Clinical medicine profile
Miconazole
Antifungal
- Route
- ORAL / TOPICAL / IV
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- Hypersensitivity.
- Many systemic azoles contraindicated with certain CYP3A4 substrates (e.g. some statins, quinidine) — check labels.
- Terfenadine/astemizole historical QT combinations.
Precautions
- Hepatotoxicity monitoring for systemic azoles.
- QT prolongation (some azoles).
- Voriconazole: visual disturbances, photosensitivity, skin cancer risk long-term.
- Confirm species for invasive disease.
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
Dosing is indication-, age-, weight- and organ-function-specific for this INN. Do not use class averages for high-risk patients. Confirm the exact regimen in the current SmPC and Kenya Standard Treatment Guidelines. Typical professional workflow: (1) confirm indication, (2) check renal/hepatic function, (3) screen interactions/allergies, (4) select dose/route/duration, (5) define monitoring.
Paediatric dosing is weight- and age-based; use a paediatric formulary / SmPC. Do not extrapolate adult tablets without calculation.
Fluconazole dose-adjust in CKD; amphotericin nephrotoxicity high-alert.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Monitor LFTs for courses >14 days or higher-risk patients.
Use, effects & interactions
Indications
- Therapeutic use is agent- and indication-specific within the class (Antifungal).
- Use according to culture results, national guidelines (Kenya STG/EML where applicable) and the current product SmPC.
- Clinical selection for Miconazole should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: Antifungal.
- Confirm site-specific dose, duration and monitoring before prescribing.
Adverse effects
- GI upset, rash, raised LFTs.
- Serious: hepatitis, severe skin reactions, arrhythmias, infusion reactions (amphotericin).
Drug interactions
Open multi-drug checker ↗- Match agent to site and species.
- For tinea, continue topical beyond clearance.
- Invasive fungal disease needs ID/specialist input and source control.
Mechanism & disposition
Azoles inhibit fungal CYP51 (lanosterol 14α-demethylase), depleting ergosterol and disrupting membrane integrity.
Read complete mechanism
Azoles inhibit fungal CYP51 (lanosterol 14α-demethylase), depleting ergosterol and disrupting membrane integrity. Terbinafine inhibits squalene epoxidase. Polyenes bind ergosterol creating membrane pores. Echinocandins inhibit β-glucan synthase (cell wall).
Days for clinical response (varies)
Days–weeks per indication
ORAL / TOPICAL / IV
with major interactions. Topicals: minimal systemic
Pregnancy, lactation & diet
Systemic azoles often avoided in pregnancy (fluconazole high-dose teratogenicity signal); topical clotrimazole commonly used for VVC.
Topicals usually fine; systemic — agent-specific.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| LabestenLab&Allied | Afya Index / Retail Reference | tabs 6's | KES 26.00afya_index_book |
| Micona Vaginal Cream | Centaur Pharmaceuticals Limited | Cream | Unavailable |
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.