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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 consecutive nights.
* **200 mg vaginal suppository:** Insert 1 suppository vaginally at bedtime for 3 consecutive nights.
* **Maximum daily dose:** Not applicable for vaginal administration; follow package instructions.
## Pediatric Dosing
Safety and efficacy in pediatric patients below 12 years of age have not been established for miconazole vaginal products. Dosing for adolescents typically mirrors adult dosing.
## Dose Adjustments
No dose adjustments are typically required for renal or hepatic impairment.
## Contraindications
Hypersensitivity to miconazole or any component of the formulation.
## Adverse Effects
Common adverse effects include vaginal itching, burning, irritation, and lower abdominal cramping.
## Key Drug Interactions
* **Warfarin:** Miconazole can inhibit CYP2C9, potentially increasing the anticoagulant effect of warfarin. Monitor INR closely if used concurrently.
* **CYP3A4 Substrates:** Miconazole inhibits CYP3A4, potentially increasing the plasma concentrations of drugs metabolized by this enzyme. Use with caution.
## Monitoring
* Monitor for symptom relief.
* Assess for signs of local irritation or allergic reaction.
## Clinical Pearls
* Avoid intercourse during treatment.
* Ensure the patient understands proper insertion technique.
* If symptoms persist or worsen after completion of therapy, re-evaluate for alternative diagnoses or resistant organisms.
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*This information is intended for healthcare professionals. Always consult the most current prescribing information and local protocols before making clinical decisions.*
