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Bifonazole is an imidazole antifungal drug used primarily for the topical treatment of superficial fungal skin infections, including athlete's foot (tinea pedis), dermatophytoses, cutaneous candidiasis, and pityriasis versicolor. It is also used in combination with urea for onychomycosis. Bifonazole acts by inhibiting ergosterol biosynthesis at two points in the fungal cell membrane pathway—specifically by inhibiting lanosterol 14-alpha demethylase (cytochrome P450 51) and directly inhibiting HMG-CoA reductase. This dual mechanism disrupts the integrity of the fungal cell membrane, leading to cell lysis and death. Bifonazole may also inhibit keratinase, reducing inflammation associated with infection[1][2][5][6][8]. It was patented in 1974 and approved for medical use in 1983[5].
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