Miconazole Nitrate
Indications
Miconazole Nitrate is used for:
Oropharyngeal & Esophageal Candidiasis.
Adult Dose
Oropharyngeal & Esophageal Candidiasis.
1 buccal tablet once daily (apply in the morning) for 7-14 days.
Child Dose
<16 years: Safety and efficacy not established
16 years or older: 1 buccal tablet once daily (apply in the morning) for 7-14 days.
Renal Dose
Administration
Buccal tablet designed to adhere to the gum; do not to crush, chew, or swallow the tablet.
Contra Indications
Hypersensitivity; hepatic impairment. Porphyria.
Precautions
Discontinue if sensitization or irritation occurs. Pregnancy and lactation.
Lactation: Unknown whether distributed in breast milk, caution advised
Pregnancy-Lactation
Pregnancy Category: C
Lactation: Unknown whether distributed in breast milk, caution advised
Interactions
May increase anticoagulant effect of warfarin. May increase or prolong the effect of the following drugs: Oral hypoglycaemics (e.g. sulfonylureas), phenytoin, HIV protease inhibitors (e.g. saquinavir), antineoplastic agents (e.g. vinca alkaloids, busulfan, docetaxel), Ca channel blockers (e.g. dihydropyridines, verapamil), immunosuppressive agents (e.g. ciclosporin, tacrolimus, sirolimus), carbamazepine, cilostazol, buspirone, disopyramide, alfentanil, sildenafil, alprazolam, brotizolam, midazolam IV, rifabutin, methylprednisolone, trimetrexate, ebastine and reboxetine.
Potentially Fatal: Increased risk of cardiac arrhythmia w/ astemizole, cisapride, dofetilide, halofantrine, mizolastine, pimozide, quinidine, sertindole, terfenadine. May increase exposure to ergot alkaloids leading to ergotism. May increase the risk of rhabdomyolysis w/ HMG-CoA reductase inhibitors (e.g. simvastatin and lovastatin). May increase the effect of triazolam and oral midazolam.
Adverse Effects
Side effects of Miconazole Nitrate :
1-10%
Diarrhea (6%), Nausea (4.6%), Headache (5%), Dysgeusia (2.9%), Upper abdominal pain (2.5%), Vomiting (2.5%)
Mechanism of Action
Miconazole inhibits ergosterol synthesis thus damaging fungal cell wall membrane and increases its permeability, allowing leakage of nutrients.