Miconazole crystallises as colourless prisms in the monoclinic space group P2 1/c. The solubilities of miconazole nitrate powder are 0.03% in water, 0.76% in ethanol and up to 4% in acetic acid. The substance is partly metabolized via the liver enzyme CYP3A4 and mainly eliminated via the faeces. In the bloodstream, 88.2% are bound to plasma proteins and 10.6% to blood cells. When applied to the oral mucosa (and possibly also for vaginal use ), it is significantly absorbed. Pharmacokinetics Īfter application to the skin, miconazole can be measured in the skin for up to four days, but less than 1% is absorbed into the bloodstream. In addition to its antifungal actions, miconazole, similarly to ketoconazole, is known to act as an antagonist of the glucocorticoid receptor. Miconazole inhibits the fungal enzyme 14α-sterol demethylase, resulting in a reduced production of ergosterol. sulfonamides with a potential to cause hypoglycaemia (low blood sugar).drugs that also prolong the QT interval because of potential problems with the heart rhythm.Miconazole is contraindicated for people who use certain drugs that are metabolized by CYP3A4, for the reasons mentioned above: These interactions are not relevant for miconazole that is applied to the skin. Such interactions occur for example with anticoagulants of the warfarin type, phenytoin, some newer atypical antipsychotics, ciclosporin, and most statins used to treat hypercholesterolemia. This can lead to increased concentrations of drugs that are metabolized by the liver enzymes CYP3A4 and CYP2C9, because miconazole inhibits these enzymes. The substance is partly absorbed in the intestinal tract when used orally, as with the oral gel, and possibly when used vaginally. The oral gel can cause dry mouth, nausea and an unpleasant taste in about 1–10% of people. In the UK, miconazole may be used to treat neonatal oral thrush, while the alternative nystatin is only licensed for patients over the age of one month, but drug interactions are possible. This oral gel may also be used for the lip disorder angular cheilitis and other associated systems. Internal application is used for oral or vaginal thrush ( yeast infection). Miconazole is mainly used externally for the treatment of ringworm including jock itch and athlete's foot. It is on the World Health Organization's List of Essential Medicines. Miconazole was patented in 1968 and approved for medical use in 1971. It works by decreasing the ability of fungi to make ergosterol, an important part of their cell membrane. Miconazole is in the imidazole family of medications. Use in pregnancy is believed to be safe for the baby. Ĭommon side effects include itchiness or irritation of the area in which it was applied. It is applied to the skin or vagina as a cream or ointment. It is used for ring worm of the body, groin (jock itch), and feet (athlete's foot). If this is a recurrent problem for you, it may help to lose weight.Miconazole, sold under the brand name Monistat among others, is an antifungal medication used to treat ring worm, pityriasis versicolor, and yeast infections of the skin or vagina. Skin folds can be a continually moist environment that aids growth of this fungus. You should also avoid sharing clothing and wear footwear in public bathrooms/showers and gyms. Clean your bath/shower with bleach and floors with an appropriate cleaner to kill any fungal spores. If you think you also have athlete’s foot, use a separate towel for your feet and try to keep your feet dry as well, by avoiding wearing shoes for long periods or wearing loose-fitting shoes. Wash your clothing and linens in hot water. Keep the area cool and dry by drying the body thoroughly after bathing and wearing loose cotton clothing. You may still see flat, brown areas of discoloration for several weeks, but these do not need to be treated as long as there is no longer itching or bumps and scales in the area. Apply it twice a day until a few days after the rash seems to be gone, which usually takes about 2–3 weeks. Over-the-counter antifungal creams such as miconazole (eg, Monistat®), clotrimazole (Lotrimin®), or tolnaftate (Tinactin®) are very effective. Check your feet and treat athlete’s foot if it is present, as it can often spread from there.
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