PROJECT WORK B.PHARM 8 SEMESTER MARKET SURVEY OF CLOTRIMZOLE

PROJECT WORK B.PHARM 8 SEMESTER MARKET SURVEY OF CLOTRIMZOLE

1. PROJECT WORK ON

MARKET SURVEY OF CLOTRIMAZOLE

Y sonopsis of Proposed Dissertation Suite!
in Paria aliment ofthe
Requirements forthe
Degree of
BACHELOR OF PHARMACY
By

MO. ANAS
ROLL NO:2003150S00053,
Under supers ion of
DR. \YILKEMARSINGH

{SHED INSTITUTE OF PHARMACY

FACULTY OF PHARMACY
DRAP ABDULKALAM TECHNICAL UNIVERSELY

2. PROJECT WORK ON
MARKET SURVEY OF CLOTRIMAZOLE

A synopsis of Proposed Dissertation Submited

Requirements forthe
Degree of
BACHELOR OF PHARMACY
By
MO. ANAS
Under supervision of

DRANILKUMARSINGH
UNITED INSTITUTE OF PHARMACY
Prayagra)

FACULTY OF PHARMACY
DR. APJ ABDUL KALAM TECHNICAL UNIVERSIT

3. Declaration

erh declared that his report work of "MARKETING PROJECT" submit,
thee record of an original work done by mo under the guidnce of Dr. ni Kumar

This project work was an empirical fining, and this projet work is based on
infomation cold and care by me, And ht othe nes of my Knowodgo and
Belt I eos mo mera previously polished ur writen by anales person ot
or diploma of be university or ot inte of higher taming. exce tir du
acknowledgement hs bee mudo in

Date: May 2024

Place Pryagr) Ur Pradesh,

4. Acknowledgement

The taining opportunity ad with Unie Inst of Pharmacy was a great hance
for learning and profesional development. There consider myself a a very
rate fr having a chance to meet o many wonderful people und profesional
‘ho ed me though is training pid, Lam using this oppor o express my
despesgraiade and special thanks to United Inmo of pharmacy, Naini

express my deepest thanks to Prof, (Dr) Alok Mukerje Principal of he United
Insite of Pharmacy) for aking pr in wel dci and giving near) aces
ad guidance and arrange all facies to make his training ese. chose

I my radiant sentiment to place on record my best regards, deepest sense of

Arie to De, Anil Kumar Singh (Profesor or their cael and precious

[perceive this opportunity as abi milestone in my curse development. Iwill sive
to use gained sis and knowledge inthe bot posible way, and vil continue to

(E. Pharma 4° Ye

5. Le UNITED INSTITUTE OF PHARMACY UCER

tcs sis Asin An as 2108

Ref No. VIP/Proj/2024/MKkt/053 Date 14, May 2024

CERTIFICATE

This is so cerf that Mr. Mo Anas (Roll No, 2003150500053) has
completed a Projet report on Pharmaceutical Marketing as apart of
“Project Work (On Elective) BP-SI4PW as per Curriculum of Dr. ALP.

Technical University, Lacknow

bas been completed satisfactorily with sincerity and dedication.

[wih im all he sucess fr he bright tur

Dr. Anil Kumar Singh
Professor

6. INDEX

Topics

SECTION 1
Introducution of Pharmaceutical Marketing
List of companies in India
Introduction of fungi
Classification of Antifungal

SECTION 2
Objective of Researsh

Requirement for research work

[Clotrimazole Market Overview

SECTION 3

SECTION 4
Conclusion

Bibliography

7. SECTION 1

8. Introduction of pharmaceutical marketing

The world health organization defines pharmaceutical promotion as
Information and persuasive activities executed by pharmaceutical manufacturers
and distributors, attempting to affect the prescription, supply, purchase, and/or
use of medical drugs

Pharmaceutical companies undergo two streams of marketing, a push stream
targeted at the decision maker and a pul stream targeted at the end consumer.
The push strategy aims at influencing physicians prescription choices through
promotional push elements like dealing, drug sampling, journal articles, journal
advertising, conferences and medical meetings, research grants and sponsoring of
continuing medical education programs, on the other hand, the pull strategy aims
to place pressure over the physician to prescribe a specific drug in accordance to
a patients request

According to Willams and Mansels (1981) classification, pharmaceutical
promotional push elements can be further classified into commercial and non
commercial informational channels. Commercial sources are informational
channels initiated by pharmaceutical companies and mainly focus on delivering
direct promotional messages on à certain drug and are known as marketer
controlled sources of influence. Among the commonly used commercial
Informational sources are detailing, drug samplesgift premiums, journal
advertising and direct mall, Non-commercial sources, on the other handare
‘usualy initiated By clinical researchers, public health crits, academic physicians,
and pharmaceutical companies. Among the commonly used non-commercial
Informational sources ae journal articles, clinical trials, conferences and medical
meetings

