Candicure 1% Topical Cream — Isoconazole Nitrate 10 mg/g — Antifungal Cream
1. Disclaimer
This monograph is intended for general educational and professional reference purposes. It does not replace the approved Egyptian product information, the package leaflet supplied with the medicine, or individualized advice from a physician or pharmacist. Product formulations, approved indications, dosing instructions, manufacturers, and regulatory status may change over time.
We do not guarantee the accuracy, currency or completeness of information regarding medications or medical products, and official sources should be verified before making any decisions. Readers are responsible for independently verifying the information before relying on it.
For patient care, the current locally approved Candicure package leaflet and instructions from the treating healthcare professional should take precedence, particularly if they differ from information published for isoconazole-containing products in other countries.
2. Summary
Candicure 1% Topical Cream is a topical antifungal preparation containing isoconazole nitrate 10 mg per gram (1% w/w). Isoconazole is an imidazole antifungal with activity against dermatophytes, yeasts, yeast-like fungi and moulds. It also demonstrates activity against certain Gram-positive bacteria and against organisms associated with erythrasma.
The cream is intended for superficial fungal infections of the skin, including infections involving the feet, hands, body, groin and external genital skin, as well as pityriasis versicolor and erythrasma where included in the locally approved indication. It is for cutaneous use only and should not be confused with Candicure vaginal ovules or Candicure-D cream.
3. Brand Name
Candicure 1% Topical Cream
Egyptian market listings identify a 30-g topical cream containing isoconazole nitrate 1% and manufactured by Al Esraa Pharmaceutical Optima.
Other similarly named products are separate formulations:
- Candicure 1 – 600 mg vaginal ovules: isoconazole nitrate vaginal preparation.
- Candicure-D topical cream: a combination containing isoconazole nitrate with diflucortolone valerate, a topical corticosteroid.
These products are not interchangeable.
4. Category
Pharmacotherapeutic category: Topical antifungal.
Drug class: Imidazole antifungal.
ATC classification: D01AC05 – Isoconazole.
5. Active Ingredient
Each 1 g of Candicure cream contains:
Isoconazole nitrate — 10 mg
Equivalent to 1% w/w isoconazole nitrate.
Current Egyptian listings confirm isoconazole nitrate as the active ingredient of Candicure 1% topical cream.
6. Pharmaceutical Form & Strength
Pharmaceutical form: Topical cream.
Strength: Isoconazole nitrate 1% w/w (10 mg/g).
Pack size: 30-g tube according to current Egyptian market listings.
Published Egyptian product information has reported excipients including purified water, white petrolatum, fatty alcohols and emulsifying agents. Because publicly available sources differ regarding the exact excipient composition, the current Egyptian package leaflet should be consulted for the definitive formulation, particularly in patients with known excipient hypersensitivity.
7. Manufacturer & Marketing Authorization Holder
Manufacturer: Al Esraa Pharmaceutical Optima, Egypt. This manufacturer is consistently identified for the 1% topical cream in current Egyptian pharmacy databases.
Marketing Authorization Holder: The current marketing authorization holder could not be independently confirmed from a publicly accessible, up-to-date Egyptian Drug Authority product monograph. The current Egyptian package and approved leaflet should therefore be consulted for the legally applicable authorization-holder information.
8. Mechanism of Action
Isoconazole is an imidazole antifungal. As an imidazole antifungal, it interferes with fungal ergosterol biosynthesis, resulting in alterations in fungal cell-membrane composition and function. Its activity is predominantly fungistatic at lower concentrations and may become fungicidal at sufficiently high local concentrations.
Isoconazole has also demonstrated antibacterial activity against several Gram-positive organisms, although Candicure should not be regarded as a general-purpose topical antibacterial treatment.
9. Spectrum of Activity
Isoconazole has a broad antimicrobial spectrum that includes:
- Dermatophytes, including susceptible Trichophyton, Epidermophyton and related species.
- Yeasts and yeast-like fungi, including Candida species.
- Malassezia species associated with pityriasis versicolor.
- Various susceptible mould fungi.
- Certain Gram-positive bacteria in vitro.
- Organisms responsible for erythrasma, which is generally associated with Corynebacterium minutissimum.
Erythrasma should therefore not be classified as a fungal infection despite its inclusion among conditions responsive to isoconazole.
10. Pharmacokinetics
Skin penetration
Isoconazole rapidly penetrates human skin. Peak concentrations in the stratum corneum and living skin have been demonstrated approximately 1 hour after topical application, with high local concentrations maintained for at least 7 hours.
