Clinical medicine profile
Miconazole Oral gel
Antifungal
- Route
- ORAL / TOPICAL / IV
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
This profile needs source confirmation
A traceable source link is not attached to this profile. Confirm prescribing decisions against the current SmPC and Kenya STG/EML.
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.
Child under 2 yrs: 2.5ml BD. 2-6 yrs: 5ml BD. Over 6yrs: 10ml QID (after food).
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
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.
- Fungal infection of oropharynx
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 |
|---|---|---|---|
| No reviewed brand listings are linked yet. | |||
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.