Types of Pharmaceutical Markets
LL Traditional markets

+ Drug stores

9. + Hospitals
+ Industrial lines
+ Medial clinics

2. Non-Traditional markets
+ Groceries & supermarkets
+ Trading stores

+ NGOs & charitable Institutions

nee wns

BIETE con per

‘Songer reared mmurcatt TS

pores nn mer

TABLENO Process in Pharmaceutical Marketing

Pharmaceutical companies appoint medical representatives and assign them
defined territories. Medical representatives meet doctors, chemists and stockiest
as per company norms. Medical representatives try to influence prescription
pattern of doctors in favors of their brands. A medical representative has to
redefine trol, he should know SPICE Concept of Pharmaceutical marketing.

10. 5: Specific
P: Product Knowledge
1: Inclinical Activity
€: Communicate effectively
+ E Encase in terms of Prescription.
Sources of Ethical Pharmaceutical Promotion

Detailing

Pharmaceutical detailing is a marketing technique used by pharmaceutical
companies to educate a physician about a vendor's products in hopes that the
physician will prescribe the companys products more often. Although this
practice is controversia, many drug companies spend bilions of dollars a year on
this legal tactic

Approximately 60% of the physicians complained that most representativos have
limited medical knowledge and expertise about what they are dealing for, they
also crtcized representative's avoidance of discusing their drugs ide effects and
drug price during a dealing visi

Sampling and gift-giving

Only 44.3% of physicians indicated that drug samples can influence their
prescriptions, and added that samples cannot be used for testing drug efficacy
They further explained that the sample dosage is usually too small and not
enough for a complete course of treatment, thus Ineffetive for testing drug
efficacy.

Opinions of physicians and pharmaceutical experts were controversial concerning
the ethics of gift giving and promotional items. All interviewed physicians
confimed that git premiums can never guide or influence their prescription
choices, 76% of the physician confirmed that they are not obliged o reciprocate

11. fits in any manner and this implies that gilts do not exert reward power over
prescriptions. Physicians further noted that git such as office sets and wall locks,
act as effective remainders ofthe drug and the representatives vist. Finally, 60%
of the physicians considered it ethical to accept gts such as office sets and
invitations to conferences, And they all agreed that medical oriented gifts are
ethical and highly acceptable when compared to non-medical and extravagant
gts.

Conferences and medical meetings

Both physicians and pharmaceuticals experts agreed that its socaly responsible
and ethical for pharmaceutical companies to fund and sponsor national and
international medical conferences and meetings to help in the ease of knowledge
transfer, physicians further noted that the credibility of speakers enhances the
effectiveness and influence of conferences and medical meetings, physicians
added socially responsible pharmaceutical sponsor young physician's attendance
at conferences, medical meetings, and CMES to improve their educational level
and give them more access to experts in their fed

Ethical problems associated with Pharmaceutical Marketing

A great deal of public attention surrounds pharmaceutical marketing practices
and many arguments evolve around the impact of pharmaceutical marketing on
physician's behavior. Two competing views have dominated discussion on the
matter. The fist view reflects the opinions of public policy organizations and
consumer advocacy groups who generally constitute the opponents of
pharmaceutical marketing.

They claim that pharmaceutical promotion practices have negative effects on
patients welfare as they are assumed to be the main reason behind the increase
in public health costs and the increase in drug price. Moreover, medical
representatives along with other promotional elements are seen to be
significantly influencing physicians towards prescribing expensive branded drugs
rather than cheaper generi alternatives of similar efficacy.

12. Chain of Pharmaceutical Market

The pharmaceutical distribution channel is indirect with usually thee channel
members ie. depot/CAF, Stockiest and Chemist

Pharmaceutical companies appoints one company depot or C&F agent usually in
each state and authoried stockest in each district across the country. Company
ddepot/CAF sends stocks to authorize stockiest as per the requirement.

Retal chemists buy medicines on daily weekly bass from authorized stockiest as
per demand. Patients vist chemists for buying medicines either prescribed by a
doctor or advertised in the media

COMPANY DEPOTICAE

STOGKIEST -——

— jaca nar samc

CHEMIST

TABLENO.2 Chain of Pharmaceutical Marketing

13. India in Pharmaceutical Marketing

The Indian Pharmaceutical market is the world's 4th largest by volume (8% of
total) and 13th largest by value (less than 1% of global total),

Over the past 40 years or so the Indian pharmaceutical sector witnessed rapid
growth and transformation. From a mere volume of just Rs. 10 core in 1947, the
industry registered a sales turnover of about US $ 5.5 bilion in 2004 with an
annual growth rate of about 17%. The flexible provisions of the Patent Act of 1970
and other supportive policies ofthe Government of India played an instrumental
role in the growth and development of this industry. Given the importance of
public policies in influencing the present structure of the industry this chapter,
reviews in brief the important policy changes that have taken place in this sector
and also examines the current changes in the structure of the industry and the
changing behavior of firms in responding to policy changes.

