Miconazole: Uses, Side Effects, Dosages, and Interactions

Published August 29th, 2021 by Bridget Reed
Fact Checked by
Chris Riley
Medically Reviewed:
Camille Freking

What is Miconazole | What is it used to Treat? | Fungal Infections | How Long Does it Take to Work? | Proper Dose | Side Effects | Drug Interactions

Fungus can be found everywhere in the world, including both indoor and outdoor environments. While fungus is usually benign, it can also cause infections of the skin, vagina, and other warm, damp parts of the body, such as the mouth, groin, and spaces between the toes. 

Miconazole is a popular over-the-counter treatment for fungal infections of the skin, mouth, throat, and vagina. The side effects most commonly associated with miconazole when used for vagina infections include abdominal cramping and vaginal irritation, itching, or burning after administration of the product. 

Patients using miconazole for the treatment of a fungal infection of the skin may experience side effects like burning, swelling, redness, tenderness, stinging, irritation, pimple-like bumps, or flaking of the treated skin. 

What Is Miconazole?

Miconazole is a generic topical medication that is most commonly used for the treatment of fungal infections of the skin and vagina. 

Sold under various brand names such as Monistat, Lotrimin AF, and Micatin, miconazole has been FDA-approved for medical use and is listed as an essential medicine by the World Health Organization. The medication works to treat fungal infections by killing fungus and preventing more fungus from growing. 

Miconazole is available in the form of a cream, ointment, spray, spray powder, powder, and tincture when used to treat fungal infections of the skin. For the treatment of vaginal yeast infections, miconazole is available in the form of a vaginal insert and a topical cream for symptom relief.

What Is Miconazole Used To Treat?

Miconazole is a topical cream that is used to treat common fungal infections of the skin or vagina, including yeast infections (candidiasis), jock itch, athlete’s foot, and ringworm. The medication is also used to treat a fungal skin condition known as pityriasis (tinea versicolor), which causes the skin on the chest, legs, arms, or neck to become lighter or darker while infected.

While miconazole can be used to treat many different types of fungal infections, one of the most common applications of the medication is the treatment of vaginal yeast infections in adults and children over the age of 12.

This common type of fungal infection results from the overgrowth of the fungus candida albicans, which is found naturally in the vagina. While the vagina naturally contains candida albicans, the population of the yeast is typically kept in check by a certain type of bacteria, lactobacillus, that prevents the overgrowth of yeast. Sometimes, this balance becomes disrupted, which can cause the fungus to grow unchecked. 

Common causes of vaginal yeast infections include:

  • The use of antibiotics
  • Pregnancy
  • Uncontrolled diabetes
  • A compromised immune system
  • The use of medications that increase estrogen levels, such as hormonal contraceptives

What Causes Fungal Infections?

Fungal infections are extremely common and can be contagious. People can develop a fungal infection from exposure to fungal spores in the environment that land on the skin or are inhaled. They can also be passed from person to person, particularly in warm or damp rooms frequented by a large number of people, such as locker rooms or bathrooms. 

Common examples of fungal infections include athlete’s foot, ringworm, thrush, and vaginal yeast infection. Infections typically occur when fungal spores colonize a specific part of the body, such as the skin, toenails, vagina, or mouth, but fungal infections can also occur when naturally occurring fungal colonies on the body are able to grow unchecked.

How Long Does It Take For Miconazole to Work?

One of the advantages of miconazole is that the medication starts to work quickly to relieve symptoms of fungal infections. The product begins to work immediately to kill fungus, which helps to relieve feelings of itching, burning, or irritation.

Depending on the formula used and the concentration of the medication, miconazole may start to provide initial relief from individual symptoms within one hour and start to provide relief for all symptoms within about four hours.

How Do I Know What Dose of Miconazole to Take?

As a topical medication, miconazole is not typically administered in doses the same way that a tablet or liquid might be. Instead, the cream, spray, powder, spray powder, or tincture is applied as a thin layer of medication to treat the affected area. 