Reported concentrations after topical isoconazole cream application were approximately:
- Stratum corneum: 3,500 µg/mL, corresponding to about 7 mmol/L.
- Living epidermis: 20 µg/mL, approximately 40 µmol/L.
- Dermis: 3 µg/mL, approximately 6 µmol/L.
These concentrations substantially exceed inhibitory and biocidal antifungal concentrations for important dermatophytes, yeasts and moulds in the superficial skin layers.
Cutaneous retention
After repeated treatment, isoconazole may remain detectable above minimum inhibitory concentrations in the stratum corneum and hair follicles for at least one week after therapy; in some subjects it has remained detectable for up to 14 days after the final application.
Systemic absorption
Systemic exposure following topical administration is very low. Even after experimental removal of the stratum corneum, less than 1% of an applied dose was absorbed during a 4-hour exposure period in a regulator-reviewed isoconazole cream study.
Metabolism and elimination
Isoconazole is not metabolically inactivated within the skin. The amount absorbed following normal topical use is too small to adequately characterize systemic metabolism from topical administration.
Following experimental intravenous administration, isoconazole was extensively metabolized and rapidly eliminated, with metabolites excreted through urine and bile. Approximately 75% of administered radioactivity was eliminated within 24 hours in the cited pharmacokinetic investigation.
11. Indications
Candicure 1% Topical Cream is intended for the treatment of susceptible superficial infections of the skin, which may include:
- Tinea pedis — athlete's foot.
- Tinea manuum — fungal infection of the hand.
- Tinea corporis — ringworm of the body.
- Tinea cruris — fungal infection of the groin.
- Cutaneous candidiasis.
- Superficial fungal infection of external genital skin.
- Pityriasis (tinea) versicolor.
- Erythrasma.
The cream is intended for external cutaneous treatment. It should not be inserted intravaginally as a substitute for an isoconazole vaginal preparation.
12. Administration
Clean and carefully dry the affected area before application. Apply a thin layer of cream to the affected skin and a small surrounding margin, then rub in gently.
Published Candicure-specific product information describes application twice daily and treatment for approximately 2–4 weeks, with tinea pedis commonly requiring about 4 weeks.
Regulator-reviewed prescribing information for other isoconazole nitrate 1% cream products, including Travogen, specifies once-daily application, usually for 2–3 weeks and up to 4 weeks for persistent infections, especially those involving interdigital spaces.
Because dosing may be authorized differently for individual brands and countries, the dosing frequency printed in the current Egyptian Candicure leaflet or prescribed by the treating healthcare professional should be followed rather than changing the frequency independently.
Treatment is generally continued for approximately 2 weeks after clinical healing to reduce the risk of recurrence.
For interdigital infections, the area should be dried especially carefully after washing. A clean strip of gauze lightly smeared with the cream may be placed between affected toes or fingers when advised.
If adequate clinical improvement is not obtained after an appropriate treatment course, the diagnosis should be reconsidered. Conditions mimicking fungal infection may require microscopy, culture or another diagnostic assessment.
13. Method of Preparation
No reconstitution, dilution or other preparation is required.
Candicure is supplied as a ready-to-use topical cream. The skin should simply be cleaned and thoroughly dried before application.
Do not mix the cream with another medicine or cosmetic product before application unless specifically advised by a healthcare professional.
14. Contraindications
Candicure should not be used in patients with known hypersensitivity to isoconazole nitrate or to any component of the formulation.
A previous significant allergic reaction to isoconazole or an excipient in the cream warrants medical review before further exposure.
15. Warnings & Precautions
Avoid contact with the eyes. If accidental eye exposure occurs, rinse thoroughly with clean water; persistent irritation should be medically assessed. Experimental data indicate that isoconazole can cause conjunctival irritation after accidental ocular exposure.
The medicine is intended for external cutaneous use. Do not swallow it and do not introduce the topical cream into the vagina.
Good hygiene is important in preventing reinfection. In tinea pedis, carefully dry the spaces between the toes after washing and change socks regularly. Towels, underwear and other items in direct contact with affected skin should not be shared.
If the current Candicure formulation contains petrolatum or paraffin-based excipients, use in the genital region may impair the integrity and effectiveness of latex barrier contraceptives such as condoms or diaphragms. The current package leaflet should be checked for product-specific advice.
If present in the current formulation, excipients such as propylene glycol, benzoic acid or fatty alcohols may contribute to local irritation or contact sensitivity in susceptible individuals.
Persistent worsening, marked inflammation, extensive blistering or signs of allergy warrant discontinuation and medical assessment.