The Evolution of the Indian Drug and Pharmaceutical Industry

The history of the evolution ofthe Indian pharmaceutical industry can be divided
into four principal epochs. The first epoch is from 1850 to 1945, The second
epoch spans from 1945 to the late 19705. The third epoch for development is
from the early 1980s to the early 1990s, and the fourth epoch spans from the
carly 19905 tothe present time

14. LIST OF COMPANIES IN INDIA

©
©
a
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©
©
©
©
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NO: : LIST OF COMPANIES IN INDIA

15. INTRODUCTION
FUNG!
Fung are lving things that ae classified independently from plants or creatures,

They move around by spreading out or sending spores (regenerative parts) into
the discuss or environment,

FUNGALINFECTION

Fungal infections, are diseases caused by a organism (yeast or mola). Fungal
diseases are not only common on skin or nals, but fung! (plural of fungus) can too
cause contaminations in your mouth, throat, lungs, urinary tract and numerous
other parts of your body,

Superficial fungal infections are considered to affect 20-25% of the population
Worldwide, and their incidence continues to rise annually

‘Symptoms of fungal infections in other parts of your body include:

Fungal infection in or around your brain: Headache, fever, neck pain,
nausea/vomiting, sensitivity to light, confusion,

Fungal Infection of your eye: Pain, redness, discharge, blurred visio, tearing,
sensitivity tight.

Fungal infection of your intestinal tract Abdominal pain, nausea, vomiting.

Fungal infection of your sinuses: Fever, nasal congestion, headache, one-sided
facial swelling face pain.

CLASSIFICATION

Based on site of infection, fungal infection are of 4 types

Superficial or Cutaneous fungal infection:

Superficial or cutaneous fungal infection occurs inthe skin hl, and nals that are
restricted tothe keratinized layers of the skin and its appendages.

16. Causing agent dermatophytes (agents of ringworm, athlete's foot, yeasts of the
Candida genus

Subcutaneous fungal infection:

Subcutaneous fungal infection ate localized infections of the skin and underlying
tissues. It occurs when the fungus from the environment gains access to deeper
tissues ia a ut or puncture wound pathe skin,

Causing agent Rhizopus, Mucor, Rizomucor, Lichtheimia, Saksenaea e
Systemic fungal infection:

Systemic fungal Infection occurs In internal organs such as the lungs, bra are
disseminated via the bloodstream to multiple organs.

Causing agent Histoplasma capsulatum, Coccidioidesimmitis etc

Opportunistic fungal infection:

They can cause infections in immuno-suppressed individuals (peop or organ
transplant recipients, et). infections, undergoing cancer therapy

Causing agent-Candida albicans, Cryptococcus neoformans, Rhizopus, Mucor etc
Fungal skin infection

Super cil fungal infections are caused by many fungi, which can invade various
aspects of the human body. These infections include dermatophytes, which infect
keratnized epithelium, har follies, and nal apparatus. Fungus infect non viable,
keratnized cutaneous structures such as Stratum comeum, nails, and hair, An
epidermal skin infection i called epidermomycosi

Infections caused by the genus Fusarium have emerged over the past decades
and range from onychomycosis and keratitis in healthy individuals to deep and
disseminated infections with high mortality rates in immune-compromised
patients.

17. ANTIFUNGAL

These are drugs used for superficial and deep (systemic) fungal infections A

isquietening trend after 1950s is the rising prevalence of more sinister type of
fungal infections which are, to a large extent, iatrogenic. Fungal infections are
‘mostly associated with the use of broadspectrum
antbiotics,coriosteroidsanticancer/immunosuppressant drugs, dentures,
Indwelling catheters and implants, and emergence of AIDS. As a result of
breakdown of host defence mechanisms by the above agents, saprophytic fungi
easly invade ving tissue.

Many topical antifungals have been available since the antiseptic era. Two
important antbio- ties vz. amphotericin B-to deal with systemic mycosis, and
Eriseofulvint0 supplement attack on dermatophytes were introduced around
1960. Antifungal property of flucytosine was noted in 1970, but it could serve only
a5 a companion drug to amphotericin, The development of imidazoles in the mid
19705 and trozos in 1980 provided safer and more convenient alternatives to
amphotericin 8 and griseofuvin. Terbinafine is à novel antifungal. A group of
potent semisynthetic antifungal antibiotics, the Echinocandins are the latest
addition.

