Miconazol

Miconazol, also spelled miconazol, is an azole antifungal agent of the imidazole class. It works by inhibiting fungal cytochrome P450-dependent enzyme lanosterol 14α-demethylase, which disrupts ergosterol synthesis and compromises fungal cell membrane integrity. The effect is generally fungistatic, though it can be fungicidal at higher concentrations against some species.

The drug has a broad spectrum that includes dermatophytes such as Trichophyton, Microsporum and Epidermophyton, as well as yeasts like Candida species. Clinically, miconazol is used topically for skin fungal infections such as tinea corporis, tinea cruris, tinea pedis and seborrheic dermatitis. It is also used in vaginal preparations for vulvovaginal candidiasis and in oral forms (gel, buccal tablets) to treat oropharyngeal candidiasis and related mucosal candidal infections, including denture-related stomatitis.

Formulations include creams, ointments, powders and sprays for skin infections, and vaginal creams or tablets and oral preparations for mucosal infections. Because topical miconazol generally remains local, systemic exposure is low; however, extensive or mucosal application can lead to systemic absorption, which may interact with other drugs by inhibiting cytochrome P450 enzymes (for example, warfarin or phenytoin) if absorbed in significant amounts.

Common adverse effects are minor and local, such as irritation, burning or itching at the application site. Rare hypersensitivity reactions can occur. Brand names in different regions include Daktarin, Micatin and Monistat.