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Miconazole
📖 About
Always check the BNF link here (or local formulary) before prescribing or recommending Miconazole.
- 💊 Phenethyl imidazole derivative.
- Used widely as a topical and oral antifungal for superficial and mucosal infections.
⚙️ Mode of Action
- Inhibits fungal ergosterol synthesis (essential for cell membrane integrity).
- Results in leaky cell membranes → fungal cell death.
📋 Indications
- 🦶 Cutaneous fungal infections (e.g. ringworm, tinea corporis).
- 👟 Athlete’s foot (tinea pedis).
- 💅 Fungal nail infections (onychomycosis).
- 👄 Angular cheilitis (often fungal or mixed).
- 🦷 Oral candidiasis (oral thrush).
- 👩🦰 Vaginal candidiasis.
- 🧴 Combined topical (Daktacort: miconazole + hydrocortisone) for inflamed fungal lesions.
💊 Dose & Preparations
- Oral gel (Daktarin): 5–10 mL QDS, held in mouth before swallowing.
- Buccal tablets (Loramyc): 50 mg OD, applied in morning.
- Topical cream/powder: apply BD, continue for 7–10 days after clinical resolution to prevent relapse.
- Daktacort: apply thinly BD for inflamed fungal skin infections.
🔄 Interactions
- ⚠️ Oral miconazole can potentiate warfarin → check INR closely.
- Also interacts with drugs metabolised by CYP3A4 (e.g. phenytoin, ciclosporin).
⛔ Contraindications & Cautions
- ⚠️ Acute porphyria (caution).
- ⚠️ Hepatic impairment → seek specialist advice (risk of hepatotoxicity).
- 🚫 Avoid contact with eyes.
- 🤰 Pregnancy & 🤱 breastfeeding → check BNF / local guidance before prescribing.
⚠️ Side Effects
- 🤢 GI upset (oral gel).
- 🌸 Allergic skin reactions / hypersensitivity.
- 🧪 Rare hepatotoxicity with systemic absorption.
- 🚨 Topical: local irritation, burning, or redness.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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