Miconazole%25252525252525252525252525252525252525252525252525252525252525252525252525252520vaginal%25252525252525252525252525252525252525252525252525252525252525252525252525252520pessary

# Miconazole Vaginal Pessary ## Overview Miconazole is an imidazole antifungal agent. Vaginal pessaries are inserted into the vagina for local treatment. ## Primary Indications Treatment of vulvovaginal candidiasis (yeast infection). ## Adult Dosing * **100 mg vaginal pessary:** Insert one pessary vaginally at bedtime for 7 consecutive days. * **200 mg vaginal pessary:** Insert one pessary vaginally at bedtime for 3 consecutive days. * **100 mg vaginal suppository (if available and chosen):** Insert one suppository vaginally at bedtime for 7 consecutive days. * **200 mg vaginal suppository (if available and chosen):** Insert one suppository vaginally at bedtime for 3 consecutive days. ## Pediatric Dosing Information for pediatric use of miconazole vaginal pessaries is limited. Generally, use in prepubertal children should be based on a healthcare provider's assessment and may require lower doses or different formulations. Safety and efficacy in children have not been established for this specific dosage form. ## Dose Adjustments No dose adjustments are typically required for renal or hepatic impairment, as systemic absorption is minimal. ## Contraindications Known hypersensitivity to miconazole or any component of the formulation. ## Adverse Effects Common adverse effects include vulvovaginal burning, itching, irritation, and lower abdominal cramping. ## Key Drug Interactions * **Warfarin:** Miconazole can inhibit CYP2C9, potentially increasing warfarin levels. Monitor INR closely if co-administered. * **CYP3A4 substrates:** Miconazole can inhibit CYP3A4, potentially increasing levels of drugs metabolized by this enzyme (e.g., some calcium channel blockers, statins, immunosuppressants). Systemic absorption from vaginal administration is low, but caution is advised. ## Monitoring * Clinical signs and symptoms of vulvovaginal candidiasis. * INR if co-administered with warfarin. ## Clinical Pearls * Complete the full course of treatment, even if symptoms improve sooner. * Avoid sexual intercourse during treatment. * May weaken latex condoms and diaphragms, reducing their effectiveness. * For recurrent or persistent infections, consider further evaluation to rule out underlying causes. *** *Disclaimer: This information is intended for clinical use and is not a substitute for professional medical advice. Always consult the most current prescribing information and your healthcare provider for any questions regarding medication use.*