II. Indications
- Dermatophyte Infection
- Superficial Candida Infection
III. Mechanism
- As with other azoles, inhibits the synthesis of ergosterol (key component of fungal cell wall)
- Blocks sterol 14-a-dimethylase (microsomal Cytochrome P450-dependent enzyme)
IV. Medications
- Precautions
- Bayer Healthcare uses the Lotrimin brand name to apply to various Antifungals (e.g. Clotrimazole, Butenafine)
- Oral for Oropharyngeal Candidiasis (Thrush)
- Miconazole Buccal Tablet (Oravig) 50 mg
- Contraindicated in milk protein Hypersensitivity
- Topical Miconazole (Micatin, Zeasorb AF)
- Miconazole 2% cream
- Miconazole 2% powder
- Miconazole Sprays 2% (spray powder or spray liquid)
-
Yeast Vaginitis
- Miconazole cream 2% and 4%
- Miconazole vaginal suppository/tablets 100 mg, 400 mg, 1200 mg
V. Dosing: Oral for Oropharyngeal Candidiasis (Thrush)
- Place 50 mg buccal tablet in the buccal space and hold in position for 30 seconds
- Precautions
- Perform after Tooth Brushing and tablet should continue to stick to mucosa after pressure released
- Tablet should remain in place for 6 hours, until fully dissolved (reposition against mucosa if falls off)
- Repeat dose if tablet is swallowed within first 6 hours of application
- Contraindicated in age <16 years old (Choke Hazard)
- Avoid chewing gum while tablet is in place
- May increase INR for patients on Warfarin
VI. Dosing: Topical
- Topical (Dermatophyte Infection or Superficial Candida infection) for adults (and off-label in children)
- Apply twice daily to affected area for 2 weeks (Tinea Pedis for 4 weeks)
-
Yeast Vaginitis
- Miconazole (Monistat-7) 2% cream per vagina (PV) at bedtime for 7 days
- Miconazole (Monistat-3) 4% cream, 5g per vagina (PV) at bedtime for 3 days
- Miconazole 100 mg vaginal suppository/tablet PV at bedtime for 7 days
- Miconazole 400 mg vaginal suppository/tablet PV at bedtime for 3 days
- Miconazole 1200 mg vaginal suppository/tablet PV at bedtime for 1 dose
VII. Safety
VIII. Resources
- Miconazole Topical Cream (DailyMed)
- Miconazole 2% Vaginal Cream (DailyMed)
- Miconazole 4% Vaginal Cream (DailyMed)
- Miconazole Buccal Tablet (Oravig)
Images: Related links to external sites (from Bing)
Related Studies
| miconazole (on 4/20/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| MICONAZOLE 2% TOPICAL CREAM | Generic OTC | $0.11 per gram |
| MICONAZOLE 2% VAGINAL CREAM | Generic OTC | $0.14 per gram |
| MICONAZOLE 3 200 MG VAG SUPP | Generic | $12.11 each |
| MICONAZOLE 3 COMBO PACK | Generic OTC | $8.75 each |
| MICONAZOLE 7 100 MG VAG SUPP | Generic OTC | $1.17 each |
| MICONAZOLE 7 CREAM | Generic OTC | $0.14 per gram |
| MICONAZOLE-7 CREAM | Generic OTC | $0.14 per gram |