Miconazole

General

Topical products: Micatin, Lotrimin AF, and others
Vaginal products: Monistat, Vagistat-3, and others
Antifungal agent

No	No	2	C

Key

Cream (OTC): 2% (15, 30, 90 g)

Lotion (OTC): 2% (30, 60 mL)

Ointment (OTC): 2% (28.4 g)

Solution (OTC): 2% with alcohol (30.3 mL)

Gel (OTC): 2% with alcohol (24 g)

Topical solution (OTC): 2% with alcohol (30.3 mL)

Powder (OTC): 2% (70, 90 g)

Spray, liquid (OTC): 2% (105 mL); contains alcohol

Spray, powder (OTC): 2% (90, 120 g); contains alcohol

Vaginal cream (OTC): 2% (15, 25, 45 g), 4% (15, 25 g)

Vaginal suppository (OTC): 100 mg (7s), 200 mg (3s)

Vaginal combination packs:
Monistat 1 Combination Pack (OTC): 1200 mg suppository (1) and 2% cream (9 g)
Monistat 3, Vagistat-3 (OTC): 200 mg suppository (3s) and 2% cream (9 g)
Monistat 7 (OTC): 100 mg suppository (7s) and 2% cream (9 g)

Dosing

Topical: Apply BID × 2–4 wk
Vaginal:
7 day regimen: 1 applicator full of 2% cream or 100 mg suppository QHS × 7 days
3 day regimen: 1 applicator full of 4% cream or 200 mg suppository QHS × 3 days
Monistat 1: 1200 mg suppository × 1 at bedtime or during the day

Notes

Use with caution in hypersensitivity to other imidazole antifungal agents (e.g., clotrimazole, ketoconazole). Side effects include pruritis, rash, burning, phlebitits, headaches, and pelvic cramps.

Drug is a substrate and inhibitor of the CYP 450 3A3/4 isoenzymes. Vaginal use with concomitant warfarin use has also been reported to increase warfarin's effect. Vegetable oil base in vaginal suppositories may interact with latex products (e.g., condoms and diaphragms); consider switching to the vaginal cream.