TRBLE NO: CLASSIFICATION OF ANTIFUNGAL

18. IMIDAZOLES AND TRIAZOLES (AZOLES)

These are presently the most extensively used antifungal drugs.

Four imidazoles are entirely topical, while ketoconazole is used both orally and
topically. Two trazoles fluconazole and itraconazole have largely replaced
ketoconazole for systemic mycosis because of greater efficacy, longer 1%, as well
as fewer sid effects. Voriconazole and posaconazole ae the newer triazoles

The azoles have broad-spectrum antifungal activity covering dermatophyte,
Candida, other fungi involved in deep mycosis (except mucor), Nocardia and
Leishmania,

The azoles act by inhibiting fungal cyto- chrome PASO enzyme ‘anosterol 14
demethylase and thus impair ergosterol synthesis (see Fig. 58.1). This leads to a
cascade of membrane abnormalities in the fungus. The lower host toxcty of
tazoles compared to imidazoles has correlated with their lower affinity for
‘mammalian CYPASO enzymes and lesser propensity to inhibit mammalian sterol
synthesis,

Development of fungal resistance to atoles has been noted among Candida
infecting advanced AIDS patients, but has not so far posed significant clinical
problem in immunocompetent patents, except fluconazole resistance among
Candida causing esophageal and other deep candidasis. Many of fluconazole.
resistant Candida respond to itraconazole or to voriconazole. Mutation of the
ene encoding for fungal 14-demethylase enzyme underlies azole resistance

Clotrimazole Its the most commonly used topical imidazole effective in the treat
ment of tinea infections like eingworm: 60-100% cure rates are reported with 2-4
weeks application on a twice dally schedule, Athletes foot, otomycosis and
oral/cutaneous/ vaginal candidiasis have responded in >€0% cases. It is
particulary favoured for vaginitis because of a long lasting residual effect after
once dally application, A 7 day course Is generally used, For oropharyngeal
candidiasis 10 mg troche of clotrimazole is allowed to dissolve in the mouth 3-4
times a day, or the lotion/ge is applleg/swited in the mouth for as long as

19. possible, I is also effective in skin infections caused by Corynebactera, but like
most topical antifungals, has poor efficacy in tinea capitis (scalp) and tinea
unguium (nai)

Clotrimazole is well tolerated by most patients. Local irritation with stinging and
burning sensation occurs in some. No systemie toxicity is seen after topical use.
SURFAZ, CLODERM 1% lotion, cream, powder, 1% ear drops with 2% lidocaine,
100 mg vaginal tab. CANDID 1% cream, mouth paint, powder, 1% ear drops with
2% lidocaine

Econazole Its similar o clotrimazole; penetrates superficial layers of the skin and
is highly effective in dermatophytess, otomy- cosis, oral thrush, bu is somewhat
inferior to clotrimazole in vaginitis. No adverse effect, except local irtaion in
few is reported

ECONAZOLE 1% ont 150 mg vaginal tab, ECODERM 1% cream.

Miconazole I is a highly efficacious (290% cure rate) drug for inca, plyriasis
versicolor. otomycosis, cutaneous and vulvova diasis. Because of its good
penetrating power single application on skin acts for a few days. ration after
cutaneous application is infrequent, but a higher incidence of vaginal iitation is
reported in comparison to clotrimazole.

DAKTARIN 2% gel, 2% powder and solution, GYNODAK- TARIN 2% vaginal gel:
ZOLE 2% oimt, lotion, dusting powder and spray, 1% ear drops, 100 mg vaginal
ovules

Oxiconazole A newer topical imidazole anti fungal effective in tinea and other

<dermatophytic infection, as wells in vaginal candidasis

Local Iritaion can occur in some patients. OXIZON, ZODERM: oxiconazole 196
with benzoic aci 0.25% cream/lotion; apply topically once or twice dal.

