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# Miconazole Vaginal ## Overview Miconazole is an imidazole antifungal agent. ## Primary Indications Treatment of vulvovaginal candidiasis (yeast infection). ## Adult Dosing * **1% Cream:** Insert 1 applicatorful (approximately 5 grams) intravaginally at bedtime for 7 days. * **2% Cream:** Insert 1 applicatorful (approximately 5 grams) intravaginally at bedtime for 3 days. * **100 mg Suppository:** Insert 1 suppository intravaginally at bedtime for 7 days. * **200 mg Suppository:** Insert 1 suppository intravaginally at bedtime for 3 days. * **150 mg Suppository:** Insert 1 suppository intravaginally as a single dose. ## Pediatric Dosing Data on use in pediatric patients is limited. Consult specific product labeling or institutional protocols. ## Dose Adjustments No dose adjustments are typically necessary for renal or hepatic impairment due to minimal systemic absorption. ## Contraindications Hypersensitivity to miconazole or any component of the formulation. ## Adverse Effects Common side effects include vulvovaginal burning, itching, and irritation. ## Key Drug Interactions Miconazole is a potent inhibitor of CYP3A4 and CYP2C9. Coadministration with sensitive substrates of these enzymes (e.g., warfarin, simvastatin, atorvastatin, certain calcium channel blockers) may lead to increased plasma concentrations of the coadministered drug, potentially causing toxicity. ## Monitoring Monitor for symptom resolution. If symptoms persist or worsen, re-evaluate for alternative diagnosis or resistant organisms. ## Clinical Pearls * Complete the full course of treatment, even if symptoms improve earlier. * Avoid intercourse during treatment. * Miconazole vaginal products can weaken latex and rubber products, such as condoms and diaphragms, increasing the risk of breakage. *** *Disclaimer: This information is intended for healthcare professionals. It is essential to consult the most current prescribing information and institutional guidelines before making any clinical decisions.*