MYCOTA CREAM

Indications

• Superficial fungal infections
• Dermatophyte infections
• Candidiasis of the skin

Dosage

Children: Refer to BNF for Children for specific dosing guidance in paediatric populations.

Adults: Refer to BNF for specific dosing recommendations based on condition and formulation.

Mechanism of action

Undecylenic acid demonstrates effectiveness against _Candida albicans_, an opportunistic pathogenic yeast. It inhibits biofilm formation and disrupts hyphal growth, which are critical for virulence and infection. At concentrations above 3 mM, it significantly reduces biofilm formation by downregulating genes associated with hyphal development, such as HWP1. Additionally, undecylenic acid may inhibit enzymes involved in lipid metabolism and affect germ tube formation by altering cytoplasmic pH through proton transport across the plasma membrane.

Pharmacodynamics

Zinc undecylenate acts as a fungistatic agent, although fungicidal effects may occur with prolonged exposure at high concentrations. It is effective against _Candida albicans_ and is thought to exert antimicrobial actions by interacting with nonspecific components in the fungal cell membrane, thereby disrupting cellular integrity and function.

Pharmacokinetics

The pharmacokinetics of undecylenate are not extensively detailed in the available literature, but as a topical application, it is expected to have localized effects with minimal systemic absorption. Its action is primarily surface-level, targeting the site of infection directly.

Pregnancy

There is limited data on the use of undecylenate during pregnancy. It is advised to consult healthcare professionals before use.

Breast-feeding

Undecylenate is not expected to pose significant risk during breastfeeding, but caution is advised. Consultation with a healthcare professional is recommended.

Storage

Store in a cool, dry place, away from direct sunlight. Keep out of reach of children.

Formulations

• Topical solution
• Cream

Indications

• Tinea pedis (athlete's foot)
• Tinea corporis (ringworm of the body)
• Tinea cruris (jock itch)
• Tinea manuum (ringworm of the hand)
• Candidiasis (cutaneous candidiasis)

Dosage

Children: Refer to the BNF for Children for specific dosing recommendations for paediatric patients.

Adults: Apply undecylenic acid topically to the affected area twice daily or as directed by a healthcare provider.

Mechanism of action

Undecylenic acid exerts its antifungal effects by inhibiting the growth of dermatophytes and other fungi. It disrupts the cell membrane of fungi, leading to leakage of cellular contents and ultimately resulting in cell lysis and death. Additionally, it may inhibit the synthesis of ergosterol, a key component of fungal cell membranes.

Pharmacodynamics

The antifungal activity of undecylenic acid is primarily due to its ability to alter the permeability of fungal cell membranes. This disruption can interfere with various cellular processes, leading to the inhibition of fungal growth. Undecylenic acid is particularly effective against common dermatophyte species, including Trichophyton, Epidermophyton, and Microsporum.

Pharmacokinetics

When applied topically, undecylenic acid is minimally absorbed into the systemic circulation. Its local antifungal action is maintained at the site of application. The exact pharmacokinetic parameters such as half-life and metabolism are not well-documented, but it is known to be primarily eliminated through topical action rather than systemic metabolism.

Adverse effects

• Skin irritation
• Burning sensation at the site of application
• Erythema
• Allergic reactions

Precautions

• Avoid contact with eyes and mucous membranes
• Use with caution in patients with sensitive skin
• Discontinue use if irritation occurs

Pregnancy

Undecylenic acid is generally considered safe during pregnancy, but it is advisable to use it under medical supervision.

Breast-feeding

Limited data are available, but topical use is not expected to pose a risk to a breastfeeding infant.

Storage

Store at room temperature, away from moisture and heat. Keep out of reach of children.

Formulations

• Topical solution
• Cream
• Powder

Mechanism of action

Undecylenic acid demonstrated effectiveness against _Candida albicans_, which is an opportunistic pathogenic yeast with two cellular morphologies: the round yeast form and the filamentous form with elongated hyphae. Hyphae formation is associated with active infections and virulence. A study proposed that undecylenic acid inhibits biofilm formation of _Candida albicans_ with optimal concentration above 3 mM and disrupts hyphal growth, which is the morphological transition from yeast to filamentous phase, at concentration above 4 mM. Under the drug treatment, hyphal formation related genes, like HWP1, were significantly reduced in transcriptional level leading to poor biofilm formation. Both biofilm and hyphae formation are critical virulence factors for the initiation of skin infection and late development of disseminated infection. Undecylenic acid may also inhibit enzyme involved in lipid metabolism and abolish germ tube formation by carrying protons across the plasma membrane, thus altering cytoplasmic pH.

Pharmacodynamics

Zinc undecylendate acts as a fungistatic agent but fungicidal activity may be observed with chronic exposure in high concentrations. It is effective against _Candida albicans_. It is proposed that undecylenic acid exerts antimicrobial actions via interacting with nonspecific components in the cell membrane.