Micatan 20 mg/gm Cream

Imidazole antifungal for:

• Oral gel 2%: oral thrush (mouth and throat candidiasis), denture stomatitis, angular cheilitis
• Cream/powder 2%: ringworm, athlete's foot, skin candidiasis, nappy rash with Candida, pityriasis versicolor
• Vaginal cream/pessary: vaginal thrush

Oral gel (adults and children 2 years and over): 2.5 ml (half a measuring spoon) four times daily after meals; keep in the mouth as long as possible before swallowing. Continue for 7 days after symptoms clear.

Infants 4–24 months: 1.25 ml four times daily, applied in small portions to the affected areas with a clean finger; not under 4 months (choking risk); not for babies with poor swallowing.

Cream/powder: apply twice daily; continue 10 days after lesions clear (athlete's foot and ringworm often 2–6 weeks).

Vaginal: one applicator of 2% cream at night for 7 days, or 1,200 mg pessary once.

• Allergy to miconazole or imidazoles
• Oral gel: infants under 4 months; liver impairment; use with warfarin (unless monitored), statins (simvastatin, lovastatin), pimozide, quinidine, ergot alkaloids, some benzodiazepines (oral midazolam, triazolam)

Oral gel: nausea, vomiting, unpleasant taste, dry mouth; rarely diarrhoea, choking in infants.

Skin/vaginal: local burning, irritation, itching, redness.

Rare: allergic reactions, liver problems (oral).

• Oral gel is absorbed enough to interact strongly with warfarin — serious bleeding has occurred; tell the doctor if you take warfarin.
• Remove dentures overnight and clean them; apply gel to the denture fitting surface.
• Vaginal forms can damage latex condoms and diaphragms.

Skin and vaginal use acceptable in pregnancy. Oral gel: avoid in pregnancy unless needed. Compatible with breastfeeding (avoid applying to nipples unless treating the baby's thrush as advised).

Mainly oral gel (CYP3A4/2C9 inhibition):

• Warfarin (marked rise in INR — bleeding)
• Simvastatin, lovastatin (muscle damage), oral midazolam, triazolam, pimozide, quinidine (contraindicated)
• Sulphonylureas (hypoglycaemia), phenytoin, ciclosporin, tacrolimus, carbamazepine (raised levels)

Oral: vomiting, diarrhoea. Supportive care.

Store below 30°C.