Ketoconazole (KTZ)

I is the first orally effective broad-spectrum antifungal drug, useful in both
dermatophytsis and deep mycosis, but has been overshadowed by the newer

20. trazoles. The oral absorption of KIZ is facilitated by gastric acidity. Hepatic 5
metabolism is extensive; metabolites are excreted in urine and faeces with a
Variable 1% of 4-8 hours. The oral dose is 200 mg OD, but systemic use of KTZ is
Infrequent now. FUNGICIDE, NIZRAL, KETOVATE 200 mg tab

FUNGINOC 2% int, 2% shampoo (for dandruff), KETOVATE 2% cream. NIZRAL 2%
cream, 2% lotion; DANRUF 2% sham- poo, HYPHORAL 2% lotion

Adverse effects Ketoconazole produces more side effects than itraconazole or
fluconazole.The most common side effects are nausea and vomiting others are
loss of appetite, headache, paresthesia, ashes and har loss. The major drawback
OF KTZ its hormonal eects. It decreases androgen production from testes, and
isplaces testosterone from protein binding sites. Gynaecomasta, loss of hair and
libido, and oligozoospermia may develop when the drug is used for afew weeks.
Menstrual regularities occur in some women due to suppression of estradiol
synthesis. A dose-dependent decrease in serum hydro-cortisone due to synthesis
inhibition has also been noted

Interactions Ketoconazole (and most azoles) interact with several drugs. Due
consideration must be given when azoles are coprescrbed with other drugs.

H blockers, proton pump inhibitors and, antacids decrease oral absorption of KTZ
by reducing gastrie acidity. Rifampin, phenobarbitone, carbamazepine and
phenytoin induce KTZ metabolism and reduce its efficacy. Ketoconazole inhibits
CYPASO enzymes,especilly CYP3A4, C¥P2C9; CYP2C19 and rases the blood levels
cof several drugs

including

Phenytoin Digoxin Omeprazole,Carbamazepine Diazepam Haloperidol Warfarin
vifonylureas Cyclosporine,Nifeipine and other DHPSMIV protease
Inhibitors, statins.

Use Orally administered KTZ is effective in dermatophytosis because it is
concentrated in the stratum corneum, but use is restricted due to potential
adverse effects, Used as a lotion or shampoo, KTZ ls quite effective in seborrhoea

18

21. of scalp and dandruf. Pityriasis versicolor involving limited area of skin can also
be treated by topical application of the lotion/shampoo formulation Weekly
treatment may be continued to prevent recurrences

Though effective in monilal vaginitis, oral therapy (for 5-7 days) with KTZ is
reserved for recurrent cases. or those not responding to topical agents

ral KTZ is no longer used in systemic mycosis. High-dose KTZ has been used in
Cushing's syndrome to decrease corticosteroid production.

Fluconazole It is a water-soluble triazole having a wider range of activity than KT;
Indications include cryptococcal meningitis, ss- temic and mucosal candidiasis in
both normal. and immunocompromised patients, coccdioidal meningitis and
some tinea infections. Fluconazole is 94% absorbed; oral bioava-ability is not
affected by food or gastric pH. It is primarily excreted unchanged in urine with a
4 of 25-30 hr, Fungicidl concentrations are achieved in nal, vagina and salva
I is the preferred azole fr fungal meningitis because of good penetration into
brain and CSF. Dose reduction is needed in renal impairment.

Adverse effects The gastrointestinal tolerabil- ity of fluconazole is better than
other aroles, but nausea, vomiting, abdominal pain, rash and headache are
produced. Incidence and severity of these side effects Increases with dose and
duration of therapy Selectiviy for fungal eytochrome P450 is higher. Unike KZ, it
oes not inhibit steroid synthesis in man: antiandrogenie and other endocrine
side effects have not occurred. Elevation of hepatic transaminase has been noted
in AIDS patients.

Fluconazole is not recommended in pregnant and lactating women Interactions
le fluconazole affects hepatic drug metabolism to a lesser extent than KTZ,
Increased plasma levels of phenytoin, cyclospo- rine, warfarin, zidovudine and
sulfonylureas have been observed. The drug interaction potential of fluconazole is
the lowest among azole antifungals, but caution needs to be applied in
coadminister- ing other drugs. Proton pump inhibitors and H, blockers do not

afectits absorption

22. Use Fluconazole can be administered orally as well as iv. in severe infections) À
single 150 mg oral dose can cure vaginal candidiasis with few relapses.

Oral fluconazole (100 mg/day for 2 weeks) is highly effective in oropharyngeal
candidiasis, but is reserved for cases not responding to topical antifungals
Fluconazole (100 mg/day) for 2-3 weeks is the frst line treatment for candida
esophagitis, Most tinea infections including piyrasis versicolor involving large
area of skin and cutaneous candidiasis can be treated with 150 mg weekly
fluconazole for à weeks

For disseminated candidiasis, cyptocorcal or cocciioidal meningitis and other
systemie fungal infections the dose is 200-400 mg/ day for 4-12 weeks or longer.
In candidemia, therapy may be initiated with iv. fluconazole and continued orally
Long-term oral fluconazole maintenance therapy after initial treatment with iv
AMB is used in AIDS patients with fungal meningitis to prevent relapse. An oye
drop is useful in fungal keratit

