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## Miconazole Vaginal Pessary
### Overview
Miconazole is an imidazole antifungal agent.
### Primary Indications
Treatment of vulvovaginal candidiasis (yeast infection).
### Adult Dosing
* **100 mg vaginal suppository:** Insert 1 suppository vaginally at bedtime for 7 days.
* **200 mg vaginal suppository:** Insert 1 suppository vaginally at bedtime for 3 days.
* **10% vaginal cream (often dispensed as a single-dose applicator):** Administer the contents of 1 applicator (approximately 5 grams) vaginally at bedtime as a single dose.
### Pediatric Dosing
Safety and efficacy in pediatric patients have not been established for the vaginal pessary/suppository formulation. Consult local guidelines or specialist for management.
### Dose Adjustments
No dose adjustments are typically needed for renal or hepatic impairment with vaginal administration.
### Contraindications
Hypersensitivity to miconazole or any component of the formulation.
### Adverse Effects
* **Common:** Vaginal burning, itching, irritation.
* **Less Common:** Pelvic cramps, rash, hives.
### Key Drug Interactions
* **Warfarin:** Miconazole can inhibit the metabolism of warfarin, potentially increasing INR. Monitor INR closely if used concurrently.
### Monitoring
* Monitor for symptom relief.
* Monitor INR if used concomitantly with warfarin.
### Clinical Pearls
* The vaginal suppositories (pessaries) and cream are for vaginal use only. Avoid contact with eyes.
* Complete the full course of treatment, even if symptoms improve earlier.
* Some products may weaken latex condoms and diaphragms. Use alternative contraception during treatment and for a few days after.
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*Disclaimer: This information is intended for healthcare professionals. Always consult the most current prescribing information and local protocols before making clinical decisions.*
