Products
Miconazole is available as a cream, miconazole mouth gel and shampoo, and commercially (e.g., Daktarin). It has been approved in many countries since 1972. This article refers to external therapy. See also under miconazole mouth gel and miconazole for nail fungus. The nail tincture for nail fungus treatment is no longer marketed in many countries.
Structure and properties
Miconazole (C18H14Cl4N2O, Mr = 416.13 g/mol) is a chlorinated imidazole derivative. It is present in drugs as a nitrate or as a free base. Miconazole nitrate is a white powder that is very slightly soluble in water.
Effects
Miconazole (ATC D01AC02) has antifungal properties against dermatophytes, yeasts, molds, and dimorphic fungi. It is further effective against some bacteria. The effects are based on the inhibition of the enzyme lanosterol-14α-demethylase in the fungi. This inhibits the synthesis of ergosterol from lanosterol, leading to accumulation of toxic precursors and disruption of the fungal cell membrane structure.
Indications
For the treatment of fungal infections, e.g., fungal skin infections, athlete’s foot, nail fungus (tincture), pityriasis versicolor, vaginal fungus, and oral thrush.
Dosage
According to the SmPC. Medicines are usually applied locally twice daily. After the disappearance of symptoms, treatment should be continued for at least one week.
Contraindications
- Hypersensitivity
For complete precautions, see the drug label.
Interactions
Miconazole is an inhibitor of CYP3A and CYP2C9. This is only of concern when administered internally (miconazole oral gel).
Adverse effects
Possible adverse effects include local skin reactions such as burning sensation, skin redness, and irritation.
