Miconazole Clinical data Trade names Desenex, Monistat, others AHFS/ Drugs.com Monograph MedlinePlus a601203 Pregnancy category
AU: A (when used topically) US: C (Risk not ruled out) (for topical use) Routes of administration topical, vaginal, sublabial ATC code Legal status Legal status
AU: S2 (Pharmacy only) Schedule 2 for topical formulations, schedule 3 for vaginal use and for oral candidiasis, otherwise schedule 4
UK: POM (Prescription only) US: OTC Identifiers
( RS)-1-(2-(2,4-Dichlorobenzyloxy)-2-(2,4-dichlorophenyl)ethyl)-1 H-imidazole CAS Number PubChem CID IUPHAR/BPS DrugBank ChemSpider UNII KEGG ChEBI ChEMBL CompTox Dashboard ( EPA) ECHA InfoCard 100.041.188 Chemical and physical data Formula C 18 H 14 Cl 4 N 2 O Molar mass 416.127 g/mol g·mol −1 3D model ( JSmol) Chirality Racemic mixture
(verify) 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. It is used for ring worm of the  body, groin (jock itch), and feet (athlete's foot). It is applied to the skin or vagina as a cream or ointment. 
Common side effects include itchiness or irritation of the area in which it was applied.
Use in  pregnancy is believed to be safe for the baby. Miconazole is in the  imidazole family of medications. It works by decreasing the ability of fungi to make  ergosterol, an important part of its cell membrane.
Miconazole was patented in 1968 and approved for medical use in 1971.
It is on the  World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. The wholesale cost in the  developing world is about 0.23 to US$0.60 for a 30 gram tube. In the United States a course of treatment costs less than US$25. 
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). This oral gel may also be used for the lip disorder angular cheilitis and other associated systems.
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.
nystatin, some miconazole is absorbed by the intestinal tract when used orally (and possibly if used vaginally ); this may lead to drug interactions.
Interactions are possible with
anticoagulants, phenytoin, terbinafine, , 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.
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: 2-5%
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)
Pessaries: 200 or 100 mg
Vaginal cream: 2% (7-day treatment), 4% (3-day treatment)
Combination: 2% cream with either 100 or 200 mg
Miconazole inhibits the fungal enzyme 14α-sterol demethylase, which reduces production of ergosterol.
In addition to its antifungal actions, miconazole, along with  ketoconazole, is known to act as an antagonist of the glucocorticoid receptor.
Miconazole has been shown to promote remyelination of neurons in chronic progressive multiple sclerosis mouse models.
The solubilities of miconazole nitrate powder are 0.03% in water, 0.76% in ethanol and up to 4% in acetic acid.
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.
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United States Patent 5461068 Archived 2014-09-10 at the Wayback Machine