Miconazole: Difference between revisions

Revision as of 12:11, 20 March 2026

Administration

Type: Antifungal
Dosage Forms: 2% Cream
Routes of Administration: Topical
Common Trade Names: Monistat-Derm, Desenex, Lotrimin, Micatin, Zeasorb

Adult Dosing

Candidiasis, cutaneous

Apply 2% Cream BID to affected area x2 weeks

Tinea corporis

Apply 2% Cream BID to affected area x4 weeks

Tinea cruris

Apply 2% Cream BID to affected area x2 weeks

Tinea pedis

Apply 2% Cream BID to affected area x4 weeks

Indications by Disease

Disease	Dose	Context
Candida vulvovaginitis	2% cream applied vaginally for 7 days OR 4% cream x 3 days	Intravaginal therapy
Candidiasis	2% cream applied topically BID x 2 weeks	Cutaneous candidiasis
Tinea corporis	2% cream applied topically BID x 4 weeks	Mild disease
Tinea cruris	2% cream applied topically BID x 2 weeks	Topical antifungal
Tinea pedis	2% cream applied topically BID x 4 weeks	Topical antifungal

Pediatric Dosing

Candidiasis, cutaneous

Apply 2% Cream BID to affected area x2 weeks

Tinea corporis

Apply 2% Cream BID to affected area x4 weeks

Tinea cruris

Apply 2% Cream BID to affected area x2 weeks

Tinea pedis

Apply 2% Cream BID to affected area x4 weeks

Indications by Disease

Special Populations

Pregnancy Rating

Risk of fetal harm not expected
May use during pregnancy

Lactation risk

May use while breastfeeding

Renal Dosing

Adult: No adjustment needed
Pediatric: No adjustment needed

Hepatic Dosing

Adult: No adjustment needed
Pediatric: No adjustment needed

Contraindications

Allergy to class/drug

Adverse Reactions

Serious

Anaphylaxis (rare)

Common

Skin irritation
Burning
Pruritus

Pharmacology

Metabolism: Hepatic
Info: Minimal systemic absorption from topical use

Mechanism of Action

Azole antifungal
- Inhibits ergosterol synthesis in fungal cell membranes

References

Authors:

@@ Line 1: / Line 1: @@
 ==Administration==
-*Type: Atypical antidepressant
+*Type: [[Antifungal]]
-*Dosage Forms:
+*Dosage Forms: 2% Cream
-*Routes of Administration: oral
+*Routes of Administration: Topical
-*Common Trade Names: Remeron
+*Common Trade Names: Monistat-Derm, Desenex, Lotrimin, Micatin, Zeasorb
 ==Adult Dosing==
-*15-45mg PO nightly
+===[[Candidiasis]], cutaneous===
+*Apply 2% Cream BID to affected area x2 weeks
+===[[Tinea corporis]]===
+*Apply 2% Cream BID to affected area x4 weeks
+===[[Tinea cruris]]===
+*Apply 2% Cream BID to affected area x2 weeks
+===[[Tinea pedis]]===
+*Apply 2% Cream BID to affected area x4 weeks
 ===Indications by Disease===
@@ Line 22: / Line 28: @@
 ==Pediatric Dosing==
-''Safety/efficacy not established''
+===[[Candidiasis]], cutaneous===
+*Apply 2% Cream BID to affected area x2 weeks
+===[[Tinea corporis]]===
+*Apply 2% Cream BID to affected area x4 weeks
+===[[Tinea cruris]]===
+*Apply 2% Cream BID to affected area x2 weeks
+===[[Tinea pedis]]===
+*Apply 2% Cream BID to affected area x4 weeks
 ===Indications by Disease===
@@ Line 38: / Line 50: @@
 ==Special Populations==
-*[[Drug pregnancy categories|Pregnancy Rating]]: C
+===[[Drug pregnancy categories|Pregnancy Rating]]===
-*Lactation risk: Infant risk cannot be ruled out
+*Risk of fetal harm not expected
-*Renal dosing, CrCl <40: increase dose slowly
+*May use during pregnancy
-*Hepatic impairment: increase dose slowly
+===Lactation risk===
+*May use while breastfeeding
+===Renal Dosing===
+*Adult: No adjustment needed
+*Pediatric: No adjustment needed
+===Hepatic Dosing===
+*Adult: No adjustment needed
+*Pediatric: No adjustment needed
 ==Contraindications==
 *Allergy to class/drug
-*MAOI use concomitantly or within past 14 days
 ==Adverse Reactions==
 ===Serious===
-*Agranulocytosis, neutropenia
+*[[Anaphylaxis]] (rare)
-*Neuroleptic malignant syndrome, serotonin syndrome
-*Seizure, status epilepticus
-*Exacerbation of depression, suicidality
-*Cirrhosis
 ===Common===
-*Increased appetite, weight gain, elevated triglycerides, constipation, xerostomia
+*Skin irritation
-*Dizziness, somnolence, disturbance in thinking
+*Burning
+*Pruritus
 ==Pharmacology==
-*Half-life: 26-37h
+*Metabolism: Hepatic
-*Metabolism: Hepatic, CYP2D6, CYP1A2, and CYP3A4
+*Info: Minimal systemic absorption from topical use
-*Excretion: Mostly renal
 ==Mechanism of Action==
-*Exact mechanism of action unknown. Potent serotonin 5HT2 and 5HT3 antagonist, moderate muscarinic antagonist. Side effects due to antihistaminergic and α-1 antagonist properties
+*Azole antifungal
+**Inhibits ergosterol synthesis in fungal cell membranes
-==Comments==
 ==See Also==
-*[[Depression]]
+*[[Antifungals]]
+*[[Candidiasis]]
+*[[Tinea corporis]]
 ==References==
@@ Line 76: / Line 90: @@
 [[Category:Pharmacology]]
-[[Category:Psychiatry]]
+[[Category:ID]]