16. Drug Interactions
No formal interaction studies have been performed with topical isoconazole. Because systemic absorption after cutaneous application is very low, clinically significant systemic interactions are considered unlikely; however, absence of interaction studies should not be interpreted as proof that interactions are impossible.
When other topical medicines are being applied to the same area, their compatibility and application schedule should be discussed with a healthcare professional rather than mixing them together.
The potential physical incompatibility between petrolatum- or paraffin-containing preparations and latex barrier contraceptives should be considered if such excipients are present in the current Candicure formulation and the cream is applied to genital skin.
17. Side Effects
Topical isoconazole is generally well tolerated. In clinical studies of regulator-reviewed isoconazole cream, the most frequently reported adverse reactions were burning and irritation at the application site.
Reported reactions include:
Common:
- Application-site burning.
- Application-site irritation.
Uncommon:
- Dryness.
- Pruritus.
- Weeping eczema.
- Dyshidrosis.
- Contact dermatitis.
Rare:
- Local swelling.
- Skin fissuring.
Frequency not known:
- Erythema.
- Blister formation.
- Allergic skin reactions.
Treatment should be stopped and medical advice obtained if a significant hypersensitivity reaction or severe skin reaction develops.
18. Use in Special Populations
Pregnancy
Clinical experience with isoconazole-containing preparations has not indicated a human teratogenic signal. Nevertheless, use during pregnancy should be based on an individual benefit–risk assessment, with particular caution during the first trimester.
Large treatment areas, prolonged unnecessary treatment and use under conditions that markedly increase absorption should be avoided unless medically indicated.
Breast-feeding
It is not established with certainty whether isoconazole is excreted into human breast milk. Because systemic absorption from intact skin is low, major exposure is unlikely, but a risk to a breast-fed infant cannot be completely excluded.
Use during breast-feeding should therefore follow a benefit–risk assessment. The cream should not be applied to the breast or nipple area where the infant could ingest it directly.
Fertility
Available nonclinical data have not demonstrated a specific adverse effect on fertility.
Paediatric population
Clinical studies of isoconazole cream have included infants, children and adolescents, and available data have not identified a substantially different safety or efficacy profile compared with adults. However, some regulator-reviewed information states that the available paediatric evidence is insufficient to establish a specific dosage recommendation.
Use in infants or young children should therefore follow professional medical advice.
Elderly patients
No specific age-related dosage adjustment has been established for topical isoconazole. Treatment should be individualized according to the condition of the skin and the extent of infection.
Renal or hepatic impairment
Specific dosage adjustments have not been established. Clinically relevant systemic exposure is expected to be low following normal cutaneous application, but dedicated pharmacokinetic studies in these populations are limited.
19. Storage Conditions
For Candicure cream, published product-specific information specifies:
- Store at a temperature not exceeding 30°C.
- Store in a dry place and protect from excessive heat and light.
- Keep the tube properly closed.
- Keep all medicines out of the sight and reach of children.
Storage requirements are formulation-specific; therefore, instructions printed on the current Candicure package should take precedence if revised.
20. Additional Sections
Overdose and Accidental Ingestion
Acute toxicity studies with topical isoconazole indicate that acute intoxication is not expected following a single excessive dermal application, even over a large surface under conditions favoring absorption. Regulator-reviewed product information also reports no acute intoxication risk expected from accidental ingestion of a typical topical amount.
Nevertheless, deliberate or substantial ingestion—particularly by a child—should be medically assessed.
Preclinical Safety
Conventional nonclinical studies of safety pharmacology, repeated-dose toxicity, genotoxicity and reproductive toxicity have not demonstrated a specific hazard associated with therapeutic use of isoconazole.
No dedicated in-vivo carcinogenicity studies have been performed. Available mutagenicity, repeated-dose toxicity, structural and mechanistic information has not provided evidence suggesting a tumorigenic potential.
Local tolerability studies have not predicted significant irritation under normal therapeutic conditions, although accidental exposure to the eye may cause conjunctival irritation.
Ability to Drive and Operate Machinery
Topical isoconazole is not expected to impair the ability to drive or operate machinery. Regulator-reviewed information reports no observed influence on these activities.
Available Candicure Presentations in Egypt
Current online Egyptian pharmacy listings identify at least the following distinct presentations:
Candicure 1% Topical Cream, 30 g
Isoconazole nitrate — manufactured by Al Esraa Pharmaceutical Optima.
Candicure 1 – 600 mg Vaginal Ovules, pack of 3
Isoconazole nitrate — listed as manufactured by Medizen Pharmaceutical Industries.
