Miconazole%25252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520vaginal%25252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520pessary

## Miconazole Vaginal Pessary ### Overview Miconazole is an imidazole antifungal agent. ### Primary Indications Treatment of vulvovaginal candidiasis (yeast infection). ### Adult Dosing * **100 mg vaginal pessary:** Insert 1 pessary vaginally at bedtime for 7 consecutive days. * **200 mg vaginal pessary:** Insert 1 pessary vaginally at bedtime for 3 consecutive days. * **100 mg vaginal suppository:** Insert 1 suppository vaginally at bedtime for 7 consecutive days. (Note: The request specified "pessary," but suppositories are common for vaginal miconazole. If a rigid pessary form containing miconazole exists, dosing would follow manufacturer instructions, but this is uncommon.) * **Maximum daily dose:** Not applicable for single-dose or short-course vaginal therapy. ### Pediatric Dosing * Data for pediatric use of miconazole vaginal pessaries is limited. Use in pediatric patients should be based on clinical judgment and manufacturer guidelines if available. ### Dose Adjustments * No dose adjustment is typically necessary for renal or hepatic impairment for vaginal administration. ### Contraindications * Hypersensitivity to miconazole or any component of the formulation. * Concurrent use with warfarin (may increase INR). ### Adverse Effects * **Common:** Vaginal burning, itching, irritation, pelvic cramps. * **Less Common:** Headache, rash. ### Key Drug Interactions * **Warfarin:** Miconazole (especially oral formulations, but vaginal potentially too) can inhibit CYP2C9, increasing warfarin levels and bleeding risk. Monitor INR closely if coadministered. ### Monitoring * Clinical signs and symptoms of vulvovaginal candidiasis. * Monitor for signs of hypersensitivity or severe local irritation. * Monitor INR if coadministered with warfarin. ### Clinical Pearls * Avoid sexual intercourse during treatment. * Miconazole vaginal products can weaken latex condoms and diaphragms, potentially leading to breakage or leakage. Advise patients to use alternative contraception during treatment and for 3 days after completion. * If symptoms do not improve after completing the course, or if they worsen, patients should consult their healthcare provider. *** *Disclaimer: This information is intended for healthcare professionals. It is essential to consult the official prescribing information and relevant guidelines for complete details and to verify current recommendations before making clinical decisions.*