Nizoral
Ocular tolerance of sertaconazole gel.

Romero A, Grau MT, Villamayor F, Zapatero J, Mayordomo L, Tortajada A, Sacristan A, Ortiz JA.

Centro de Investigacion Grupo Ferrer, Barcelona, Spain.

The in vitro and in vivo tolerance of sertaconazole gel, a new topical azole antifungal, was studied. Ketoconazole gel (Panfungol) was used as a reference substance. The methods applied for tolerance assessment were the bovine corneal opacity and permeability test for the in vitro assay and a modified Draize test for the in vivo assay. The results obtained show that both substances can be classified as slightly irritant and with acceptable tolerance. However, unlike ketoconazole gel, sertaconazole gel did not cause a positive lesion index in vivo. Ketoconazole was 5.25 times more irritant in vitro than sertaconazole gel, whose effect was similar to that of saline solution. Consequently, the negligible irritant effect of sertaconazole gel on a type of epithelium that is extremely sensitive, i.e. the cornea, confirms the good tolerance of this new antifungal gel on other structures such as the skin and mucous membranes.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8786760&dopt=Abstract ketoconazole Nizoral



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Different effects of azole-antifungal agents on the regulation of intracellular calcium concentration of Trichophyton rubrum.

Inoue I, Seishima M, Osada K, Kitajima Y.

Department of Dermatology, Gifu University School of Medicine, Japan.

Prior studies have indicated that intracellular calcium concentration ([Ca2+]i) is involved in fungal cell growth. However, it has not been known whether antifungal drugs affect signal transduction via calcium in fungal cells. In this context, we examined the effects of antifungal drugs, itraconazole, bifonazole and ketoconazole, on [Ca2+]i in Trichophyton rubrum. Itraconazole (1-5 ng/ml) induced a rapid and transient [Ca2+]i increase, peaking at 15-20s in hyphal cells of T. rubrum, but not in spores. The slow descending phase of the [Ca2+]i increase induced by itraconazole was depleted by chelating extracellular calcium with ethylene glycol bis (beta-aminoethyl ether)-N, N,N',N'-tetraacetic acid (EGTA), suggesting that the increase in [Ca2+]i is biphasic: Ca2+ mobilization from the internal pool and influx from the outside of the cell. At 10 ng/ml and 100 ng/ml, however, itraconazole induced an explosive and sustained calcium increase in both spores and hyphae. At less than 1 ng/ml, no [Ca2+]i increase was caused in both hyphae and spores. On the other hand, although some hyphal cells showed a transient [Ca2+]i increase, most of the cells did not show any changes of [Ca2+]i after the addition of ketoconazole at 10 ng/ml. Both spores and hyphal cells incubated with 100 ng/ml of bifonazole or ketoconazole showed a gradual increase of intracellular calcium concentration until 5 min, when the measurement was ceased. These findings suggest that signal transduction via calcium might be involved in some biological effects of itraconazole on T. rubrum, and that bifonazole and ketoconazole could differently affect [Ca2+]i in T. rubrum from itraconazole. In addition, the determination of [Ca2+]i changes induced by antifungal agents may contribute to clarification of the biological effects on fungal membranes.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8814548&dopt=Abstract ketoconazole Nizoral



Nizoral
Topical anti-inflammatory properties of flutrimazole, a new imidazole antifungal agent.

Merlos M, Vericat ML, Garcia-Rafanell J, Forn J.

Research Center, J. Uriach & Cia, Barcelona, Spain.

