Indications
Miconazole treats fungal and yeast infections:
- Cream: skin infections such as ringworm, athlete foot (tinea pedis), jock itch (tinea cruris), fungal infections of skin folds and yeast (Candida) infections of the skin, including nappy rash infected with yeast. Creams combined with Hydrocortisone also calm inflamed, itchy rashes.
- Oral gel: thrush (Candida infection) of the mouth and throat.
- Vaginal tablets (usually combined with Metronidazole): vaginal thrush and mixed vaginal infections, as prescribed.
How It Works
Miconazole is an azole antifungal. It stops the fungus making ergosterol, an essential part of its cell wall, so the fungus is damaged and stops growing.
Dosage and Administration
- Cream 2%: apply a thin layer to the affected skin and the area around it twice a day. Continue for 1 to 2 weeks after the rash has cleared to stop it coming back; total treatment is usually 2 to 6 weeks.
- Oral gel 20 mg/g, adults and children 2 years and over: 2.5 ml four times a day after meals. Keep the gel in the mouth as long as possible before swallowing. Continue for at least 1 week after symptoms have gone.
- Oral gel, infants 4 to 24 months: 1.25 ml four times a day after feeds. Divide each dose into small portions and smear onto the affected areas with a clean finger. Never put the gel at the back of the throat, as it may cause choking.
- Vaginal tablets: as prescribed or as directed on the pack.
Wash hands before and after use.
Interactions
The oral gel is absorbed into the body and can strongly increase the effect of Warfarin, causing serious bleeding; this has also been reported with skin and vaginal use. The oral gel must not be taken with certain medicines whose levels it raises, including Simvastatin, Lovastatin, Pimozide, Quinidine, Ergotamine, Triazolam and oral Midazolam. It may also raise levels of Phenytoin and diabetes tablets such as Glimepiride. Vaginal products can damage latex condoms and diaphragms.
Contraindications
- Allergy to miconazole, other azole antifungals or any ingredient
- Oral gel: babies under 4 months, or infants with a poor swallowing reflex
- Oral gel: liver disease, or use with the medicines listed under Interactions that must not be combined
Side Effects
Cream: mild burning, stinging, itching or redness where applied. Oral gel: nausea, vomiting, unpleasant taste, dry mouth or mouth discomfort.
Get urgent medical help for signs of a severe allergic reaction (swelling of the face, lips or throat, difficulty breathing, widespread rash), a severe skin reaction with blistering or peeling, choking in an infant, or unusual bleeding or bruising if you take Warfarin.
Pregnancy and Lactation
Skin cream can usually be used in pregnancy and breastfeeding when advised by a doctor or pharmacist, as very little is absorbed; do not apply it to the breast while breastfeeding. Avoid the oral gel in pregnancy unless a doctor advises it, and ask a doctor before using it while breastfeeding. For vaginal products in pregnancy, use only on medical advice and insert carefully.
Precautions and Warnings
- For external use (cream) or mouth use (gel) only as directed. Keep the cream away from the eyes.
- Complete the full course even if symptoms improve.
- Creams that also contain Hydrocortisone are for short-term use only; do not use them for long periods, on large areas of the face, or on children without medical advice.
- Keep the skin clean and dry, and do not share towels.
- With oral thrush, remove dentures at night and clean them; the gel can also be applied to the denture surface.
Overdose
Swallowing a large amount of cream or gel may cause vomiting and diarrhoea. Seek medical advice, especially for a child or anyone taking Warfarin.
Therapeutic Class
Azole antifungal (for skin, mouth and vaginal use).
Storage
Store below 30°C, away from light and out of the reach of children. Do not freeze. Keep the cap tightly closed.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.