miconazole at a glance
Medicine class
Imidazole antifungal
Licensed use
Fungal infections of the mouth and throat
How it is used
Applied inside the mouth and kept there before swallowing
Important interaction
Can markedly increase warfarin's anticoagulant effect
What is miconazole used for?
Selected oral gels are licensed for superficial fungal infection of the mouth and throat, particularly candidosis (oral thrush).
Oral candidosis affecting the mouth and throat in adults and children within the product's licensed age range.
How does miconazole work?
Miconazole blocks production of ergosterol, an essential part of the fungal cell membrane. This disrupts the membrane and causes fungal cells to die.
miconazole preparations and strengths
Oral gel
Route: Oromucosal
Strengths: 2%
How to take miconazole
Follow the product leaflet or prescriber's instructions. Apply the oral gel after food, keep it in contact with affected areas, and do not swallow it immediately.
Apply with a clean finger.
For infants and young children, use small portions at the front of the mouth; never place gel at the back of the throat.
Do not apply oral gel to a breastfeeding woman's nipple to give it to an infant.
When treating oral candidosis, remove dentures at night and brush them with the gel.
miconazole side effects
Common or expected effects
- Nausea or vomiting
- Unusual taste
- Mouth discomfort or dryness
- Regurgitation, particularly in young children
Get urgent medical advice
- Choking, especially in infants and young children
- Severe allergic reaction, including facial or throat swelling and breathing difficulty
- Severe blistering, peeling or widespread skin reaction
- Hepatitis or symptoms such as jaundice and dark urine
- Serious bleeding when interacting with anticoagulants
miconazole in pregnancy
Selected oral gels should preferably be avoided during pregnancy unless a prescriber judges that the expected benefit outweighs the potential risk.
miconazole while breastfeeding
It is uncertain whether miconazole passes into breast milk, so use should be reviewed by a prescriber or pharmacist. Never put oral gel on the nipple to give it to an infant because it may cause choking.
miconazole interactions
Oral gel is partly absorbed and inhibits CYP2C9 and CYP3A4, so clinically important interactions can occur.
Warfarin and other oral anticoagulants
Miconazole may greatly increase anticoagulation and bleeding risk. The pharmacy product is contraindicated with warfarin; planned prescription use requires careful specialist monitoring.
Simvastatin or lovastatin
Concentrations and toxicity risk may increase; concurrent use is contraindicated.
Common questions about miconazole
Answers are fully visible for fast scanning and source review.
Can miconazole oral gel be used for a baby?
Selected products are licensed from 4 months only when the swallowing reflex is adequately developed. Premature infants or those with delayed development may need a higher minimum age and clinical assessment.
Can miconazole oral gel be used with warfarin?
Do not self-treat. The pharmacy product is contraindicated with warfarin because severe bleeding can occur; proposed prescription use requires careful clinical oversight and anticoagulation monitoring.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.