miconazole vaginal

Action and Spectrum

Actions and Spectrum: 

miconazole is an antifungal medication commonly used to treat vaginal yeast infections. It is available in various forms, including creams, suppositories, and vaginal tablets. When used vaginally, miconazole acts locally to combat fungal infections in the vagina. 

The action of miconazole involves inhibiting the growth and reproduction of fungi, specifically dermatophytes, yeasts (such as Candida species), and molds. miconazole works by disrupting the fungal cell membrane, leading to the leakage of cellular contents and ultimately causing the death of the fungus. 

In the case of vaginal yeast infections, miconazole is applied intravaginally as creams, suppositories, or tablets. These formulations release the active ingredient, miconazole, directly into the vagina, allowing it to come into direct contact with the fungal infection. miconazole then acts locally, reducing the growth of yeast and alleviating symptoms such as itching, burning, and abnormal discharge. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Irritation 

Burning 

Allergic contact dermatitis 

Abdominal cramps 

Itching 

Black Box Warning

Black Box Warning: 

None 

Contraindication / Caution

Contraindication/Caution: 

Contraindication 

There are some contraindications and precautions to consider before using miconazole vaginal products.  

• Hypersensitivity: Individuals with known hypersensitivity or allergy to miconazole or its components should avoid using miconazole vaginal products. 
• Pregnancy: While there is limited evidence of harm during pregnancy. 
• Use of latex products: Some miconazole vaginal products contain ingredients that may damage latex, such as condoms or diaphragms. This can lead to decreased effectiveness of the latex barrier. It is advisable to avoid using miconazole vaginal products with latex condoms or diaphragms. Instead, non-latex alternatives should be considered. 
• Open wounds or damaged skin: miconazole should not be applied to damaged skin, open wounds, or areas with severe inflammation. It is intended for use in the vaginal area only. 
• Immune-compromised individuals: Individuals with compromised immune systems, such as HIV/AIDS or undergoing immunosuppressive therapy, should use miconazole vaginal products cautiously. 
• Children: miconazole vaginal products are generally not recommended for children unless specifically directed by a healthcare professional. 

Caution 

There are a few cautions to keep in mind when using them.  

• Consult a healthcare professional: Before using miconazole vaginal products, it is recommended to consult with a healthcare professional, especially if it is your first time experiencing symptoms of a vaginal infection. They can help confirm the diagnosis and provide appropriate guidance on treatment. 
• Allergic reactions: Although uncommon, allergic reactions to miconazole can occur. If you experience symptoms such as rash, itching, swelling, dizziness, or difficulty breathing after using miconazole vaginal products, discontinue and seek medical attention immediately. 
• Persistence or worsening of symptoms: If your symptoms persist or worsen after using miconazole vaginal products for the recommended duration, consult a healthcare professional. It could indicate a more severe infection or a condition other than a yeast infection. 
• Interference with other medications: miconazole can interact with certain medications, including anticoagulants (blood thinners) like warfarin.  
• Use during menstruation: miconazole vaginal products can be used during menstruation but inserting them before bedtime is generally recommended for longer contact time and better absorption. 
• Use of tampons or douches: It is advisable to avoid using tampons or douches while using miconazole vaginal products, as they may interfere with the absorption and effectiveness of the medication. 
• Sexual activity: Sexual intercourse is generally not recommended using miconazole vaginal products. If a sexual activity cannot be avoided, it is advisable to use alternative methods of contraception, as some miconazole formulations may weaken latex condoms or diaphragms. 

Pregnancy / Lactation

Pregnancy consideration:  

US FDA pregnancy category: C 

Lactation:   

Excreted into human milk: Not known. 

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
• Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    
• Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

miconazole vaginal is an antifungal medication belonging to the imidazole class. It exerts its pharmacological action by inhibiting the synthesis of ergosterol. By disrupting ergosterol synthesis, miconazole increases membrane permeability, leading to leakage of cellular contents and ultimately causing fungal cell death.

miconazole has a broad spectrum of antifungal activity, primarily effective against Candida species, including Candida albicans, the common cause of vaginal yeast infections. When used vaginally, miconazole acts locally in the vaginal tissue with minimal systemic absorption, making it a safe and effective treatment option for uncomplicated vaginal yeast infections. 

