Fresno

Fresno Uses, Dosage, Side Effects, Food Interaction and all others data.

Fresno is a broad spectrum antifungal. It also exhibits activity against Trichomonus, Staphylococci, Streptococci and Bacteroides. Fresno kills fungi and yeasts by interfering with their cell membranes. It works by stopping the production of ergosterol, which is an essential component of fungal cell membranes resulting in increased membrane permeability and leakage of essential constituents of the fungal cells. Fresno acts reliably on dermatophytes, yeasts and other fungi; it is also effective against Trichomonas vaginalis and Gram-positive microorganisms (streptococci/ staphylococci) and Gram-negative microorganisms (bacteroides/ Haemophilus vaginalis).

Fresno is a broad-spectrum antifungal agent that inhibits the growth of pathogenic yeasts by changing the permeability of cell membranes. The action of clotrimazole is fungistatic at concentrations of drug up to 20 mcg/mL and may be fungicidal in vitro against Candida albicans and other species of the genus Candida at higher concentrations . Unfortunately, resistance to clotrimazole, which was rare in the past, is now common in various patient populations .

Fresno is generally considered to be a fungistatic, and not a fungicidal drug, although this contrast is not absolute, as clotrimazole shows fungicidal properties at higher concentrations .

Trade Name Fresno
Availability Prescription only
Generic Clotrimazole
Clotrimazole Other Names Clotrimazol, Clotrimazole, Clotrimazolum
Related Drugs fluconazole, nystatin, Diflucan, itraconazole, miconazole
Weight 500mg, 2%w/w
Type Tablet, Cream
Formula C22H17ClN2
Weight Average: 344.837
Monoisotopic: 344.108026261
Protein binding

98%

Groups Approved, Vet approved
Therapeutic Class Drugs for subcutaneous and systemic mycoses, Topical Antifungal preparations
Manufacturer Biogen Pharma
Available Country Pakistan
Last Updated: September 19, 2023 at 7:00 am
Fresno
Fresno

Uses

The confirmed indication for Fresno include:

  • All dermatomycoses due to dermatophytes (e.g. Trichophyton species).
  • All dermatomycoses due to yeasts (Candida species).
  • Dermatomycoses due to moulds and other fungi.
  • Skin diseases showing superinfections with these fungi.

To the dermatomycoses listed under 1-4 belong for example, interdigital myocoses (e.g. athlete’s foot), paronychias (associated with nail mycoses), myocoses in skin folds, Candida vulvitis, Candida balanitis, Pityriasis versicolor, erythrasma.

Fresno rectal preparation is used for vaginal itching, burning and discharge associated with recurrent vaginal yeast infections (Vaginal candidiasis) and also in viginitis due to Candida species as well as Mycotic infections complicated by other microorganisms sensitive to the drug.

Fresno Sterile Eye Ointment is used for the treatment of fungal keratitis due to filamentous fungi and Candida species.

Fresno Ear Drop is used for the treatment of fungal infections of the ear.

Fresno is also used to associated treatment for these conditions: Balanitis candida, Candidiasis, Dermatitis, Dermatomycoses, Ear infection fungal, Erythrasma, Fungal Vaginal Infections, Fungal skin infection, Genital candidiasis, Inflammation, Mixed Vaginal Infections, Oropharyngeal Candidiasis, Pityriasis versicolor, Pyoderma, Ringworm, Skin Infections, Skin candida, Tinea Corporis, Tinea Cruris, Tinea Pedis, Tinea inguinalis, Trichophytosis, Vaginal Candidiasis, Vaginal Mycosis, Vulvitis, Cutaneous candidiasis, Infection mycotic, Susceptible Bacterial Infections, Symptomatic Tinea Corporis caused by Trichophyton mentagrophytes, Trichophyton rubrum, Epidermophyton floccosum, Symptomatic Tinea Cruris caused by Trichophyton mentagrophytes, Trichophyton rubrum, Epidermophyton floccosum, Symptomatic Tinea Pedis caused by Trichophyton mentagrophytes, Trichophyton rubrum, Epidermophyton floccosum, Tinea versicolor caused by Malassezia infection