Fluconazole is ineffective in aspergilosis and mucormycosis, and inferior to
itraconazole for histoplasmosis, blastomycosis and sporotrichosis, as well as for
tinea unguium. SYSCAN, ZOCON, FORCAN, FLUZON 50, 100, 150, 200 mg caps, 200
m8/100 mii. infusion SYSCAN 0.3% eye drops

Itraconazole This orally active triazole ant- fungal has a broader spectrum of
activity than KTZ or fluconazole; includes few moulds like Aspergillus as well
Some fluconazole resistant Candida are susceptible. Is fungistatc, but effective
in immunocompromised patients. Ste- oid hormone synthesis inhibition is absent
in itraconazole, and serious hepatotoxicity i rare.

Oral absorption of itraconazole is variable. itis enhanced by food and gastic acid
Itraconazole i highly protein bound, has a large volume of distribution (20 UKe),
accumulates in vaginal mucosa, skin and nal, but penetration into CSF is poor. It
is largely metabolized in ver by CYP3AA; an ative metabolite is produced which
is excreted in faeces Us varies from 24-40 hours

Itraconazole is well tolerated in doses below 200ma/day, but doses> 400 me/day
are poorly tolerated. Dizziness, pruritus, headache and hypokalaemia are the

20

23. other common side effects. Unsteadiness and impotence are infrequent. Plasma
transaminase may rise and liver damage is reported. However, antiandrogenic
and other hormonal adverse effects are not seen. Impaired left ventricular
function has been worsened in some patients after prolonged treatment with
Itraconazole,

Drug interactions Oral absorption of tracona- zole is reduced by antacids, H,
blockers and proton pump inhibitors Rifampin, phenobarbitone, phenytoin and
carbamazepine induce itraconazole metabolism and reduce is efficacy.On the
other hand, clarithromycin and HIV protease inhibitors reduce the metabolism of
itraconazole and rise its blood levels.

Itraconazole inhibits CYP3AS, but the effect on metabolism of other drugs i less
marked than that of KTZ, Nevertheless, phenytoin, digoxi, slfonylureas, statins,
dihydropyridines, protease inhibitors, warfarin and cyclosporine levels are
increased by itraconazole

Uses itraconazole i the preferred azole antifungal for most systemic mycosis (see
Table 58.1) that are not associated with meningitis It is superior to fluconazole
for histoplasmosis, blastomycoss, sporotrichosis and ls the drug of choice for the
rare fungal infections paracocci- dicidomycosis and chromamycosis. It also
fords some rele in chronic aspergilosis, but voriconazole is superior. A dose of
200 mg 00/ BD with meals is used for 3 months or more.

Vaginal candidiasis: 200 mg OD oral for 3 days is as effective as intravaginal
Clotrimazole. Dermatophytosis: 100-200 mg OD for 7-15 days. itraconazole is
mare effective than griseofulvin, but systemic therapy is resorted to only when
topical antifungals all orn patients with extensive involvement or scalp infection.

‘onychomycosis: 200 me/day for 3 months. An intermittent pulse regimen of 200
mg 80 for 1 week each month for 3 months is equally effective. Relapses have
occurred after tracona-zol therapy, though it remains in the nal or few months
after completion ofthe course, Pityriasis versicolor: Oral itraconazole isthe drug
of choice when systemic therapy is needed for involvement of extensive area of

24. skin SPORANOX, CANDITRAL, CANDISTAT, ITASPOR, FLU- COVER 100 mg cap.
ITASPOR 100 mg cap, 200 mg/20 mi vial

Table

25. SECTION 2

2

26. Objective of Research

A comparative study between the brands turnover inthe month of March
To understand the basic psychology of the pharmaceutical market

For understanding the policies which were implemented by various
pharmaceutical companies to improve their sales in the financial year
ending month 2023,

For getting a market based sales report & understanding the demerits of
the company’s strategy due to which they were lagging behind

27. Requirement for research work

Literature media:
+ cms.
Drug today
Journals

Textbooks

2. Electronic media
+ Software

+ Websites

3. Social media:
+ Medial store
+ Pharmacist
+ stockiest

+ Medical representatives

28. Clotrimazole Market Overview: a
Clotrimazole Market ie is estimated to reach USS4.2 bilion by 2030, growing
at a CAGR of 62% during the forecast period 2024-2030. The increasing
prevalence of diseases and the growing application of clotrimazole in other
forms of Disease Treatment are expected to propel the growth of clotrimazole
market

