BMA Concise Guide to Medicine & Drugs

Miconazole

Brand names Daktarin, Gyno-Daktarin, Loramyc

Used in the following combined preparation Daktacort

QUICK REFERENCE

Drug group Antifungal drug

Overdose danger rating Low

Dependence rating Low

Prescription needed No (cream, powder); Yes (other preparations)

Available as generic Yes

GENERAL INFORMATION

Miconazole is an antifungal drug used to treat candida (yeast) infections of the mouth, Candida and bacterial infections of the vagina, and a range of other fungal infections affecting the skin.

The drug is available as a treatment for oral infections in the form of a gel to be used on dentures. Cream, dusting powder, or ointment are used for skin infections, and a variety of vaginal preparations is available.

Side effects usually only occur with oral preparations because miconazole is absorbed in only very small quantities following topical or vaginal application.

The pessaries, vaginal capsules, and vaginal cream damage latex condoms and diaphragms.

INFORMATION FOR USERS

Follow instructions on the label. Call your doctor if symptoms worsen.

How taken/used Buccal tablets, pessaries, vaginal cream, vaginal capsules, cream, ointment, oral gel, spray powder.

Frequency and timing of doses 1 x daily in morning (buccal tablets); 4 x daily after food (oral gel); 1–2 x daily (vaginal/skin preparations).

Adult dosage range Vaginal infections 1 x 5g applicatorful (cream); 1 x 100mg pessary; 1 x 1.2g vaginal capsule. Oral/skin infections As directed.

Onset of effect 2–3 days.

Duration of action Up to 12 hours.

Diet advice None.

Storage Keep in original container at room temperature out of the reach of children.

Missed dose No cause for concern, but apply missed dose or application as soon as you remember.

Stopping the drug Apply the full course. Even if you feel better, the original infection may still be present and may recur if treatment is stopped too soon.

Exceeding the dose An occasional unintentional extra dose is unlikely to cause problems. But if you notice any unusual symptoms or if a large amount has been swallowed, notify your doctor.

POSSIBLE ADVERSE EFFECTS

Adverse effects are rare with miconazole and usually occur only with oral preparations of the drug. The main adverse effects include skin irritation or a rash, nausea, vomiting, and vaginal irritation, which should be reported to your doctor.

INTERACTIONS

Oral anticoagulants, ciclosporin, phenytoin, antidiabetics, quinidine, and pimozide Miconazole oral gel and buccal tablets may increase the effects and toxicity of these drugs.

Carbamazepine, phenytoin, calcium channel blockers, and sirolimus, tacrolimus Miconazole oral gel and buccal tablets may increase the effects and toxicity of these drugs.

Simvastatin There is an increased risk of muscle damage if this drug is taken with miconazole. Avoid using together.

SPECIAL PRECAUTIONS

Be sure to consult your doctor or pharmacist before taking this drug if:

· You have porphyria.

· You have liver problems.

· You are taking other medicines.

Pregnancy No evidence of risk with topical preparations. Safety not established for other preparations. Discuss with your doctor.

Breast-feeding Safety not established. Discuss with your doctor.

Infants and children Reduced dose necessary (oral gel).

Over 60 No special problems.

Driving and hazardous work No special problems.

Alcohol No special problems.

PROLONGED USE

No problems expected. Most types of miconazole are not usually prescribed long-term but oral gel may cause diarrhoea if used for a long time.