How Fresno works

Fresno acts primarily by damaging the permeability barrier in the cell membrane of fungi. Fresno causes inhibition of ergosterol biosynthesis, an essential constituent of fungal cell membranes. If ergosterol synthesis is either completely or partially inhibited, the cell is no longer able to construct an intact and functional cell membrane ,. Because ergosterol directly promotes the growth of fungal cells in a hormone‐like fashion, rapid onset of the above events leads to dose-dependent inhibition of fungal growth .

Though decreased ergosterol, due to the inhibition of lanosterol 14-demethylase (also known as CYP51) is accepted to be primarily responsible for the antimycotic properties of clotrimazole, this drug also shows other pharmacological effects. These include the inhibition of sarcoplasmic reticulum Ca2+‐ATPase, depletion of intracellular calcium, and blocking of calcium‐dependent potassium channels and voltage‐dependent calcium channels . The action of clotrimazole on these targets accounts for other effects of this drug that are separate from its antimycotic activities .

Dosage

Fresno dosage

Topical

Wash skin with soap and water and dry thoroughly. Apply a thin layer of the cream or solution 2-3 times daily and gently massage over affected area as directed by the doctor. For Athlete’s foot, pay special attention to the spaces between the toes. Best results in Athlete's foot and ringworm are usually obtained with 4 weeks use of this product. The cream should be applied two or three times daily for one month or for at least two weeks after the disappearance of all signs of infection. If satisfactory results have not occurred within these times consultation with doctor is essential. For best results, follow directions and continue treatment for length of time indicated. The duration of treatment varies; it depends among other factors on the extent and localization of the disease.

Recommended duration of treatment :

  • Dermatomycoses: 3-4 weeks
  • Candida vulvitis and candida balanitis: 1-2 weeks
  • Erythrasma and pityriasis versicolor (approx.): 3 weeks
  • In fungal infection of the feet, to prevent relapses:Treatment should be continued for about 2 weeks beyond the disappearance of all signs of disease.

Fresno cream is odourless, can be washed off and does not stain.

Rectal

First infections: In general, a 3-day treatment is sufficient for Candida vaginitis. On 3 consecutive nights, Fresno 200 mg vaginal preparation is inserted as deeply as possible into the vagina. This is best achieved when lying on one's back with the knees slightly bent.

Re-infections: In general, a 6-day treatment is sufficient. This applies also to mixed infections with the above-mentioned causative organisms. On six consecutive nights, 1 Fresno 100 mgvaginal preparation is inserted as deeply as possible into the vagina. If necessary, 2 Fresno 100 mg(1 in the morning and 1 in the evening) or 1 Fresno 200 mg daily can be used for 6-12 days. Treatment should be timed so as to avoid the menstrual period and be finished before the onset of menstruation. To avoid re-infection, the partner should undergo local treatment with Fresno cream at the same time.

Fresno 500 mg vaginal preparation: Single dose, complete treatment with one vaginal tablet. The tablet should be inserted as deeply as possible into the vagina. This is best achieved when lying on one's back with the knees slightly bent. It is recommended that the treatment should be timed so as to avoid the menstrual period. For prevention of re-infection the partner should be treated locally with Fresno cream at the same time.

Fresnovaginal preparation are colorless and do not stain the underwear.

Eye

Adult: It should be applied thinly and evenly to the conjunctival sac every 4 hours daily or as advised by a physician.

Children: Safety and effectiveness in children have been established for Fresno when used as indicated and in the recommended dosage.

Ear

Instill 2-3 drops of Clarizol Ear Drops in the affected ear two or three times daily.The treatment should be continued for at least two weeks after the disappearance of all signs of infection to prevent re-infection.