When used to treat fungal infections of the skin, miconazole is typically applied twice a day or as directed by a doctor. While miconazole can be used to treat fungal infections of both the skin and vagina, the formulas are not interchangeable despite containing the same active ingredient. Only formulas that are designed to treat vaginal yeast infections should be applied to the vagina. Similarly, vaginal creams are not meant to be used to treat fungal infections on the skin.

When used for the treatment of vaginal yeast infections, miconazole is typically available in three different formulas, including a one-day formula (such as Monistat 1), a three-day formula (such as Monistat 3) or a seven-day formula (such as Monistat 7). Which formula a patient chooses to use will depend on her specific needs.

One-day miconazole products often include a vaginal insert and a symptom relief cream. Women who lead active lifestyles, including those who exercise frequently or engage in a high level of activity, may benefit from choosing this formula because the vaginal insert is convenient and stays in place throughout the day, so it won’t interfere with their lifestyle. 

This formula contains all of the miconazole a patient will need for the treatment of a vaginal yeast infection, so some women may be uncomfortable administering such a high dose of the medication all at once.

Patients who are concerned about the high dose of miconazole administered in the one-day formula may prefer to use a regular-strength three-day formula. Three-day formulas may be available in the form of vaginal inserts, suppositories, or topical creams. Patients typically apply the product at night every day for a total of three days.

The least concentrated doses of miconazole are available in the seven-day formula. The seven-day formula is available in the form of a topical cream that is applied each night before bed over a period of seven days. This option is the only treatment option recommended for women who are pregnant or diabetic and are suffering from a yeast infection.

Are There Any Side Effects I Should Be Aware Of?

Miconazole is available over the counter and is associated with a low risk of side effects. The side effects most commonly reported with the use of vaginal miconazole include vaginal irritation, itching, or burning after inserting a miconazole antifungal vaginal insert, while others report abdominal cramping. Patients using miconazole for the treatment of a fungal infection of the skin may experience side effects like burning, swelling, redness, tenderness, stinging, irritation, pimple-like bumps, or flaking of the treated skin. Rarely, some patients may experience serious side effects, such as abdominal pain, headache, or severe vaginal burning, itching, swelling, or irritation. The medication may also cause hives or a skin rash in some patients.

What Drug Interactions Are Associated With Miconazole?

Miconazole is associated with very few drug interactions and is generally considered safe for use by most people. 

However, there are some medications that are known to interact with miconazole, so it is important for patients to give their doctor and pharmacist a complete list of medications that they are taking, including prescription drugs, over-the-counter medications, dietary supplements, and herbal supplements.

Certain medications may make patients more likely to develop fungal infections of the skin or vagina. Medications known to interact with miconazole include:

  • Anisindione
  • Dicumarol
  • Warfarin

Summary

Miconazole is a popular over-the-counter treatment for fungal infections of the skin and vagina. Under the brand names Lotrimin AF, and Micatin, miconazole is used for the treatment of fungal skin infections like jock itch, athlete’s foot, ringworm, and pityriasis, while the medication is used for the treatment of vaginal yeast infections when sold under the brand name Monistat. 

The side effects most commonly associated with miconazole when used for the treatment of vaginal infections include vaginal irritation, itching, or burning, and abdominal cramping, after inserting a miconazole antifungal vaginal insert. 

Serious side effects are rare but may include abdominal pain, headache, or severe vaginal itching, swelling, burning, or irritation. Patients using miconazole for the treatment of a fungal infection of the skin may experience side effects like burning, swelling, redness, tenderness, stinging, irritation, pimple-like bumps, or flaking of the treated skin.

Sources:

Three Convenient Strengths to Serve Your Needs | Monistat 

23 July 2019 WHO model list of essential medicines | World Health Organization 

Athlete's foot - Symptoms and causes | Mayo Clinic 

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