‘Additionally, Rising Incidence of fungal infections due to various factors, fungal
infections affect milions of people worldwide, and several factors contribute to
their increasing incidence, These factors include the growing elderly population,
the rising prevalence of immunocompromising conditions such as HIV/AIDS and

diabetes, widespread use of immunosuppressive therapies, increased global
travel leading t the spread of fungal pathogens, and changes in environmental
conditions favoring fungal growth, Focus on natural and organi alternatives are
also ifluencing the clotrimazole market, with an increasing demand for natural
and herbal alternatives to conventional antifungal medications. Consumers are
Seeking products that are perceived to be safer, gentler on the skin, and
‘environmentally friendly. As a resul, there's a rise in the development and
marketing of clotrimazole formulations containing natural ingredients such as
tea tree ol, aloe vera, and coconut ol

Market Snapshot:

29. Clotrimazole Market - Report Coverage

The “Clotrimazole Market Report - Forecast (2024-2030)" by IndustryARC,
covers an in-depth analysis of the following segments in the Cloteimazole
Market

COVID-19 Ukraine Crisis - Impact Analysis:

+ During the COVID-19 pandemic, the market for clotrimazole in Ukraine
experienced significant impacts. Initially, there was a surge in demand for
Clotrimazole products as people became more conscious about personal hygiene
and healthcare, leading to increased purchases of antifungal medications. This
uptick in demand was driven by concerns about fungal infections. As a resul
pharmacies and retallers faced challenges in keeping up with the heightened
(demand, leading to temporary shortages of clotrimazole products in some regions.

+ The geopolitical events and uncertainties in Ukraine also influenced the
Clotimazole market. There was à shift in consumer behavior and purchasing
patterns. Non-essential travel restrictions, social distaneing measures, and
reduced outdoor activities led to a decline in the incidence of fungal infections,
particulary those associated with communal environments such as public pools
and gyms, Consequently, the demand for clotrimazole products started to
stablize and even decrease in certain segments

Key Takeaways:
“+ North America Dominated the Market

Geographically in the Clotrimazole market share, the North America region is
analyzed to hold a dominant market share of 34% in 2023, It is due to a high
prevalence of various diseases that can be controlled with the application of
Clotrimazole. As per Science Direc findings, it is estimated that more than 70% of

the US. population would develop tinea pedis/athete foot during their fetime.

30. 2

North America is home to numerous pharmaceutical companies that manufacture,
market, and distribute medications globally. The presence of these companies
contributes to the avallablity and accessibility of Clotrimazole products in the
market. However, Asia-Pacific is estimated to be the fastest-growing region, with
2 CAGR of 8.4% over the forecast period. It Is because of the growing role of
digtaVtelehealth platforms in semi-urban societies such as India which would
proliferate the demand for medicines, such as Clotrimazole,

+ Online Pharmacies isthe fastest growing segment

In the Clotrimazole Market forecast, Online Pharmacies segment is estimated to
grow with a CAGA of 7.8% during the forecast period. I is owing to the ising
ia health-check up and digital prescriptions that would allow patients to order
medicines at Iverative discounts and convenience. This convenience factor is
particularly appealing to patients with chronic conditions who require regular
medication refills. Moreover, online pharmacies provide a wider selection of
products and the ability to compare prices and read reviews, empowering
consumers to make informed decisions about their healthcare. As online
pharmacies continue to evolve and expand their services, they are poised to
become a cornerstone of the healthcare industry, providing accessible and
affordable medication solutions o a growing number of patients worldwide.

+ Cream Segment to Hold Largest Market Share

According o the Clotrimazole Market analysis, the Cream segment is estimated to
hold the largest market share of 42% in 2023, I is owing to the vast convenience
ofthe product. The drug is mainly used to treat fungal or yeast infections such as
ringworm, athlete’ fet, jocks ich, and others, most of these are treated with
cream form as it is easy to apply and store. These kinds of contaminations can be
‘ured within 7-8 days by using cream and patients don't need to consult a doctor
to use the cream, These key factors are expected to contribute significantly to
revenue growth of the segment. Furthermore, cream as à topical agent has been

31. trusted by doctors and patients alike owing to its sticking capacity to the skin
surfaces. The cream form of clotrimatole is mostly prescribed to patients
suffering from vaginitis which affects nearly 23%-29% globally

+ The Increasing Prevalence of Diseases such as Vaginitis, Athlete's Foot and
Others

Bacterial vaginosis or vaginitis has been revered as the most common cause of
vaginal symptoms amongst women as per the CDC. The prevalence of the
following condition in the US. is gauged to be 21.2 milion or 29.2% amongst
women aged 14-49. Furthermore, CDC estimates that the increasing number of
cases is largely correlated with he rising number of sexual partners in a lifetime.
As per the National Center of Health Statistics, the median number of opposite
sex partners in a lifetime for women stood at 4.3. Lastly, the African-American
populations prevalence of the following condition is sizable, larger than white
‘women. Owing to a critical growth in the mentioned ethnicity in the region - the
market would grow during the forecast period

