Pharmacology: Miconazole possesses an antifungal activity against the common dermatophytes and yeasts as well as an antibacterial activity against certain gram-positive bacilli and cocci. Its activity is based on the inhibition of the ergosterol biosynthesis in fungi and the change in the composition of the lipid components in the membrane, resulting in fungal cell necrosis.
Pharmacokinetics: The oral bioavailability is low (25-30%) because there is little absorption of miconazole from the intestinal tract.
Dosages of 1000 mg in healthy volunteers produce plasma levels of 1.16 mcg/mL, 2-4 hrs after intake. These levels are insufficient for the treatment of superficial and systemic mycoses. The absorbed part of miconazole is mostly metabolized. Less than 1% of the administered dosage is found unchanged in the urine. There are no active metabolites and the terminal half-life is about 20 hrs.
Oropharyngeal candidiasis: Infants 4-24 months: 1.25 mL (¼ measuring spoon) of gel, applied 4 times/day. Each dose should be divided into smaller portions and the gel should be applied to the affected area(s). The gel should not be swallowed immediately but kept in the mouth as long as possible. Adults and Children ≥2 years 2.5 mL (½ measuring spoon) of gel applied 4 times/day. The gel should not be swallowed immediately, but kept in the mouth as long as possible.
The treatment should be continued for at least a week after the symptoms have disappeared.
For oral candidosis, dental prostheses should be removed at night and brushed with the gel.
Gastrointestinal Candidiasis: The gel may be used for infants (≥6 months of age), children and adults who have difficulty in swallowing tablets. The dosage is 20 mg/kg body wt/day, administered in 4 divided doses. The daily dose should not exceed 250 mg (10 mL Oral Gel) 4 times/day. The treatment should be continued for at least a week after the symptoms have disappeared.
Treatment: Treatment is symptomatic and supportive. A specific antidote is not available.
In the event of accidental ingestion of large quantities of Daktarin, an appropriate method of gastric emptying may be used, if considered necessary (see Interactions).
It is advisable to monitor miconazole and phenytoin levels, if they are used concomitantly.
Effects on the Ability to Drive or Operate Machinery: Daktarin Oral Gel does not affect the alertness or driving ability.
Use in Pregnancy & Lactation: Although there is no evidence that Daktarin Oral Gel is embryotoxic or teratogenic in animals, potential hazards of prescribing these drugs during pregnancy should always be weighed against the expected therapeutic benefits.
There are no data available on the excretion of miconazole in human milk; therefore, caution should be exercised when prescribing Daktarin Oral Gel to nursing mothers.
There are no data available on the excretion of miconazole in human milk; therefore, caution should be exercised when prescribing Daktarin Oral Gel to nursing mothers.
Post-marketing reports of adverse drug reactions: Immune system disorders: Very rare: Allergic conditions including angioneurotic edema and anaphylactic reactions. Respiratory, thoracic and mediastinal disorders: Very rare: Choking. Gastrointestinal system disorders: Very rare: Nausea, vomiting and diarrhea. Hepatobiliary disorders: Very rare: Hepatitis. Skin and subcutaneous system disorders: Very rare: Lyell syndrome (toxic epidermal necrolysis), Stevens-Johnson syndrome, urticaria, rash.
Drugs which should not be used during treatment with miconazole: Oral miconazole is contraindicated with the co-administration of the following drugs that are subject to metabolism by CYP3A4 (see Contraindications): Substrates known to prolong QT-interval eg, astemizole, bepridil, cisapride, dofetilide, halofantrine, mizolastine, pimozide, quinidine, sertindole and terfenadine; ergot alkaloids; HMG-CoA reductase inhibitors eg, simvastatin and lovastatin; triazolam and oral midazolam.
When co-administered with oral miconazole, the following drugs should be used with caution because of a possible increase or prolongation of the therapeutic outcome and/or adverse effects. If necessary, their dosage should be reduced and when appropriate, plasma levels monitored: Others: Oral hypoglycemics (CYP2C9), phenytoin (CYP2C9), carbamazepine, buspirone, alfentanil, sildenafil, alprazolam, brotizolam, midazolam IV, rifabutin, methylprednisolone, trimetrexate, ebastine and reboxetine.
Drugs subject to metabolism by CYP2C9 (see Precautions): Oral anticoagulants eg, warfarin; oral hypoglycemics eg, sulfonylureas; phenytoin.
Other drugs subject to metabolism by CYP3A4: HIV protease inhibitors eg, saquinavir; certain antineoplastic agents eg, vinca alkaloids, busulfan and docetaxel; certain calcium channel blockers eg, dihydropyridines and verapamil; certain immunosuppressive agents: cyclosporine, tacrolimus, sirolimus (rapamycin); others: alfentanil, alprazolam, brotizolam, buspirone, carbamazepine, cilostasol, disopyramide, ebastin, methylprednisolone, midazolam IV, reboxetine, rifabutin, sildenafil and trimetrexate.


CANDID B CREAM 15GM 














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