Imidazole antifungal
Miconazole
Brand names: Daktarin, Loramyc
Adult dose
Dose: Oral gel: 5–10mL QDS after food, retain in mouth before swallowing; continue 7 days after symptoms resolve. Topical cream/powder: BD
Route: Topical/Buccal/PO
Frequency: BD-QDS
Clinical pearls
- Oral candidiasis, dermatophyte/candida skin infections
- Significant systemic absorption from oral gel — consider if patient is on warfarin
Contraindications
- Concurrent warfarin (oral gel — major INR rise)
- Concurrent statins (myopathy)
- Children <4 months (oral gel — choking risk)
- Hypersensitivity
Side effects
- Local irritation
- Allergic reactions
- Hepatotoxicity (rare with topical/buccal)
- GI upset
Interactions
- Major: warfarin (raised INR — even with oral gel)
- Statins
- Sulfonylureas
Reference: BNF; MHRA Drug Safety Update; https://bnf.nice.org.uk/drugs/miconazole/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023