Miconazole, sold under the brand name Monistat among others, is an antifungal medication used to treat ring worm, pityriasis versicolor, and yeast infections of the skin or vagina. It is applied to the skin or vagina as a cream or ointment.
Common side effects include itchiness or irritation of the area in which it was applied. Use in pregnancy is believed to be safe for the baby. Miconazole is in the imidazole family of medications. It works by decreasing the ability of fungi to make ergosterol, an important part of its cell membrane.
Miconazole was patented in 1968 and approved for medical use in 1971. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. The wholesale cost in the developing world is about 0.23 to 0.60 USD for a 30 gm tube. In the United States a course of treatment costs less than 25 USD.
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Medical uses
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). The oral gel may also be used for the lip disorder angular cheilitis.
In the UK, miconazole may be used to treat neonatal oral thrush, while the alternative nystatin is only licensed for patients over the age of one month, but drug interactions are possible.
Side effects
Unlike nystatin, some miconazole is absorbed by the intestinal tract when used orally (and possibly if used vaginally); this may lead to drug interactions.
Interactions are possible with anticoagulants, phenytoin, terbinafine,, some newer atypical antipsychotics, cyclosporin, and some statins used to treat hypercholesterolemia.
Brand names and formulations
Oral treatment: (brands: Daktarin in UK)
- Oral gel 24 mg/ml (20 mg/g)
- Oravig 50 mg once daily buccal tablet:
In 2010, the U.S. Food and Drug Administration approved Oravig (miconazole) buccal tablets once daily for the local treatment of oropharyngeal candidiasis, more commonly known as thrush, in adults and children age 16 and older. Oravig is the only local, oral prescription formulation of miconazole approved for this use in the U.S.
External skin treatment: (brands: Desenex and Zeasorb in US and Canada, Micatin, Monistat-Derm, Daktarin in India, UK, Australia, Belgium and the Philippines, Daktar in Norway, Fungidal in Bangladesh, Decocort in Malaysia)
- Topical cream: 2%
- Combination: hydrocortisone/miconazole cream with 1% and 2%, respectively (Daktacort in UK, Daktodor in Greece)
- Dusting powder: 2% powder with chlorhexidine hydrochloride (mycoDust)
Vaginal treatment: (brands: Miconazex, Monistat, Femizol or Gyno-Daktarin in UK)
- Pessaries: 200 or 100 mg
- Vaginal cream: 2% (7-day treatment), 4% (3-day treatment)
- Combination: 2% cream with either 100 or 200 mg
Pharmacology
In addition to its antifungal actions, miconazole, along with ketoconazole, is known to act as an antagonist of the glucocorticoid receptor.
Remyelination
Miconazole has been shown to promote remyelination of neurons in chronic progressive multiple sclerosis mouse models.
Physical properties
The solubilities of miconazole nitrate powder are 0.03% in water 0.76% in ethanol and up to 4% in acetic acid.
Other uses
Miconazole is also used in Ektachrome film developing in the final rinse of the Kodak E-6 process and similar Fuji CR-56 process, replacing formaldehyde. Fuji Hunt also includes miconazole as a final rinse additive in their formulation of the C-41RA rapid access color negative developing process.
Source of the article : Wikipedia
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