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MICONAZOLE NITRATE

Medical Diagnosis and Drugs, Medications
MICONAZOLE NITRATE
(mi-kon'a-zole)
Monistat-Derm, Monistat 3, Monistat 7, Femizol-M, M-Zole, Micatin, Tetterine, Fungoid, Lotrimin AF, Desenex
Classifications: antibiotic; azole antifungal;
Therapeutic: antibiotic; azole antifungal
Prototype: Fluconazole
Pregnancy Category: B

Availability

100 mg, 200 mg vaginal suppositories; 2% cream; 2% ointment; 2% powder; 2% spray; 2% solution

Action

Broad-spectrum agent with fungicidal activity. Mode of action appears to inhibit uptake of components essential for cell reproduction and growth as well as cell wall structure, thus promoting cell death of fungi.

Therapeutic Effect

Effective against Candida albicans and other species of this genus. Inhibits growth of common dermatophytes, and the organism responsible for tinea versicolor (Malassezia furfur).

Uses

Vulvovaginal candidiasis, tinea pedis (athlete's foot), tinea cruris, tinea corporis, and tinea versicolor caused by dermatophytes.

Contraindications

Hypersensitivity to miconazole; azole antifungal agents; children <2 y.

Cautious Use

Pregnancy (category B), lactation.

Route & Dosage

Fungal Infection
Adult: Topical Apply cream sparingly to affected areas twice a day, and once daily for tinea versicolor, for 2 wk (improvement expected in 2–3 d, tinea pedis is treated for 1 mo to prevent recurrence) Intravaginal Insert suppository or vaginal cream q h.s. x 7 d (100 mg) or 3 d (200 mg)

Administration

Topical
  • Apply cream sparingly to intertriginous areas (between skin folds) to avoid maceration of skin.
  • Massage affected area gently until cream disappears.
  • Store at 15°–30° C (59°–86° F) unless otherwise directed.

Adverse Effects (≥1%)

Urogenital: Vulvovaginal burning, itching, or irritation; maceration, allergic contact dermatitis.

Interactions

Drug: may increase INR with warfarin; may inactivate nonoxynol-9 spermicides.

Pharmacokinetics

Absorption: Small amount absorbed from vagina. Metabolism: Rapidly metabolized in liver. Elimination: In urine and feces. Half-Life: 2.1–24 h.

Nursing Implications

Assessment & Drug Effects

  • Expect clinical improvement from topical application in 1 or 2 wk. If no improvement in 4 wk, diagnosis is reevaluated. Treat tinea pedis infection for 1 mo to assure permanent recovery.

Patient & Family Education

  • Complete full course of treatment to ensure recovery.
  • Do not interrupt vaginal application during menstrual period.
  • Avoid contact of drug with eyes.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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