Products
Miconazole was commercially available for the treatment of nail fungus as a tincture (Daktarin). The drug was approved in many countries since 1981. It was discontinued from distribution in 2020.
Structure and properties
Miconazole (C18H14Cl4N2O , Mr = 416.13 g/mol) is an imidazole derivative. It is not present in the tincture as the salt miconazole nitrate as usual, but deprotonated.
Effects
Miconazole (ATC D01AC02) has antifungal properties against dermatophytes, yeasts, and molds. The effect is due to inhibition of the synthesis of ergosterol in the fungal cell.
Indications
For the treatment of a nail fungus.
Dosage
According to the professional information. The tincture is applied twice daily to the nail and surrounding tissues and allowed to dry. Before each application, the nail should be cleaned with acetone (nail polish remover) to remove remnants of the old film. The treatment takes several months.
Contraindications
- Hypersensitivity
- The tincture should not come into contact with the eyes, open wounds or mucous membranes.
The full precautions can be found in the drug information leaflet.
Interactions
Miconazole is an inhibitor of CYP3A4 and CYP2C9. When used topically, interactions with other drugs are unlikely.
Adverse effects
Possible adverse effects include local reactions such as irritation, rash, and hypersensitivity.
