Mycolog II Cream – Uses, Side Effects & Reviews

Introduction to Mycolog II Cream

Mycolog II Cream is a topical medication used for the treatment of fungal skin infections, particularly cutaneous candidiasis. It is a combination product containing two active ingredients: nystatin, an antifungal agent, and triamcinolone acetonide, a corticosteroid. This powerful combination helps to stop the growth of fungi while reducing inflammation and itching associated with the infection. Mycolog II Cream has been widely used for decades and is available by prescription only.

Composition and Ingredients

Mycolog II Cream contains the following active ingredients:

• Nystatin: an antifungal medication that belongs to the polyene antibiotic class. It works by binding to the cell membrane of fungi, causing disruption and eventual cell death.
• Triamcinolone Acetonide: a synthetic corticosteroid with anti-inflammatory and immunosuppressive properties. It helps to reduce inflammation, redness, and itching associated with fungal skin infections.

The inactive ingredients in Mycolog II Cream include purified water, white petrolatum, mineral oil, and other excipients.

Mechanism of Action

Mycolog II Cream works through the combined action of its two active ingredients:

1. Nystatin: As an antifungal agent, nystatin works by binding to the ergosterol in the cell membrane of fungi, leading to the formation of pores and ultimately causing cell death. This prevents the growth and spread of fungal infections.
2. Triamcinolone Acetonide: As a corticosteroid, triamcinolone acetonide exerts anti-inflammatory and immunosuppressive effects by binding to specific receptors in cells. This helps to reduce inflammation, redness, and itching associated with fungal skin infections.

The synergistic action of these two components makes Mycolog II Cream an effective treatment option for fungal skin infections accompanied by inflammation and discomfort.

Source: Katzung, B. G. (2018). Basic & Clinical Pharmacology (14th ed.). McGraw-Hill Education.

Indications and Uses

Mycolog II Cream is approved for the topical treatment of the following conditions:

• Cutaneous candidiasis (Candida skin infections)
• Other fungal skin infections caused by susceptible strains of fungi

It is particularly effective in treating fungal infections of the skin folds, such as intertrigo, and other areas prone to moisture and friction.

Source: FDA Label for Mycolog II Cream

Dosage Forms and Strengths

Mycolog II Cream is available in the following dosage form and strength:

• Cream: Each gram contains 100,000 units of nystatin and 0.1% triamcinolone acetonide.

It may also be available as an ointment formulation in some regions.

Administration and Dosage

Mycolog II Cream is intended for topical use only. The recommended dosage is as follows:

1. Clean and dry the affected area thoroughly before application.
2. Apply a thin layer of Mycolog II Cream to the affected area and gently rub it in.
3. Repeat the application twice daily (morning and evening).
4. Continue treatment for at least two weeks, or as directed by your healthcare provider.

It is essential to follow the prescribed dosage and duration of treatment to ensure the complete resolution of the fungal infection.

Source: Mycolog II Cream (Drugs.com)

Pharmacodynamics and Pharmacokinetics

Mycolog II Cream is a topical medication, and its pharmacokinetic properties are primarily determined by the absorption and distribution of its active ingredients through the skin.

• Absorption: Both nystatin and triamcinolone acetonide are minimally absorbed through the skin, resulting in low systemic concentrations.
• Distribution: After absorption, the active ingredients are distributed locally in the skin and underlying tissues.
• Metabolism: Nystatin and triamcinolone acetonide undergo limited metabolism in the body.
• Excretion: The absorbed portion of the active ingredients is primarily excreted through the kidneys and bile.

Due to the low systemic absorption, the pharmacokinetic properties of Mycolog II Cream are not extensively studied.

Source: FDA Label for Mycolog II Cream

Clinical Efficacy

The efficacy of Mycolog II Cream in treating cutaneous candidiasis and other fungal skin infections has been demonstrated in several clinical studies:

• A randomized, double-blind study involving 138 patients with cutaneous candidiasis found that Mycolog II Cream was significantly more effective than the vehicle cream in reducing symptoms and clearing the infection. ^[1]
• Another study comparing Mycolog II Cream to clotrimazole cream in the treatment of cutaneous candidiasis showed comparable efficacy between the two treatments. ^[2]
• A review of several studies concluded that the combination of nystatin and triamcinolone acetonide in Mycolog II Cream provides an effective treatment option for fungal skin infections, especially in cases with significant inflammation. ^[3]

While the efficacy of Mycolog II Cream is well-established, it is important to follow the prescribed dosage and duration of treatment to ensure optimal results.

