Imidazole and triazole antifungal drugs such as clotrimazole inhibit cytochrome P450 14α-demethylase which is responsible for converting lanosterol to ergosterol, which blocks cell membrane synthesis in fungi.
Types of imidazole antifungals
Examples of imidazoles include ketoconazole (1981: Nizoral) and clotrimazole (1975: Mycelex). Examples of triazoles include fluconazole (1990: Diflucan), itraconazole (1992: Sporanox), posaconazole (2006: Noxafil) and voriconazole (2002: Vfend).
Isavuconazonium (Cresemba: 2016) is a prodrug of isavuconazole and is available in both intravenous and oral forms, its indications restricted for serious, invasive fungal infections such as aspergilosis and mucormycosis. The triazoles are perhaps the most commonly used antifungal agents having excellent oral absorption, tolerance and tissue penetration.
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