Miconex

Indications

Miconex Oral Gel is effective in treating:

• Oral and Gastrointestinal Candidiasis: Used for managing fungal infections in the mouth and digestive tract.
• Fungal Eradication: Helps eliminate fungal colonization in the oral cavity and gastrointestinal system.
• Bacterial Superinfections: Provides treatment for secondary infections caused by gram-positive bacteria.

Miconex Cream is indicated for treating various dermatophyte and yeast infections, including:

• Tinea Pedis (Athlete’s Foot)
• Tinea Corporis (Ringworm)
• Tinea Cruris (Jock Itch)
• Tinea Manuum (Hand Fungal Infections)
• Candidiasis Infections
• Tinea Versicolor
• Intertriginous Infections (skin folds)
• Perianal and Perioral Infections
• Stomatitis Angularis (Cheilitis)
• Balanoposthitis
• Otitis Externa (Outer Ear Infection)

In addition, Miconazole cream provides rapid relief from itching (pruritus), which commonly accompanies these infections.

Always follow your healthcare provider’s recommendations for proper usage.

Pharmacology

Pharmacodynamics: Miconazole demonstrates broad-spectrum antifungal activity against common dermatophytes and yeasts, as well as antibacterial effects against certain gram-positive bacteria. It works by inhibiting a key enzyme in the ergosterol biosynthesis pathway. Disruption of ergosterol production compromises the fungal cell membrane, leading to its breakdown and eventual death of the fungus.

Pharmacokinetics: Miconazole has low oral bioavailability (25-30%) due to limited absorption in the gastrointestinal tract. After administration as an oral gel, Miconazole is absorbed systemically, where it binds to plasma proteins (88.2%) such as serum albumin and red blood cells (10.6%). Less than 1% of the administered dose is excreted unchanged in the urine. The terminal half-life of Miconazole is typically between 20-25 hours, and its elimination half-life remains consistent even in patients with renal impairment.

Dosage Instructions

Miconazole Oral Gel:

• For Oropharyngeal Candidiasis:
  • Infants (4-24 months): 1.25 ml (1/4 measuring spoon) 4 times a day after meals.
  • Adults and Children (2 years and older): 2.5 ml (1/2 measuring spoon) 4 times a day after meals.
• For Gastrointestinal Candidiasis:
  • Infants (4 months and older): 20 mg/kg body weight per day, divided into 4 doses. Do not exceed 250 mg (10 ml) 4 times daily.

Missed Dose: Apply as soon as you remember. If the next dose is due, skip the missed dose and continue with your regular schedule.

Miconazole Cream: Apply a sufficient amount of cream to cover the affected area twice daily (morning and evening) for conditions like tinea pedis, tinea cruris, tinea corporis, and cutaneous candidiasis. For tinea versicolor, apply once daily. When used in skin folds, apply sparingly to avoid maceration.

Patients often experience symptom relief within 2-3 days, with clinical improvement seen shortly after starting treatment. Most lesions clear within 2-5 weeks, though extended treatment (up to 10 days) may be needed to prevent recurrence. Tinea pedis typically requires a month-long treatment.

Always consult with a registered healthcare provider before use.

Administration

For localized oral lesions, apply a small amount of Miconazole Oral Gel 2-4 times daily directly to the affected area using a clean finger. Ensure the gel remains in contact with the infected area for as long as possible. Continue treatment for at least one week after symptoms resolve for optimal results. For oral candidiasis, remove and clean dental prostheses, applying the gel before sleep.

Consult your doctor for the correct treatment and duration.

Drug Interactions

• Avoid concurrent use with Terfenadine, Astemizole, and Cisapride, as Miconex may inhibit their metabolism, potentially leading to adverse effects.
• Miconex may interact with Phenytoin and Cyclosporine, potentially increasing the risk of toxicity. Monitor levels closely when used together.

Contraindications

Miconazole is contraindicated in patients who are hypersensitive to the active ingredient.

Side Effects

Possible side effects include:

• Gastrointestinal disturbances: Nausea, vomiting, and diarrhea with prolonged use.
• Rare allergic reactions: Skin rash, itching, or swelling may occur.

Pregnancy & Lactation

There is limited information regarding the safety of Miconazole oral gel during pregnancy. It is recommended to avoid use unless absolutely necessary, weighing the potential risks against the benefits. Caution is also advised when using Miconazole while breastfeeding, as it may be excreted in human milk.

Precautions & Warnings

• Monitor anticoagulant therapy: When using Miconex with anticoagulants, regularly check the anticoagulant effect to avoid complications.
• Phenytoin and Miconex: Monitor plasma levels to avoid toxicity, especially when used together.
• Infants and young children: Use caution to prevent the gel from causing choking or obstruction in the throat.

Overdose Effects

In case of overdose, symptoms may include vomiting and diarrhea. Treatment is symptomatic, and supportive care should be provided. No specific antidote is available.

Therapeutic Class

Aural Anti-Fungal Preparations

Storage Instructions

Store Miconex in a cool, dry place, away from light and heat. Keep out of reach of children.