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Action/Kinetics:
Broad-spectrum fungicide that alters the permeability of the fungal membrane by inhibiting synthesis of sterols; thus, essential intracellular materials are lost. The drug also inhibits biosynthesis of triglycerides and phospholipids and also inhibits oxidative and peroxidative enzyme activity. May be fungistatic or fungicidal, depending on the concentration.
Uses:
Topical, Vaginal: Tinea pedis, tinea cruris, tinea corporis caused by
Trichophyton rubrum, T. mentagrophytes and
Epidermophyton floccosum (both OTC and Rx). Moniliasis and tinea versicolor (Rx only).
Contraindications:
Hypersensitivity. Use of topical products in or around the eyes.
Special Concerns:
Safe use in children less than 1 year of age has not been established.
Side Effects:
Following systemic use. G
I: N&V;, diarrhea, anorexia.
Hematologic: Thrombocytopenia, aggregation of erythrocytes, rouleaux formation on blood smears. Transient decrease in hematocrit.
Dermatologic: Pruritus, rash, flushing, phlebitis at injection site.
CV: Transient tachycardia or arrhythmias following rapid injection of undiluted drug.
Miscellaneous: Fever, chills, drowsiness, transient decrease in serum sodium values. Hyperlipemia due to the vehicle (polyethylene glycol 40 and castor oil).
Following topical use: Vulvovaginal burning, pelvic cramps, hives, skin rash, headache, itching, irritation, maceration, and allergic contact dermatitis.
Drug Interactions:
-
Amphotericin B /
Activity of each drug
-
Coumarin anticoagulants /
Anticoagulant effect
How Supplied:
Topical Cream: 2%;
Powder: 2%;
Spray: 2%;
Vaginal Cream: 2%;
Suppository: 100 mg, 200 mg;
Combination Pack: Suppositories, 200 mg and Cream, 2%
Dosage
?Topical, Aerosol Powder, Aerosol Solution, Cream, Lotion, Powder
Apply to cover affected areas in morning and evening (once daily for tinea versicolor) for 7 days.
?Vaginal Cream or Suppository
Monistat 3: One suppository daily at bedtime for 7 days (100-mg suppositories) or 3 consecutive days (200-mg suppositories).
Monistat 7: One applicator full of cream or one suppository at bedtime daily for 7 days. Course may be repeated after presence of other pathogens has been ruled out.
?Combination Pack
Vaginal yeast infections, relief of external vulval itching and irritation due to yeast infection.
Three day treatment consisting of miconizole suppositories, 200 mg and miconazole nitrate cream, 2%.