Pharmacodynamics: 

Mechanism of action: The action of miconazole vaginal involves its ability to inhibit the growth and reproduction of fungi, particularly Candida species that commonly cause vaginal yeast infections. miconazole belongs to the azole class of antifungal drugs and acts by disrupting the synthesis of ergosterol. 

Specifically, miconazole inhibits the enzyme lanosterol 14α-demethylase, which converts lanosterol to ergosterol in fungal cells. Ergosterol is crucial for maintaining the integrity and fluidity of the fungal cell membrane. By inhibiting lanosterol 14α-demethylase, miconazole disrupts the ergosterol synthesis, accumulating toxic sterol intermediates and altering the fungal cell membrane structure. 

The disruption of the fungal cell membrane by miconazole results in increased membrane permeability, leakage of intracellular contents, and impairment of essential cellular functions. Ultimately, this leads to the death of the fungal cells and the elimination of the fungal infection. 

Pharmacokinetics: 

Absorption 

When miconazole vaginal products are used intravaginally, they have minimal systemic absorption. The active ingredient, miconazole, primarily acts locally in the vaginal tissue to combat fungal infections. Systemic absorption may occur to a limited extent, but most of the medication remains in the vaginal area. 

Distribution 

Since miconazole vaginal products are predominantly used locally, the distribution of the drug within the body is not a significant concern. The medication remains primarily in the vaginal tissue, where it exerts its antifungal effects. 

Metabolism 

miconazole undergoes hepatic metabolism, primarily through the cytochrome P450 enzyme system. The metabolites produced are generally inactive or have minimal pharmacological activity. 

Elimination and Excretion 

The excretion of miconazole and its metabolites occurs mainly through the feces. After systemic absorption, the drug is metabolized in the liver and eliminated from the body through biliary excretion into the feces. 

Adminstartion

Administration: 

Vaginal administration 

miconazole vaginal products are available in various formulations, such as creams, suppositories, and vaginal tablets. The specific administration instructions may vary depending on the product you are using.  

• Read the instructions: Carefully read the instructions provided with the specific miconazole product you are using. The instructions will provide detailed information on using the product correctly and effectively. 
• Wash your hands: Before using miconazole vaginal products, thoroughly wash your hands with soap and water to maintain cleanliness and minimize the risk of introducing additional bacteria into the vaginal area. 
• Prepare the product: If you use a cream or suppository, remove the product from its packaging. If you use a vaginal tablet, you may need to unwrap it or prepare it according to the instructions. 
• Position yourself: Find a comfortable position, either lying down with your knees bent or standing with one leg elevated. This position will make it easier to insert the product into the vagina. 
• Insert the product: Gently insert the cream, suppository, or tablet into the vagina as per the instructions provided. The product should be inserted as deeply as possible without causing discomfort. 
• Follow the recommended dosage: Use the product for the recommended duration and dosage as specified by the instructions or as directed by your healthcare professional. It is essential not to exceed the recommended dosage or duration of use. 
• Rewash your hands: After administering the product, wash your hands thoroughly to remove residual medication. 
• Follow any additional instructions: Some miconazole vaginal products may require specific instructions, such as avoiding sexual intercourse or using the product at a specific time. Follow any additional instructions provided with the product. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: miconazole vaginal 

Pronounced: [ mi-KON-a-zole ] 

Why do we use miconazole vaginal? 

miconazole vaginal products are primarily used to treat vaginal yeast infections, also called as vaginal candidiasis. These infections are caused by an overgrowth of Candida, a fungus commonly residing in the vaginal area. miconazole helps combat the fungal infection by inhibiting the growth and also reproduction of the Candida fungus.  

• Treatment of vaginal yeast infections: miconazole vaginal products, including creams, suppositories, and vaginal tablets, commonly treat uncomplicated vaginal yeast infections. Symptoms of a yeast infection might include itching, burning, redness, swelling, abnormal vaginal discharge (thick, white, and cottage cheese-like), and discomfort during sexual intercourse or urination. miconazole helps relieve these symptoms and eliminates fungal infections. 
• Prevention of recurrent yeast infections: In some cases, miconazole vaginal products may be used to prevent recurrent vaginal yeast infections. Recurrence can be expected in specific individuals, and miconazole can help reduce the frequency of episodes when used as a preventive measure.