For the treatment to become a complete success, reliable and sufficiently long application of Fresno cream is important. The duration of treatment varies; it depends among other factors on the extent and localisation of the disease.

Side Effects

Fresno is generally well tolerated after local application but the few side effects have been reported infrequently like erythema, stinging, blistering, peeling, oedema, pruritus, urticaria and general irritation.

Since there is practically no Fresno absorption through the vaginal skin, no systemic effect is expected. The local tolerance of Fresno vaginal tablet is generally good. Local irritation or burning sensation may occur in a very few cases but these symptoms are not considered harmful.

Rarely patients may experience burning or irritation immediately after applying the ointment.

Toxicity

Symptoms of overdose include erythema, stinging, blistering, peeling, edema, pruritus, urticaria, burning, and general irritation of the skin, and cramps. As with all topical agents, skin sensitization may result .

Oral LD50 (rat): 708 mg/kg; Intraperitoneal LD50 (rat): 445 mg/kg; Subcutaneous LDLO (rat): 10 g/kg; Oral LD50 (mouse): 761 mg/kg; Subcutaneous LDLO (mouse): 10 g/kg; Intraperitoneal LD50 (mouse): 108 mg/kg;

Overdose

This drug poses no risk of acute intoxication, as it is unlikely to occur following a single vaginal or dermal application of an overdose (application over a large area under conditions favorable to absorption) or accidental oral ingestion. There is no specific antidote .

Effects on Fertility

No human studies of the effects of clotrimazole on fertility have been conducted; however, animal studies have not shown any effects on the drug on fertility .

Use in Pregnancy

There are limited data regarding the use of clotrimazole in pregnant women. Animal studies do not show direct or indirect harmful effects on reproduction. Although the topical application of clotrimazole may result in very low serum and tissue levels, the use of clotrimazole topical cream by pregnant women is not recommended unless it is advised by the prescribing physician. Fresno topical cream should not be used in the first trimester of pregnancy unless it is considered by the physician to be essential to patient well-being .

Use in Breastfeeding

Available pharmacodynamic/toxicological studies in animals have shown excretion of clotrimazole/metabolites in breastmilk. Fresno should not be administered during breastfeeding. Although the topical application of clotrimazole has resulted in very low serum and tissue levels, the use of clotrimazole topical cream by lactating women is not recommended unless it recommended by the prescribing physician .

Precaution

If local intolerance develops, consider withdrawal of the medicine and institution of appropriate therapy. Fresno solution is not intended for ophthalmic use. Avoid contact with eyes upon topical application. Children 3 yrs. Pregnancy, lactation. If irritation or sensitivity develops with the use of Fresno ointment, treatment should be discontinued.

Interaction

There have been reports of a heat reaction when this medication used concomitantly with Sofradex drops in the ear.

Antagonism with polyene antibiotics.

Food Interaction

No interactions found.

Fresno Disease Interaction

Moderate: hepatic dysfunction

Volume of Distribution

The topical form is minimally absorbed in the serum and tissues . Fresno is a lipophilic drug , and has been shown to be secreted in breastmilk in animal studies . There are limited data available regarding the volume of distribution following oral troche administration.

Elimination Route

Because clotrimazole is generally not significantly absorbed, drug interactions are not a major issue with its use .

Elimination Route

Mainly hepatic .

Pregnancy & Breastfeeding use

Pregnancy:Fresno is recommended during pregnancy only after first consulting a doctor.

Lactation:Because systemic absorption of clotrimazole following topical application is marginal, there should be no risk for the infant during lactation.

Contraindication

Hypersensitivity to clotrimazole.

Acute Overdose

Supportive measures should be taken incase of accidental oral ingestion.

In case of accidental oral ingestion, supportive measures should be taken.

Interaction with other Medicine

There have been reports of a heat reaction when this medication used concomitantly with Sofradex drops in the ear.