The topical anti-inflammatory properties of flutrimazole, a new imidazole antifungal, have been evaluated. Flutrimazole inhibited mouse ear oedema induced by arachidonic acid, tetradecanoylphorbol-acetate and dithranol, with IC50 values of 3.32, 0.55 and 2.42 mumols/ear, respectively. Ketoconazole showed similar potency in arachidonic acid and dithranol models (IC50 = 3.76 and 2.41 mumols/ear) whereas it was less active against tetradecanoylphorbol acetate (IC50 = 1.96 mumols/ear). The standard anti-inflammatory sodium diclofenac was overall slightly more potent than antifungals (IC50 = 2.23, 0.57 and 0.57 mumols/ear against arachidonic acid, tetradecanoylphorbol acetate and dithranol, respectively). Both 2% flutrimazole and 2% ketoconazole creams, applied topically, inhibited carrageenan-induced rat paw oedema by about 40%. Under the same conditions, 1% flutrimazole and diclofenac creams inhibited by 26 and 54%, respectively. Flutrimazole may work through the inhibition of 5-lipoxygenase, as it inhibited LTB4 production by human granulocytes with an IC50 value of 11 microM (IC50 value for ketoconazole was 17 microM), whereas ram seminal vesicle cyclooxygenase was only inhibited by 16% at a concentration of 25 microM. Drugs such as flutrimazole, with dual anti-inflammatory/antifungal activity, may be advantageous in the treatment of topical fungal infections with an inflammatory component.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8821774&dopt=Abstract ketoconazole Nizoral



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Ketocazole as an adjunct to finasteride in the treatment of androgenetic alopecia in men.

Hugo Perez BS.

California College of Podiatric Medicine, 371 Columbus Avenue, San Francisco, CA 94133, USA. Hugo2002 yahoo.com

Dihydrotestosterone (DHT) binding to androgen receptors (AR) in hair follicles is commonly accepted as the first step leading to the miniaturizing of follicles associated with androgenetic alopecia (AGA). Testosterone is converted to DHT by the enzyme 5alpha-reductase. Finasateride a 5alpha-reducase inhibitor blocks the production of DHT and is currently used to treat AGA. The inhibition is not complete but a reduction of DHT systemically and in the scalp is accomplished. Ketoconazole has been clinically shown to be effective in the treatment of AGA. In this paper, evidence is presented to support the hypothesis that ketoconazole 2% shampoo has a local disruption of the DHT pathway. It is proposed that using ketoconazole 2% shampoo as an adjunct to finasteride treatment could lead to a more complete inhibition of DHT and thus better treat AGA.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14729013&dopt=Abstract ketoconazole Nizoral



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Inhibition of mitochondrial function in isolated rate liver mitochondria by azole antifungals.

Rodriquez RJ, Acosta D Jr.

Department of Pharmacology/Toxicology, University of Texas at Austin 78712-1074, USA.

Ketoconazole is an imidazole oral antifungal agent with a broad spectrum of activity. Ketoconazole has been reported to cause liver damage, but the mechanism is unknown. However, ketoconazole and a related rug, miconazole, have been shown to have inhibitory effects on oxidative phosphorylation in fungi. Fluconazole, another orally administered antifungal azole, has also been reported to cause liver damage despite its supposedly low toxicity profile. The primary objective of this study was to evaluate the metabolic integrity of adult rat liver mitochondria after exposure to ketoconazole, miconazole, fluconazole, and the deacetylated metabolite of ketoconazole by measuring ADP-dependent oxygen uptake polarographically and succinate dehydrogenase activity spectrophotometrically. Ketoconazole, N-deacetyl ketoconazole, and miconazole inhibited glutamate-malate oxidation in a dose-dependent manner such that the 50% inhibitory concentration (I50) was 32,300, and 110 microM, respectively. In addition, the effect of ketoconazole, miconazole, and fluconazole on phosphorylation coupled to the oxidation of pyruvate/malate, ornithine/malate, arginine/malate, and succinate was evaluated. The results demonstrated that ketoconazole and miconazole produced a dose-dependent inhibition of NADH oxidase in which ketoconazole was the most potent inhibitor. Fluconazole had minimal inhibitory effects on NADH oxidase and succinate dehydrogenase, whereas higher concentrations of ketoconazole were required to inhibit the activity of succinate dehydrogenase. N-deacetylated ketoconazole inhibited succinate dehydrogenase with an I50 of 350 microM. In addition, the reduction of ferricyanide by succinate catalyzed by succinate dehydrogenase demonstrated that ketoconazole caused a dose-dependent inhibition of succinate activity (I50 of 74 microM). In summary, ketoconazole appears to be the more potent mitochondrial inhibitor of the azoles studied; complex I of the respiratory chain is the apparent target of the drug's action.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9029271&dopt=Abstract ketoconazole Nizoral