Clinical medicine profile
Miconazole, skin
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.
Adult and children: Skin: Apply OD or BD until 10days after lesions have disappeared. Nails: Apply thinly OD covering with non-perforated bandage until new nail growth is established.
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 skin infections.
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 |
|---|---|---|---|
| Cipconazole | Cipla | cream 2% 15g | Unavailable |
| Laeotarin | Lab&Allied | tabs 15g | Unavailable |
| Zarin | Xepa | cream 2% 20g | Unavailable |
| Zarin | Xepa | cream 2% 30g | Unavailable |
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.