should be discontinued and appropriate therapy instituted. If signs of epidermal irritation should occur, the drug should be discontinued.

Information for Patients

The patient should be instructed to:

  1. Use OXISTAT as directed by the physician. The hands should be washed after applying the medication to the affected area(s). Avoid contact with the eyes, nose, mouth, and other mucous membranes. OXISTAT is for external use only.
  2. Use the medication for the full treatment time recommended by the physician, even though symptoms may have improved. Notify the physician if there is no improvement after 2 to 4 weeks, or sooner if the condition worsens (see below).
  3. Inform the physician if the area of application shows signs of increased irritation, itching, burning, blistering, swelling, or oozing.
  4. Avoid the use of occlusive dressings unless otherwise directed by the physician.
  5. Do not use this medication for any disorder other than that for which it was prescribed.

Drug Interactions

Potential drug interactions between OXISTAT and other drugs have not been systematically evaluated.

Pregnancy

Teratogenic Effects: Reproduction studies have been performed in rabbits, rats, and mice at oral doses up to 100, 150, and 200 mg/kg/day (57, 40, and 27 times the human dose based on mg/m2), respectively, and revealed no evidence of harm to the fetus due to oxiconazole nitrate. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

Nursing Mothers: Because oxiconazole is excreted in human milk, caution should be exercised when the drug is administered to a nursing woman.

Pediatric Use: Safety and effectiveness in pediatric patients have not been established.

Geriatric Use: A limited number of patients at or above 60 years of age (n ~ 396) have been treated with oxiconazole nitrate cream in US and non-US clinical trials, and a limited number (n = 43) have been treated with OXISTAT Lotion in US clinical trials. The number of patients is too small to permit separate analysis of efficacy and safety. No adverse events were reported with OXISTAT Lotion in geriatric patients, and the adverse reactions reported with oxiconazole nitrate cream in this population were similar to those reported by younger patients. Based on available data, no adjustment of dosage of OXISTAT Lotion in geriatric patients is warranted.

ADVERSE REACTIONS

In a controlled, multicenter clinical trial of 269 patients treated with oxiconazole nitrate lotion, 1%, 7 (2.6%) reported adverse reactions thought to be related to drug therapy. These reactions included burning and stinging (0.7% each) and pruritus, scaling, tingling, pain, and dyshidrotic eczema (0.4% each).

The following additional adverse experiences have been reported with the topical use of oxiconazole nitrate: irritation and allergic contact dermatitis, folliculitis, erythema, papules, fissure, maceration, rash, and nodules.

OVERDOSAGE

When 5% oxiconazole cream (5 times the concentration of the marketed product) was applied at a rate of 1 g/kg to approximately 10% of body surface area of a group of 40 male and female rats for 35 days, 3 deaths and severe dermal inflammation were reported. No overdoses in humans have been reported with use of oxiconazole nitrate cream or lotion.

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DOSAGE AND ADMINISTRATION

OXISTAT Lotion should be applied to affected and immediately surrounding areas once to twice daily in patients with tinea pedis, tinea corporis, or tinea cruris. Tinea corporis and tinea cruris should be treated for 2 weeks and tinea pedis for 1 month to reduce the possibility of recurrence. If a patient shows no clinical improvement after the treatment period, the diagnosis should be reviewed.

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