Miconazole Nitrate

	Zambia HIV National Guidelines
	Introduction HIV Counseling and Testing Sexually Transmitted Infections (STIs) General Principles of Antiretroviral Therapy for Chronic HIV Infection in Adults and Adolescents When to Start ARV Therapy for Chronic HIV Infection in Adults and Adolescents Initial Regimen for ARV Therapy Adherence Baseline evaluation and Monitoring Calculations: Ideal Body Weight, Body Mass Index and Creatinine Clearance ARV Therapy for Individuals with Tuberculosis Co-Infection Adverse Effects and Toxicity Immune Reconstitution Inflammatory Syndrome (IRIS) Changing or Stopping ART Treatment Failure Stopping ARV Therapy Post Exposure Prophylaxis Cotrimoxazole Prophylaxis WHO Staging in Adults and Adolescents Nutrition Care and Support Palliative Care in HIV and AIDS
	Guide Editors
	Editor In Chief Joel E. Gallant, MD, MPH Pharmacology Editor Paul Pham, PharmD, BCPS Zambia Guideline Team Peter Mwaba MMed PhD FRCP Alywn Mwinga MMed Isaac Zulu MMed MPH Velepie Mtonga MMed Albert Mwango MBChB Jabbin Mulwanda MMed FCS

Drugs>Antimicrobial Agents>

Miconazole

Pham P and Bartlett JG
08-28-2008

Zambia Specific Information

Available formulation in Zambia: Ointment or cream: 2% (nitrate).
Tinea involving sensitive areas (e.g. tinea cruris) or not responsive to benzoic acid: miconazole 2% cream apply to affected area q8h. Continue for 2 weeks after lesions have cleared.
Vaginal candidiasis: miconazole 200 mg intra-vaginal daily x 3 days

REFERENCES

Zambia Information Author: Paul A. Pham Pharm.D.

INDICATIONS

FDA

Cutaneous candidiasis
Tinea cruris
Tinea pedis
Tinea corporis

FORMS

brand name	generic	Mfg	brand forms	cost*
Monistat-7	Miconazole	Generic manufacturers	vaginal cre 2% (35g)	$7.73
			vaginal sup 100mg	$1.20
Monistat-derm	Miconazole	Generic manufacturers	topical cream 2% (15g)	$10.98
			topical cream 2% (30g)	$11.98

Monistat-1	Miconazole	Generic manufacturers	vaginal sup 1200mg	$16.78
			vaginal cream 6.5%	$14.38
Monistat-3	Miconazole	Generic manufacturers	vaginal cream 4%	$13.20
			vaginal sup 200 mg	$14.38

*Prices represent cost per unit specified and are representative of "Average Wholesale Price" (AWP). AWP Prices were obtained and gathered by Lakshmi Vasist Pharm D using the Red Book, manufacturer's information, and the McKesson database.

^Dosage is indicated in mg unless otherwise noted.

USUAL ADULT DOSING

Vulvovaginal candidiasis: 100 mg qhs intravaginal x 7 days or 200 mg intravaginal qhs x 3 days.
Cutaneous candidiasis: Apply topically twice daily x 1-4 weeks .

RENAL DOSING

DOSING FOR GLOMERULAR FILTRATION OF 50-80

Usual dose.

DOSING FOR GLOMERULAR FILTRATION OF 10-50

Usual dose.

DOSING FOR GLOMERULAR FILTRATION OF <10 ML/MIN

Usual dose.

DOSING IN HEMODIALYSIS

Usual dose.

DOSING IN PERITONEAL DIALYSIS

Usual dose.

DOSING IN HEMOFILTRATION

Usual dose.

ADVERSE DRUG REACTIONS

OCCASIONAL

Burning, itching and irritation

DRUG INTERACTIONS

None

SPECTRUM

Candida spp. and dermatophytes

PHARMACOLOGY

Pharmacology

COMMENTS

Topical antifungal agent that is effective forms of treatment for vaginal candidiasis. In the immunocompetent host, one time dose of fluconazole is equivalent and more cost effective.

REFERENCES

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Acknowledgments

Abbreviations