← Search & browse all drugs
ANTIINFECTIVES FOR SYSTEMIC USE › ANTIMYCOTICS FOR SYSTEMIC USE › ANTIMYCOTICS FOR SYSTEMIC USE › Imidazole derivatives
miconazole
J02AB01
Forms & Strengths
- Vaginal suppository: 100 mg, 200 mg, 1200 mg
- Vaginal cream: 2%, 4%
- Topical cream: 2%
- Topical ointment: 2%
- Topical powder: 2%
- Oral mucosal gel: 20 mg/mL
Adult Dosing
- Vulvovaginal candidiasis: 1200 mg vaginal suppository x 1 once, OR 200 mg suppository daily x 3 days, OR 100 mg suppository daily x 7 days
- Topical fungal infections (tinea): Apply to affected area twice daily for 2 to 4 weeks
- Oral candidiasis: 2.5 mL (50 mg) oral gel applied four times daily after meals
Pediatric Dosing
- Oral candidiasis (infants >= 6 months): 1.25 mL (25 mg) oral gel applied four times daily after meals
- Topical fungal infections (>= 2 years): Apply to affected area twice daily for 2 to 4 weeks
Indications
- Vulvovaginal candidiasis
- Topical dermatophyte infections (tinea pedis, tinea cruris, tinea corporis)
- Cutaneous candidiasis
- Orally administered or applied gel for oral cavity candidiasis
Mechanism of Action
- Inhibits fungal cytochrome P450 14-alpha-demethylase
- Blocks conversion of lanosterol to ergosterol
- Causes increased fungal cell membrane permeability and leakage of cellular contents
Contraindications
- Known hypersensitivity to miconazole or other azole antifungals
- Co-administration with drugs metabolized by CYP3A4 that prolong QTc interval (e.g., cisapride, pimozide, quinidine)
Adverse Reactions
- Vaginal burning, irritation, or itching (vaginal formulations)
- Local skin irritation, burning, or maceration (topical formulations)
- Nausea and vomiting (with oral gel ingestion)
- Headache
Drug Interactions
- Significant systemic absorption from vaginal or oral gel can inhibit CYP3A4 and CYP2C9
- Increases plasma concentrations of warfarin, potentially elevating bleeding risk
- Increases exposure and toxicity risks of statins (e.g., simvastatin, lovastatin)
- May increase serum concentrations of phenytoin and sulfonylureas
Curated Content: Needs Vetting Before Put to Clinical Use