Miconazole

Miconazole is a imidazole antifungal medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Fungal skin infections such as ringworm of the body, groin, or feet when a cream is prescribed.
• Cutaneous candidiasis and other susceptible yeast infections of the skin.
• Oropharyngeal candidiasis, commonly called oral thrush, when an oral gel is prescribed.

Use Miconazole exactly as directed by the prescribing doctor or pharmacist. For cream, adults are usually advised to apply a thin layer to the affected and surrounding skin regularly and continue for the recommended duration, even if symptoms improve earlier. For oral gel, adults are usually advised to apply it inside the mouth after meals, keep it in contact with the affected area as long as possible, and then swallow if instructed. The exact amount, frequency, and treatment length depend on the infection site, severity, and product strength, so follow the doctor’s specific instructions.

• Common: local burning, stinging, itching, redness, irritation, dryness, or rash with skin application.
• Oral gel: nausea, unpleasant taste, dry mouth, mouth irritation, vomiting, or diarrhoea.
• Serious but uncommon: allergic reaction such as swelling of the face or throat, breathing difficulty, severe rash, or widespread skin reaction.
• Oral gel may rarely contribute to choking if used incorrectly, especially in young children; it should not be placed at the back of the throat.

People with a history of allergy to miconazole or other imidazole antifungals should be cautious. Avoid contact of cream with the eyes, and do not use it on large areas, broken skin, or for prolonged periods unless advised. Oral gel needs extra caution in people taking interacting medicines, in those with liver disease, and where swallowing difficulty or choking risk is present. Use under the guidance of a registered doctor or pharmacist, especially for persistent, recurrent, severe, or widespread infection.

• Warfarin and other coumarin anticoagulants: oral miconazole can greatly increase bleeding risk and should generally be avoided unless a doctor specifically supervises it.
• Some oral diabetes medicines such as sulfonylureas: oral miconazole may increase the risk of low blood sugar.
• Phenytoin and some other anti-seizure medicines: blood levels and side effects may increase.
• Certain statins, benzodiazepines, immunosuppressants, and other CYP2C9 or CYP3A4-metabolised medicines may interact, especially with oral gel.
• Topical cream has fewer interactions, but tell the doctor or pharmacist about all medicines being used.

• Known hypersensitivity to miconazole, other imidazole antifungals, or any component of the product.
• Oral gel should not be used together with medicines where the product label or doctor identifies a serious interaction risk, such as warfarin, unless specifically managed by a specialist.
• Oral gel is contraindicated in infants below the age specified on the product label because of choking risk.

During pregnancy or breastfeeding, use Miconazole only if a doctor considers it necessary. Skin cream has low absorption when used correctly, but unnecessary or prolonged use should be avoided. For oral gel, medical advice is especially important because some absorption and drug interactions can occur. Breastfeeding mothers should avoid applying cream to the nipple area unless specifically instructed, and any treated area should be cleaned before feeding if advised by a clinician.

Store at room temperature, away from excessive heat, moisture, and direct sunlight. Keep the container tightly closed and out of the reach of children. Do not use after the expiry date, and follow the product label for any specific storage instructions.