Miconazole

Indications
 Mouth/Throat
Intestinal or oropharyngeal candidiasis
Adult: As oral gel containing 20 mg/g (24 mg/ml): 5-10 ml after food 4 times a day. Retain near oral lesions before swallowing. Continue treatment until 48 hr after lesions have healed. For treatment of oral lesions, apply directly onto the lesions 4 times a day for 5-7 days. Continue treatment until 48 hr after lesions have healed.
Child: As oral gel containing 20 mg/g: 1 mth-2 y: 2.5 ml bid. 2-6 yr: 5 ml bid. >6 yr: 5 ml 4 times a day. Retain near oral lesions before swallowing. Continue treatment until 48 hr after lesions have healed.
Vaginal
Vaginal candidiasis
Adult: 100 mg (as pessary or 5 g of 2% cream) inserted at night for 7-14 days. Alternatively, 100 mg bid for 7 days; 200 or 400 mg (as pessaries) daily for 3 days or 1200 mg (as pessary) as a single dose.
Topical/Cutaneous
Skin fungal infections
Adult: Apply 2% cream once daily.
Child: Apply 2% cream once daily.
Contraindications
 Hypersensitivity; hepatic impairment (oral gel). Porphyria.
Warnings / Precautions
 For external use only; discontinue if sensitization or irritation occurs. Pregnancy and lactation.
Adverse Reactions
 Nausea, vomiting, febrile reactions, rash, drowsiness, diarrhoea, anorexia and flushing, hepatitis. Local irritation and sensitisation, contact dermatitis.
Potentially Fatal: IV: Anaphylactic reaction and cardiac arrest.
Drug Interactions
 Increased toxicity reported with carbamazepine. Miconazole acts as an inhibitor of CYP3A4 and CYP2D6 and may, therefore, interact with a large number of drugs e.g. statins, HIV protease inhibitors, ciclosporin, tacrolimus, sildenafil, quinidine, pimozide.
Potentially Fatal: Potentiates anticoagulant effect of warfarin. Increased risk of cardiotoxicity with cisapride, astemizole or terfenadine.
See Below for More miconazole Drug Interactions
Mechanism of Actions
 Miconazole inhibits ergosterol biosynthesis thus damaging fungal cell wall membrane and increases its permeability, allowing leakage of nutrients.
Absorption: Incomplete from the GI tract (oral); minimal (topical).
Metabolism: Hepatic; converted to inactive metabolites.
Excretion: 10-20% of an oral dose will be excreted in urine (as metabolites), 50% of an oral dose is excreted as unchanged drug in the faeces. Elimination half-life: 40 minutes (initial), 126 minutes (secondary), 24 hr (terminal).
ATC Classification
 D01AC02 - miconazole ; Belongs to the class of imidazole and triazole derivatives. Used in the topical treatment of fungal infection.
A01AB09 - miconazole ; Belongs to the class of local antiinfective and antiseptic preparations. Used in the treatment of diseases of the mouth.
G01AF04 - miconazole ; Belongs to the class of imidazole derivative antiinfectives. Used in the treatment of gynecological infections.
J02AB01 - miconazole ; Belongs to the class of imidazole derivatives. Used in the systemic treatment of mycotic infections.
A07AC01 - miconazole ; Belongs to the class of imidazole derivative antiinfectives. Used in the treatment of intestinal infections.
S02AA13 - miconazole ; Belongs to the class of antiinfectives used in the treatment of ear infections.
Available As
  • Miconazole 0.01% w/w
  • Miconazole 1%
  • Miconazole 1% w/v
  • Miconazole 100 mg
  • Miconazole 2 % w/w
  • Miconazole 2%
  • Miconazole 2% w/v
  • Miconazole 2% w/w
  • Miconazole 2.0% w/w
  • Miconazole 2.00 w/w
  • Miconazole 2.00% w/w
  • Miconazole 200 mg
  • Miconazole 3%

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