Storage Condition

Store at a cool and dry place. Protect from light. Do not freeze.

Innovators Monograph

You find simplified version here Fresno

Fresno contains Clotrimazole see full prescribing information from innovator Fresno Monograph, Fresno MSDS, Fresno FDA label

FAQ

What is Fresno used for?

Fresno is used to treat vaginal yeast infections, oral thrush, diaper rash, pityriasis versicolor, and types of ringworm including athlete's foot and jock itch. It is also used to treat skin infections such as athlete's foot, jock itch, ringworm, and other fungal skin infections (candidiasis). Fresno is used to treat skin infections caused by a fungus (yeast).

How safe is Fresno?

Food and Drug Administration and is safe and effective when used according to the Fresno facts label directions.

How does Fresno work?

Fresno work by killing the fungus (yeast) that is causing the infection. Fresno kills fungus by causing holes to appear in its cell membrane and the contents leak out.

What are the common side effects of Fresno?

Common side effects of Fresno are include: Burning, stinging, swelling, irritation, redness, pimple-like bumps, tenderness, or flaking of the treated skin may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Is Fresno safe during pregnancy?

Fresno is generally considered safe for pregnant women to use. If you are using the pessary to treat vaginal thrush during pregnancy it is recommended that you insert it with your fingers rather than with the applicator provided.

Is Fresno safe during breastfeeding?

Fresno is generally considered safe to use while you're breastfeeding. If your baby is being treated for oral thrush you can carry on breastfeeding but you'll need to be treated at the same time. Apply Fresno cream on and around your nipples after each time you breastfeed your baby.

Can I drink alcohol with Fresno?

Yes, you can drink alcohol while using Fresno.

When should be taken of Fresno?

Apply Fresno to the affected area 2 to 3 times a day. It will work better if you use it 3 times a day. If the affected area is large or hairy, it's best to use either the spray or solution.

Should Fresno be taken with food?

Do not eat or drink while Fresno is in your mouth.

How long does Fresno take to work?

Fresno usually takes 7 days for fungal infections to improve. Apply Fresno to the infected area 2 or 3 times a day for at least 2 weeks.

What is the half life of Fresno?

The elimination half-life of Fresno is 3.5-5 hours.

Can I take Fresno for long time?

Do not use Fresno cream, spray or solution for more than 4 weeks, unless a doctor tells you to.

What happens if I use too much Fresno?

Using too much of this medicine or using it for a long time may increase your risk of having adrenal gland problems. The risk is greater for children and patients who use large amounts for a long time.

When should I not use Fresno?

Do not use Fresno cream, spray or solution for more than 4 weeks, unless a doctor tells you to. A fungal infection can become resistant to Fresno, which means it will no longer work properly.

How many times a day can I use Fresno?

Adults and children use two times a day, morning and evening.

Does Fresno stop itching?

Fresno reduces vaginal burning, itching, and discharge that may occur with this condition.

Does Fresno raise blood sugar?

Fresno can raise blood glucose level by antagonizing the action and suppressing the secretion of insulin, which results in inhibition of peripheral glucose uptake and increased gluconeogenesis.

Can a man use Fresno cream?

Fresno can be used for men and women.

Will Fresno cure toenail fungus?

Over the counter fungal creams like Fresno don't work well for treating toenail fungus.

Does Fresno affect the liver?

The cause of the serum enzyme elevations during Fresno therapy is unknown, but many of the antifungal azoles have been implicated in causing liver injury.

Can I overdose on Fresno?

An overdose of Fresno topical is not expected to be dangerous. Seek emergency medical attention if anyone has accidentally swallowed the medication.

What happens if I stop taking Fresno?

Stopping the Fresno too early may allow fungus to continue to grow, which may result in a relapse of the infection. Inform your doctor if your condition persists or worsens.

Does Fresno dry out skin?

 Burning, tingling, dry skin, or stinging may occur.

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