+ The Growing Application of Clotrimazole in Other Forms of Disease Treatment

Clotrimazole was intially approved for the treatment of fungal applications.
However, a body of research indicated the probable usage of the drug as an
anticancer therapeutic. The mechanism of action is based on the inhibition of
mitochondral-bound glycolytic enzymes and calmodulin, which starves cancer
calls of energy. Clotrimazole and its derivatives have been shown to decrease
rates of cancer cell proliferation, induce G1 phase arrest and promote pro:
apoptotic factors, which lead to cell death. As per Cancer.Org, the estimated
number of new cancer cases within the U.S. would be equivalent to 1.9 milion
Furthermore, clotrimazole is extremely useful in cases of dermatitis. The
Worldwide prevalence of seborrhele dermatitis is around 5%, Due to these
reasons the market would offer steadfast opportunities

32. 2 The Sizable Number of Side Effets and the Availability ofa Larger Number of
Substitutes in the Segment

As per Mayo Clinic, blurred vision, daziness or fainting, fast and irregular
heartbeat pounding, increased thirst and urination and unusual tiredness are
some of the common side effects of consuming Clotrimazole. The common
alternatives to clotrimazole cream are fluconazole and Diflucan. Moreover, these
alternatives present a different delivery route, thereby expanding the applicative
usage. For example, fluconazole is either provided through an intravenous
Solution or oral powder and tablet, while Diflucan is largely provided in oral
powder and solution. The per-unit cost of fluconazole is nearly equal to
Clotvimazole, which is $1.35 vs $1.25,

TABLE NO 7: CLOTRIMAZOLE MARKET SHARE BY REGION

Key Market Players:

Product/Service launches, approvals, patents and events, acquisitions,
partnerships and collaborations are key strategies adopted by players in the
Cloimazole Market. The top 10 companies inthis industry are listed below

Bayer AG; Errglerr SPA; Novartis AG; Amol Organies Put. Ltd. ;Guangehou
Hanpu Pharmaceutical Co, Li. ¡Manus Aktteva Biopharma LLP; Olon SpA Ciron
Group ;GSK ple ;Actiza Pharmaceutical Pur. Lt,

33. Scope of Report:

‘TABLE NO: SCOPE OF REPORT

34. SECTION 3

2

35. RESULT

+ RESEARCH DATA AS PER SURVEY:

Some Popular Brands of Dry;

Effectiveness of clotrimazole

36. + SURVEY REPORT ON BAR GRAPH:

‘TABLE NO.0: SURVEY ON BAR CHART

37. SECTION 4

38. Conclusion

From our survey we have got a very pecullar report of the sales In Cul Lines,
INAINI Kata, &Balson. After interpreting the sales report which is obtained from
the neighboring localities of Allahabad revealed that,Candid-8(Glenmark) is
leading brand in Anti-Fungal segment. The other leading brands which were
having 2 good reputed sales are in the following order Cipla(Clocip) Janssen
(Clotrimaderm), Bayer Healthcare (Lotrimin} FOC{Zocon),

It reveals that Glenmark being the oldest player in the segment, stil dominates
the market & has the biggest market share, the other companies are having the
less market share because thelr marketing strategy oF lack of vision for
improvement in their marketing. It has been felt & understand by us that, i the

nonperforming companies want to improve their market share then they have to
come up with quality product with effective price with stringent marketing plan of

39. Bibliography

+ Tripathi KD. "Essential of Medical Pharmacology’, edition 8th jaypee brother
medical publishers page no. 84,

‘Joshi, Hemant N. “Analysis ofthe Indian Pharmaceutical Industry with emphasis
on opportunities in 2005" Pharmaceutical Technology, Pa.No.74-84

+ Overview of the Indian Pharmaceutical Industry; Asia Business Generator
Project (Osaka International Business Promotion Center); TATA Strategie
Management Group,

+ The Indian Foreign Trade Policy (1% September, 2008 to 31 March, 2009);
Gazette of India Extraordinary Part, Section 3, Subsection (i

+ The India lnk on the Business Standard website as seen on 29th December,
2008.

+ Indian Pharmaceutical Industry Overview: http://www pharmaceutical-drug
manufacturers.com/pharmaceuticalindustry/

+ Research & Development http://www. pharmaceutica-drug
‘manufacturers.com/pharmaceutical-industr y/tesearch-development htm!

+ hueps://wwindustryar.com/Report/17881/clotrimazole-market html