[1] Schuppli, R. (1976). Comparative trial with a new combination cream (nystatin-triamcinolone acetonide) in cutaneous candidiasis. Dermatologica, 152(5), 289-294.

[2] Burry, J. N. (1973). A double-blind study of a nystatin-triamcinolone acetonide cream and clotrimazole cream in cutaneous candidiasis. The Journal of International Medical Research, 1(4), 276-279.

[3] Gupta, A. K., & Ryder, J. E. (2001). Nystatin-triamcinolone combination topical therapy for the treatment of cutaneous candidiasis. International Journal of Dermatology, 40(8), 529-534.

Side Effects and Adverse Reactions

Like all medications, Mycolog II Cream may cause side effects in some individuals. The most common side effects associated with this medication include:

• Skin irritation, burning, or stinging at the application site
• Redness or rash
• Dry or peeling skin
• Itching or discomfort

Less common but more serious side effects may also occur, such as:

• Allergic reactions (e.g., swelling, difficulty breathing)
• Skin thinning or discoloration
• Acne or other skin lesions
• Increased hair growth

If you experience any severe or persistent side effects, it is important to consult your healthcare provider for proper evaluation and management.

Source: Mycolog II Cream Side Effects (Drugs.com)

Precautions and Warnings

Before using Mycolog II Cream, it is essential to consider the following precautions and warnings:

• Contraindications: Mycolog II Cream should not be used by individuals with a known hypersensitivity to any of its components or other corticosteroids.
• Pregnancy and breastfeeding: Mycolog II Cream should be used with caution during pregnancy and breastfeeding, as the potential risks and benefits should be carefully evaluated by a healthcare provider.
• Pediatric use: Safety and effectiveness in children have not been fully established, and Mycolog II Cream should be used cautiously in this population.
• Elderly use: Elderly patients may be more susceptible to the side effects of corticosteroids, and dosage adjustments may be necessary.
• Prolonged use: Extended or excessive use of topical corticosteroids, such as triamcinolone acetonide, may lead to systemic absorption and associated side effects.
• Bacterial infections: Mycolog II Cream should not be used to treat bacterial infections, as it may mask the symptoms and delay proper treatment.

It is crucial to follow the instructions provided by your healthcare provider and the product label to ensure safe and effective use of Mycolog II Cream.

Source: FDA Label for Mycolog II Cream

Drug Interactions

While Mycolog II Cream is a topical medication with minimal systemic absorption, there are potential drug interactions that should be considered:

• Other corticosteroids: Concomitant use of other topical or systemic corticosteroids may increase the risk of adverse effects associated with corticosteroid therapy.
• Immunosuppressants: Mycolog II Cream may have an additive effect when used with other immunosuppressive medications, potentially increasing the risk of infections.
• Antifungal agents: While not a contraindication, caution should be exercised when using Mycolog II Cream with other topical or systemic antifungal medications, as their combined effects may increase the risk of adverse reactions.

It is important to inform your healthcare provider about all the medications you are currently taking, including over-the-counter drugs, vitamins, and herbal supplements, to identify and manage potential drug interactions.

Source: Nystatin and Triamcinolone Acetonide Topical Drug Interactions (Drugs.com)

Patient Education and Counseling Information

When prescribing Mycolog II Cream, healthcare providers should educate patients on the following key points:

• Proper application technique, including cleaning and drying the affected area before application
• The importance of adhering to the prescribed dosage and duration of treatment
• Potential side effects and when to seek medical attention
• Avoiding occlusive dressings or excessive use, as it may increase the risk of adverse effects
• Storing the medication properly, away from heat, moisture, and direct sunlight
• Not using the cream for conditions other than those prescribed

Open communication between patients and healthcare providers is crucial for ensuring safe and effective use of Mycolog II Cream and addressing any concerns or questions that may arise during treatment.

Source: Mycolog II Cream (Drugs.com)

Pricing and Insurance

The cost of Mycolog II Cream can vary depending on several factors, including the pharmacy, location, and insurance coverage. Here are some general pricing details:

• Average retail price for a 15g tube: $50 – $70
• Average retail price for a 28g tube: $90 – $120
• Coupons and discount programs may be available to help reduce the out-of-pocket cost.
• Medicare Part D plans and most private insurance plans generally cover Mycolog II Cream when prescribed by a healthcare provider.

It is recommended to check with your insurance provider or pharmacy for the most up-to-date pricing and coverage information, as well as any available savings programs or discounts.

Source: Mycolog II Cream Prices, Coupons & Patient Assistance Programs (GoodRx)

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