Miconazole, sold under the brand name Monistat among others, is an antifungal medication used to treat ring worm, pityriasis versicolor, and yeast infections of the skin or vagina.[1] It is used for ring worm of the body, groin (jock itch), and feet (athlete's foot).[1] It is applied to the skin or vagina as a cream or ointment.[1]
Common side effects include itchiness or irritation of the area in which it was applied.[1] Use in pregnancy is believed to be safe for the baby.[2] Miconazole is in the imidazole family of medications.[1] It works by decreasing the ability of fungi to make ergosterol, an important part of its cell membrane.[1]
Miconazole was patented in 1968 and approved for medical use in 1971.[3] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[4] The wholesale cost in the developing world is about 0.23 to 0.60 USD for a 30 gram tube.[5] In the United States a course of treatment costs less than 25 USD.[2]
Contents
1Medical uses
2Side effects
3Brand names and formulations
4Pharmacology
5Remyelination
6Physical properties
7Other uses
8See also
9References
10External links
10.1Medical
10.2Photographic
Medical uses
Miconazole is mainly used externally for the treatment of ringworm including jock itch and athlete's foot. Internal application is used for oral or vaginal thrush (yeast infection). The oral gel may also be used for the lip disorder angular cheilitis.
In the UK, miconazole may be used to treat neonatal oral thrush, while the alternative nystatin is only licensed for patients over the age of one month, but drug interactions are possible.
Side effects
Unlike nystatin, some miconazole is absorbed by the intestinal tract when used orally (and possibly if used vaginally[6]); this may lead to drug interactions.
Interactions are possible with anticoagulants, phenytoin, terbinafine,[citation needed], some newer atypical antipsychotics, cyclosporin, and some statins used to treat hypercholesterolemia.
Brand names and formulations
Vaginal miconazole 20 mg/g - Brazil
Oral treatment: (brands: Daktarin in UK, Fungimin Oral Gel in Bangladesh )
Oral gel 24 mg/ml (20 mg/g)
Oravig 50 mg once daily buccal tablet:
In 2010, the U.S. Food and Drug Administration approved Oravig (miconazole) buccal tablets once daily for the local treatment of oropharyngeal candidiasis, more commonly known as thrush, in adults and children age 16 and older. Oravig is the only local, oral prescription formulation of miconazole approved for this use in the U.S.[citation needed]
External skin treatment: (brands: Desenex and Zeasorb in US and Canada, Micatin, Monistat-Derm, Daktarin in India, UK, Australia, Belgium and the Philippines, Daktar in Norway, Fungidal in Bangladesh, Decocort in Malaysia)
Topical cream: 2%
Combination: hydrocortisone/miconazole cream with 1% and 2%, respectively (Daktacort in UK, Daktodor in Greece)
Dusting powder: 2% powder with chlorhexidine hydrochloride (mycoDust)
Vaginal treatment: (brands: Miconazex, Monistat, Femizol or Gyno-Daktarin in UK)
Miconazole inhibits the fungal enzyme 14α-sterol demethylase, which reduces production of ergosterol.[7] In addition to its antifungal actions, miconazole, along with ketoconazole, is known to act as an antagonist of the glucocorticoid receptor.[8]
Remyelination
Miconazole has been shown to promote remyelination of neurons in chronic progressive multiple sclerosis mouse models.[9]
Physical properties
The solubilities of miconazole nitrate powder are 0.03% in water, 0.76% in ethanol and up to 4% in acetic acid.[10]
Other uses
Miconazole is also used in Ektachrome film developing in the final rinse of the Kodak E-6 process and similar Fuji CR-56 process, replacing formaldehyde. Fuji Hunt also includes miconazole as a final rinse additive in their formulation of the C-41RA rapid access color negative developing process.
See also
Antifungal medication
Castor oil
Clotrimazole
Cremophor EL
Isoconazole
References
^ abcdef"Miconazole Nitrate". The American Society of Health-System Pharmacists. Archived from the original on 21 December 2016. Retrieved 8 December 2016..mw-parser-output cite.citation{font-style:inherit}.mw-parser-output q{quotes:"""""""'""'"}.mw-parser-output code.cs1-code{color:inherit;background:inherit;border:inherit;padding:inherit}.mw-parser-output .cs1-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/6/65/Lock-green.svg/9px-Lock-green.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-limited a,.mw-parser-output .cs1-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Lock-gray-alt-2.svg/9px-Lock-gray-alt-2.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/a/aa/Lock-red-alt-2.svg/9px-Lock-red-alt-2.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration{color:#555}.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration span{border-bottom:1px dotted;cursor:help}.mw-parser-output .cs1-hidden-error{display:none;font-size:100%}.mw-parser-output .cs1-visible-error{font-size:100%}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration,.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-right{padding-right:0.2em}
^ abHamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 180. ISBN 9781284057560.
^Fischer, Janos; Ganellin, C. Robin (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 502. ISBN 9783527607495. Archived from the original on 2016-12-20.
^"WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Archived (PDF) from the original on 13 December 2016. Retrieved 8 December 2016.
^"Miconazole Nitrate". International Drug Price Indicator Guide. Archived from the original on 10 May 2017. Retrieved 8 December 2016.
^British National Formulary '45' March 2003
^Becher, R; Wirsel, SG (August 2012). "Fungal cytochrome P450 sterol 14α-demethylase (CYP51) and azole resistance in plant and human pathogens". Applied Microbiology and Biotechnology. 95 (4): 825–40. doi:10.1007/s00253-012-4195-9. PMID 22684327.
^Duret C, Daujat-Chavanieu M, Pascussi JM, Pichard-Garcia L, Balaguer P, Fabre JM, Vilarem MJ, Maurel P, Gerbal-Chaloin S (2006). "Ketoconazole and miconazole are antagonists of the human glucocorticoid receptor: consequences on the expression and function of the constitutive androstane receptor and the pregnane X receptor". Mol. Pharmacol. 70 (1): 329–39. doi:10.1124/mol.105.022046. PMID 16608920.
^Najm, Fadi J.; Madhavan, Mayur; Zaremba, Anita; Shick, Elizabeth; Karl, Robert T.; Factor, Daniel C.; Miller, Tyler E.; Nevin, Zachary S.; Kantor, Christopher (2015-01-01). "Drug-based modulation of endogenous stem cells promotes functional remyelination in vivo". Nature. 522 (7555): 216–220. doi:10.1038/nature14335. PMC 4528969. PMID 25896324.
^United States Patent 5461068 Archived 2014-09-10 at the Wayback Machine.
External links
Medical
Micatin
Miconazole (National Institutes of Health)
United States Patent 5461068 Imidazole derivative tincture and method of manufacture
Photographic
Kodak process E6 Ektachrome (color transparency) processing manual Z-119
Kodak process E6 Q-LAB processing manual Z-6 (more details than processing manual Z119 above)
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