Miconazole

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Miconazole

Miconazole is an imidazole antifungal agent 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.

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). 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.

Side effects

Unlike nystatin, some miconazole is absorbed by the intestinal tract when used orally (and possibly if used vaginally ) 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.