MICONAZOLE
Patient Counselling
Instructions for use 1, 2:
· All miconazole products are placed high in the vagina once daily, usually at bedtime to decrease leakage from the vagina.
· Insertion is similar to inserting a tampon. Insert the applicator as far as it comfortably goes. Gently depress the plunger until it stops to release the medication and remove the applicator.
· Wash all reusable applicators with water and soap after each use. Throw out disposable applicators after one use.
· A small amount of miconazole 2% cream can be applied externally to the vaginal opening once to twice daily for more symptom relief, up to a maximum of 7 days.
· Do not stop treatment if your period starts.
· Continue treatment for full duration of therapy, even if symptoms resolve before treatment is complete.
· Avoid sexual intercourse during treatment of vaginal candidiasis.
· Do not use tampons, vaginal douches, or other intra-vaginal products because they can decrease the effectiveness of miconazole.
· Avoid use with latex condoms, diaphragms, spermicides, cervical caps as the miconazole formulations could cause failure of these contraceptives2.
Potential side effects 1,2, 3,4:
· Local vaginal irritation, burning, or hypersensitivity reaction
· Abdominal cramps
· Headache
Follow-up 1,2,3:
· Symptoms do not resolve after seven days of starting treatment
· Recurrence of symptoms within two months of treatment
· Symptoms worsen during treatment
· Hypersensitivity reaction
References
1. Patient Self-Care. 1st Edition. Canadian Pharmacists Association 2002. Chapter 50 – Vaginal Symptoms. Laura-Lynn Pollock. Pages 676-679.
2. Joseph T. DiPiro, Robert L. Talbert, Gary C. Yee, Gary R. Matzke, Barbara G. Wells, L. Michael Posey. Pharmacotherapy: A Pathophysiologic Approach, 8th Edition. Chapter 129: Superficial Fungal Infections. Toronto: McGraw-Hill; 2011.
3. Centers for Disease Control and Prevention (CDC). Diseases characterized by vaginal discharge. In: Sexually transmitted diseases treatment guidelines, 2010 [Erratum appears in MMWR Recomm Rep. 2011 Jan 14;60(1):18]. MMWR Recomm Rep 2010 Dec 17;59(RR-12):56-63.
4. Miconazole. Micromedex® Healthcare Series [Internet database]. Greenwood Village, Colo: Thomson Healthcare. Updated periodically.
· All miconazole products are placed high in the vagina once daily, usually at bedtime to decrease leakage from the vagina.
· Insertion is similar to inserting a tampon. Insert the applicator as far as it comfortably goes. Gently depress the plunger until it stops to release the medication and remove the applicator.
· Wash all reusable applicators with water and soap after each use. Throw out disposable applicators after one use.
· A small amount of miconazole 2% cream can be applied externally to the vaginal opening once to twice daily for more symptom relief, up to a maximum of 7 days.
· Do not stop treatment if your period starts.
· Continue treatment for full duration of therapy, even if symptoms resolve before treatment is complete.
· Avoid sexual intercourse during treatment of vaginal candidiasis.
· Do not use tampons, vaginal douches, or other intra-vaginal products because they can decrease the effectiveness of miconazole.
· Avoid use with latex condoms, diaphragms, spermicides, cervical caps as the miconazole formulations could cause failure of these contraceptives2.
Potential side effects 1,2, 3,4:
· Local vaginal irritation, burning, or hypersensitivity reaction
· Abdominal cramps
· Headache
Follow-up 1,2,3:
· Symptoms do not resolve after seven days of starting treatment
· Recurrence of symptoms within two months of treatment
· Symptoms worsen during treatment
· Hypersensitivity reaction
References
1. Patient Self-Care. 1st Edition. Canadian Pharmacists Association 2002. Chapter 50 – Vaginal Symptoms. Laura-Lynn Pollock. Pages 676-679.
2. Joseph T. DiPiro, Robert L. Talbert, Gary C. Yee, Gary R. Matzke, Barbara G. Wells, L. Michael Posey. Pharmacotherapy: A Pathophysiologic Approach, 8th Edition. Chapter 129: Superficial Fungal Infections. Toronto: McGraw-Hill; 2011.
3. Centers for Disease Control and Prevention (CDC). Diseases characterized by vaginal discharge. In: Sexually transmitted diseases treatment guidelines, 2010 [Erratum appears in MMWR Recomm Rep. 2011 Jan 14;60(1):18]. MMWR Recomm Rep 2010 Dec 17;59(RR-12):56-63.
4. Miconazole. Micromedex® Healthcare Series [Internet database]. Greenwood Village, Colo: Thomson Healthcare. Updated periodically.