Miconazole

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Miconazole
Systematic (IUPAC) name
1-[2-(2,4-dichlorophenyl)-2- [(2,4-dichlorophenyl) methoxy]ethyl]imidazole
Identifiers
CAS number	22916-47-8
ATC code	D01 AC02
PubChem	4189
DrugBank	APRD01115
Chemical data
Formula	C₁₈H₁₄Cl₄N₂O
Mol. weight	416.127 g/mol
Pharmacokinetic data
Bioavailability	n/a
Metabolism	n/a
Half life	n/a
Excretion	n/a
Therapeutic considerations
Pregnancy cat.	?
Legal status
Routes	topical

Miconazole is an imidazole antifungal agent, developed by Janssen Pharmaceutica, and commonly applied topically (to the skin) or mucus membranes to cure fungal infections. It works by inhibiting the synthesis of ergosterol, a critical component of fungal cell membranes. It can also be used against certain species of Leishmania protozoa (which are a type of unicellular parasite), as these also contain ergosterol in their cell membranes. In addition to its antifungal and antiparasitic actions, it also has some limited antibacterial properties.

1 Indications
2 Side effects
3 Formulations
4 See also
5 References
6 External links

[edit] Indications

Miconazole is mainly used externally for the treatment of Athlete's foot, Ringworm and Jock itch. Internal application is used for oral or vaginal thrush (yeast infection). In addition the oral gel may also be used for the lip disorder angular cheilitis.

It has an advantage over nystatin in the treatment of neonatal oral thrush in that the latter is only licensed in the UK for those over the age of one month; but note the possibility for drug interactions.

[edit] Side effects

Unlike nystatin, some miconazole is absorbed by the intestinal tract when used orally (and possibly if used vaginally ^[1]) which may lead to drug interactions.

Of note may be interactions with anticoagulants, phenytoin, terbinafine, some newer atypical antipsychotics, cyclosporin and some statins used to treat hypercholesterolemia.

[edit] Formulations

Oral treatment: (brands: Daktarin in UK)

Oral gel 24mg/ml (20mg/g)

External skin treatment: (brands: Monistat-Derm, Daktarin in UK)

Topical cream: 2%.
Combination: 2% cream with 1% hydrocortisone (Daktacort in UK)

Vaginal treatment: (brands: Monistat, Femizol or Gyno-Daktariin in UK)

Pessaries: 200 mg or 100 mg
Vaginal cream: 2%
Combination: 2% cream with either 100mg or 200 mg pessaries.

[edit] See also

Antifungal drugs

[edit] References

↑ British National Formulary '45' March 2003

[edit] External links

Miconazole (www.meds-help.com)
Miconazole (National Institutes of Health)

Antifungals (D01 and J02) edit
Antibiotics:	Griseofulvin, Hitachimycin, Natamycin, Nystatin
Topical Azoles:	Clotrimazole, Econazole, Fluconazole, Ketoconazole, Miconazole, Oxiconazole, Sertaconazole, Sulconazole, Tioconazole
Other topicals:	Ciclopirox, Ethylparaben, Flucytosine, Salicylic acid, Selenium sulfide, Terbinafine, Tolnaftate
For systemic use:	Amphotericin B, Anidulafungin, Caspofungin, Griseofulvin, Itraconazole, Terbinafine, Voriconazole
Other:	Posaconazole, Thiabendazole, Tea tree oil