Terconazole and Butoconazole

Terconazole and butoconazole nitrate (Femstat) are available as a 2% vaginal cream. They are used at bedtime for 3 d in nonpregnant females. There is a slower response during pregnancy, which requires a 6-d course of treatment. 

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Terconazole and butoconazole Terconazole is a ketal triazole with structural similarities to ketoconazole. The mechanism of action of terconazole is similar to that of the imidazoles. The 80-mg vaginal suppository is inserted at bedtime for 3 days, whereas the 0.4% vaginal cream is used for 7 days, and the 0.8% cream for 3 days. Clinical efficacy and patient acceptance of both preparations are at least as good as for clotrimazole in patients with vaginal candidiasis. Butoconazole is an imidazole that is pharmacologically quite comparable to clotrimazole. 

Because of their limited, activity, small spectmm, and side effects, the older topical antimycotics have generally been surpassed by newer antimycotic chemotherapeutic agents. These newer antimycotics for topical use iaclude the imida2ole derivatives clotrimazole, miconazole, econazole, isoconazole, sulconazole, fenticonazole, oxiconazole, bifonazole, butoconazole, ziaoconazole, tioconazole, and the triazole derivative, terconazole (Table 2) (5—7). The iatroduction of the azole derivatives represents a milestone ia the treatment of mycoses. 

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