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# Miconazole Vaginal
## Overview
Miconazole is an imidazole antifungal agent used for the topical treatment of vaginal yeast infections.
## Primary Indications
* Vulvovaginal candidiasis (yeast infection)
## Adult Dosing
* **1-Day Treatment:**
* 1200 mg vaginal suppository inserted intravaginally once at bedtime.
* **3-Day Treatment:**
* 200 mg vaginal suppository inserted intravaginally once at bedtime for 3 consecutive days.
* **7-Day Treatment:**
* 100 mg vaginal suppository inserted intravaginally once at bedtime for 7 consecutive days.
* Alternatively, 100 mg vaginal cream inserted intravaginally once at bedtime for 7 consecutive days.
## Pediatric Dosing
Safety and efficacy in pediatric patients under 12 years of age have not been established.
## Dose Adjustments
No specific dose adjustments are necessary for renal or hepatic impairment.
## Contraindications
* Hypersensitivity to miconazole or any component of the formulation.
## Adverse Effects
* **Common:** Vulvovaginal burning, itching, irritation, redness, pelvic cramps.
* **Less Common:** Headache, rash.
## Key Drug Interactions
* **Warfarin:** Miconazole, particularly when used systemically or in high vaginal doses, may inhibit CYP2C9, leading to increased warfarin effect and bleeding risk. Monitor INR closely.
## Monitoring
* Clinical improvement of symptoms (e.g., itching, burning, discharge).
## Clinical Pearls
* Avoid sexual intercourse during treatment.
* The vaginal suppositories and cream may damage latex condoms and diaphragms, reducing their effectiveness.
* Ensure complete insertion of the applicator or suppository for optimal efficacy.
* If symptoms persist after completing the course, re-evaluate for alternative diagnoses or resistant organisms.
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*This information is intended for healthcare professionals. Always consult the current prescribing information and relevant clinical guidelines before making treatment decisions.*