Candicure-D Topical Cream, 15 g
Isoconazole nitrate + diflucortolone valerate — manufactured by Al Esraa Pharmaceutical Optima.
The presence of diflucortolone valerate in Candicure-D means that it has corticosteroid-related indications, precautions and treatment limitations that do not apply to plain Candicure 1% cream.
21. Frequently Asked Questions (FAQ)
What is Candicure 1% cream used for?
It is a topical antifungal used for susceptible superficial fungal skin infections such as athlete's foot, ringworm, jock itch, fungal infections of the hands, cutaneous candidiasis and pityriasis versicolor. It may also be used for erythrasma where included in the locally approved indication.
Is Candicure an antibiotic?
No. Its principal action is antifungal. Isoconazole does have activity against some Gram-positive bacteria and against organisms associated with erythrasma, but the cream should not be used as a general treatment for bacterial skin infections.
How often should Candicure cream be applied?
Available Candicure-specific information describes twice-daily application, whereas regulator-approved labeling for some other isoconazole nitrate 1% creams uses once-daily application. The frequency printed in the current Candicure package leaflet or prescribed by the healthcare professional should therefore be followed.
How long is treatment usually continued?
Many superficial fungal infections require approximately 2–4 weeks of treatment. Interdigital or persistent infections, including athlete's foot, may require around 4 weeks. Treatment is commonly continued for approximately 2 additional weeks after clinical healing to reduce recurrence.
Can Candicure cream be used in the genital area?
It may be used on affected external genital skin when medically appropriate. The topical cream is not intended for intravaginal administration. A vaginal ovule is a different pharmaceutical form.
Is Candicure cream a corticosteroid?
No. Plain Candicure 1% cream contains isoconazole nitrate only as its active drug. Candicure-D is a different product containing isoconazole plus the corticosteroid diflucortolone valerate.
Can Candicure be used during pregnancy?
Isoconazole has not demonstrated a human teratogenic signal in available experience, but use during pregnancy should follow an individualized medical benefit–risk assessment, particularly during the first trimester.
Can Candicure be used while breast-feeding?
It may be considered after medical benefit–risk assessment. It should not be applied to the nipple or breast area where an infant could ingest the medicine.
What should be done if the infection does not improve?
The diagnosis should be reviewed rather than simply extending treatment indefinitely. Dermatitis, psoriasis, bacterial infections and other conditions can resemble fungal disease, and microbiological testing may sometimes be required.
Can the cream be used with latex condoms?
If the current Candicure formulation contains petrolatum or paraffin-based excipients, contact with latex condoms or diaphragms may weaken the latex and reduce their reliability. The current package leaflet should therefore be checked for product-specific advice.
22. References
- Singapore National Drug Formulary. Travogen Cream 1% (Isoconazole Nitrate 10 mg/g). Product information updated 16 September 2026. Provides current regulatory information on strength, indications and dosing.
- Malta Medicines Authority. Travogen Cream — Summary of Product Characteristics. Includes indications, contraindications, pregnancy and breast-feeding information, adverse effects, pharmacodynamics, pharmacokinetics and preclinical safety data.
- Ethiopian Food and Drug Authority. Azonit Isoconazole Nitrate Cream 10 mg/g — Summary of Product Characteristics. Provides independent regulatory information regarding administration, pharmacokinetics, adverse effects and preclinical safety.
- Veraldi S. Isoconazole nitrate: a unique broad-spectrum antimicrobial azole effective in the treatment of dermatomycoses, both as monotherapy and in combination with corticosteroids. Mycoses. 2013;56(Suppl 1):3–15. doi:10.1111/myc.12054.
- Czaika VA, et al. Reactive oxygen species and the bacteriostatic and bactericidal effects of isoconazole nitrate. Mycoses. 2013;56(Suppl 1). Provides evidence concerning the antibacterial properties of isoconazole nitrate.
- Candicure Cream — product-specific published information. Includes published Candicure formulation information, listed indications, dosage information, 30-g packaging and storage requirements.
- Current Egyptian pharmacy listings for Candicure 1% Topical Cream 30 g. These confirm the marketed cream, isoconazole nitrate active ingredient and Al Esraa Pharmaceutical Optima as manufacturer.
- Current Egyptian listings for Candicure 1 vaginal ovules and Candicure-D topical cream. Used to distinguish these formulations from Candicure 1% topical cream.
- Occupational Safety and Health Administration (OSHA). Mineral oil and/or petrolatum-containing skin products and latex. Supports the precaution concerning potential weakening of natural-rubber latex after exposure to petrolatum-containing products.