miconazole (Buccal mucosa route)

Pronunciation

mye-KON-a-zole

Commonly used brand name(s)

In the U.S.

  • Oravig

Available Dosage Forms:

  • Tablet

Therapeutic Class: Antifungal

Chemical Class: Imidazole

Uses For miconazole

Miconazole buccal treats fungus (yeast) infections in the mouth and throat (oral thrush). It belongs to the group of medicines called antifungals and works by killing or preventing growth of the fungus or yeast.

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miconazole is available only with your doctor's prescription.

Before Using miconazole

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For miconazole, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to miconazole or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of buccal miconazole in children younger than 16 years of age. Safety and efficacy have not been established.

Geriatric

No information is available on the relationship of age to the effects of buccal miconazole in the elderly.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking miconazole, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using miconazole with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Pimozide

Using miconazole with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Amiodarone
  • Clozapine
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Escitalopram
  • Fentanyl
  • Hydrocodone
  • Piperaquine
  • Warfarin

Using miconazole with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Anisindione
  • Dicumarol
  • Fosphenytoin
  • Oxycodone
  • Phenprocoumon
  • Phenytoin
  • Tolterodine
  • Trimetrexate

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of miconazole. Make sure you tell your doctor if you have any other medical problems, especially:

  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
  • Milk protein allergy, history of—Should not be used in patients with this condition.

Proper Use of miconazole

Take miconazole exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

miconazole comes with a patient information insert. Read and follow the instructions in the insert carefully. Ask your doctor if you have any questions.

Keep using miconazole for the full treatment time, even if you feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.

To use the buccal tablet:

  • Apply the tablet in the morning, after brushing your teeth.
  • With dry hands, place the rounded side of one tablet on your upper gum above the incisor tooth. You have a right and left incisor tooth. They are just to the right and left of your 2 front teeth.
  • Hold the tablet in place by placing your fingertip over the upper lip for 30 seconds. This will make the tablet stick to your gum.
  • Allow the tablet to dissolve. Do not crush, chew, or swallow the tablet.
  • It is not a problem if the tablet sticks to the cheek or the inside of the lip.
  • If the tablet does not stick or falls off within the first 6 hours, use the same tablet and put it on again. If it still does not stick, use a new tablet.
  • If you swallow the tablet within the first 6 hours, drink a glass of water and place a new tablet on your gum.
  • If the tablet falls off after 6 hours or longer, do not apply a new tablet. Wait for your next dose.
  • You may eat or drink normally when the tablet is in place, but chewing gum should be avoided.

Dosing

The dose of miconazole will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of miconazole. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For buccal dosage form (tablets):
    • For fungus infection in the mouth and throat:
      • Adults and teenagers 16 years of age and older—One tablet placed on the upper gum once a day for 14 days.
      • Teenagers and children younger than 16 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of miconazole, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using miconazole

It is very important that your doctor check your progress at regular visits. This will allow your doctor to make sure the medicine is working properly and to check for any unwanted effects that may be caused by the medicine.

miconazole may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth while you are using miconazole.

If your symptoms do not improve, or if they become worse, check with your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

miconazole Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common
  • Body aches or pain
  • cough
  • difficulty with breathing
  • ear congestion
  • fever or chills
  • headache
  • loss of voice
  • lower back or side pain
  • nasal congestion
  • painful or difficult urination
  • pale skin
  • runny nose
  • sneezing
  • sore throat
  • troubled breathing with exertion
  • unusual bleeding or bruising
  • unusual tiredness or weakness
Rare
  • Black, tarry stools
  • pale skin
  • shortness of breath
  • ulcers, sores, or white spots in the mouth

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Change in taste
  • diarrhea
  • dry mouth
  • headache
  • itching skin
  • loss of taste
  • nausea
  • pain, redness, and swelling of the gums
  • sores on the tongue
  • toothache
Less common
  • Abdominal or stomach pain
  • loss of appetite
  • pain
  • upper abdominal or stomach pain
  • weakness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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