Miconazole%25252525252525252525252525252525252525252525252525252525252525252520vaginal%25252525252525252525252525252525252525252525252525252525252525252520pessary

# Miconazole Vaginal Pessary ## Overview Miconazole vaginal pessaries are topical antifungal agents used for the treatment of vulvovaginal candidiasis. ## Primary Indications * Treatment of vulvovaginal candidiasis (yeast infection). ## Adult Dosing * **100 mg vaginal pessary:** Insert one pessary vaginally at bedtime for 7 consecutive nights. * **200 mg vaginal pessary:** Insert one pessary vaginally at bedtime for 3 consecutive nights. * **100 mg vaginal suppository:** Insert one suppository vaginally at bedtime for 7 consecutive nights. * **200 mg vaginal suppository:** Insert one suppository vaginally at bedtime for 3 consecutive nights. * **Single-dose 1200 mg vaginal suppository:** Insert one suppository vaginally once at bedtime. ## Pediatric Dosing * Safety and efficacy in pediatric patients have not been established. Dosing in this population is at the discretion of the prescriber. ## Dose Adjustments * No specific dose adjustments are recommended for renal or hepatic impairment. ## Contraindications * Hypersensitivity to miconazole or any component of the formulation. ## Adverse Effects * **Common:** Vaginal burning, itching, irritation, pelvic cramping. * **Less Common:** Headache, rash. ## Key Drug Interactions * **Warfarin:** Miconazole can inhibit CYP2C9, potentially increasing warfarin levels and the risk of bleeding. Monitor INR closely and consider alternative antifungal therapy if feasible. ## Monitoring * Monitor for signs and symptoms of vulvovaginal candidiasis. * Monitor for and manage adverse effects. * If using concurrently with warfarin, monitor INR. ## Clinical Pearls * Complete the full course of therapy as prescribed, even if symptoms improve. * Avoid sexual intercourse during treatment. * Pessaries/suppositories may weaken latex condoms and diaphragms. Consider alternative contraception. * If symptoms do not improve after completing the course, or if they worsen, reassess diagnosis and consider alternative therapy. *** *This information is intended for healthcare professionals and does not substitute for consulting the official prescribing information or current clinical guidelines. Always verify current dosing and safety information with the manufacturer's product insert or reliable drug references.*