Miconazole
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Miconazole is an imidazole antifungal agent commonly applied topically (to the skin) or mucus membranes to cure fungal infections. It works by inhibiting the synthesis of ergosterol, a critical component of fungal cell membranes. It can also be used against certain species of Leishmania protozoa (which are a type of unicellular parasite), as these also contain ergosterol in their cell membranes. In addition to its antifungal and antiparasitic actions, it also has some limited antibacterial properties.
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Indications
Miconazole is mainly used externally for the treatment of Athlete's foot, Ringworm and Jock itch. Internal application is used for oral or vaginal thrush (yeast infection).
It has an advantage over nystatin in the treatment of neonatal oral thrush in that the latter is only licensed in the UK for those over the age of one month; but note the possibility for drug interactions.
1H-Imidazole, 1-(2-(2,4-dichlorophenyl)-2-((2,4-dichlorophenyl)methoxy)ethyl)-
CAS No. 22916-47-8
Side effects
Unlike nystatin, some Mixconazole is absorbed by the intestinal tract when used orally (and possibly if used vaginally Template:Ref) which may lead to drug interactions.
Of note may be interactions with anticoagulants, phenytoin anticonvulsant, terbinafine antihistamine, some newer atypical antipsychotics, ciclosporin immunosuppressant, and some statins used to treat hypercholesterolemia.
Formulations
Oral treatment: (brands: Daktarin in UK)
- Oral gel 24mg/ml (20mg/g)
External skin treatment: (brands: Monistat-Derm, Daktarin in UK)
- Topical cream: 2%.
- Combination: 2% cream with 1% hydrocortisone (Daktacort in UK)
Vaginal treatment: (brands: Monistat, Femizol or Gyno-Daktariin in UK)
- Pessaries: 200 mg or 100 mg
- Vaginal cream: 2%
- Combination: 2% cream with either 100mg or 200 mg pessaries.
See also
References
- Template:Note British National Formulary '45' March 2003