Antifungal
Also known as ERTACZO
Sertaconazole, an imidazole antifungal, inhibits the fungal cytochrome P450 enzyme 14 -demethylase, which converts lanosterol to ergosterol. Ergosterol is essential for the fungal cell membrane; its depletion and the accumulation of toxic intermediate sterols increase membrane permeability and lead to fungal cell death. At topical concentrations, azoles may also directly increase fungal cytoplasmic membrane permeability.
Increased phenytoin levels, leading to dose-dependent adverse effects such as nystagmus, ataxia, confusion, and lethargy.
Monitor phenytoin levels if sertaconazole is used extensively or for prolonged periods. Adjust phenytoin dose as needed. Advise patients to report any signs of phenytoin toxicity.
Increased risk of hypoglycemia (e.g., dizziness, sweating, confusion, tremor).
Monitor blood glucose levels more closely if sertaconazole is used extensively or for prolonged periods in patients on sulfonylureas. Advise patients to be aware of hypoglycemia symptoms and to carry a source of fast-acting sugar.
Increased risk of hypoglycemia.
Monitor blood glucose levels more closely if sertaconazole is used extensively or for prolonged periods in patients on tolbutamide. Advise patients to be aware of hypoglycemia symptoms.
Increased INR and risk of bleeding (e.g., bruising, epistaxis, hematuria, gastrointestinal bleeding).
Monitor INR more frequently if sertaconazole is used extensively or for prolonged periods in patients on warfarin. Adjust warfarin dose as needed. Advise patients to report any signs of bleeding.
Potentially altered efficacy of losartan, though clinically significant effects are unlikely due to minimal systemic absorption.
Generally no specific management required due to minimal systemic absorption. Monitor blood pressure as usual.
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e, Katzung·Verified: 2026-05-13 · House clinical team