Miconazole
MONISTAT
What it isImidazole CYP51 inhibitor; cutaneous, vulvovaginal, and oropharyngeal fungal infections.
Why this oneIts topical, vaginal, and buccal formulations treat local disease with little systemic exposure.
What limits it⚑ Even vaginal or buccal use can potentiate warfarin enough to cause bleeding; local irritation is common.
FDA-approved for
- fungal infections (topical/vaginal)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Vaginal yeast infection | ≥12 yr | 1 applicatorful intravaginally QHS ×7 nights | ||
| External vulvar itching/irritation | ≥12 yr | apply to vulva BID ×up to 7 days PRN |
Renal Undefined
Hepatic Undefined
Instructions
- Insert 1 applicatorful into vagina at bedtime; discard applicator after use
- For external itch/irritation, apply cream to vulva twice daily up to 7 days
- Children under 12: ask a doctor
Pregnancy Undefined
Lactation Undefined
NO BOXED WARNINGS
Principal riskEven topical forms raise warfarin enough to cause bleeding
Cost, est. cash$10–$300/month
Generic entry1992
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityLocal irritation or hypersensitivity; systemic toxicity is minimal with correct local use.
Mechanism of action: Miconazole ballicule
