title: Miconazole - Neonatal Intensive Care Drug Manual
text: Miconazole
  Revision Date : 02-03-2020
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  Approved: TC, KOH
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  Indication :
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  1. Oral thrush (gel)
  2. Superficial candida infections (cream)
  3. Antifungal prophylaxis
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  Dose :
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  1. 25 mg (1.25 mL of gel 4 times a day).
  2. Apply cream TWICE a day after nappy changes
  3. 25 mg (approximately 1 cm of gel 4 times a day).
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  Interval :
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  1 and 3. 6 hourly.
  2. 12 hourly
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  Route :
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  Oral, topical
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  Total Daily Dose :
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  Up to 100 mg/day.
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  Comments :
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  -Fungostatic activity without significant G.I. absorption.
  -Oral Gel: Gel can be drawn up in a syringe. Rub around gums and inside of mouth using a cotton bud or finger. Ensure any excess gel is removed from the mouth. Note: Do not use a spoon to administer gel.
  -Administer after a feed
  -Caution in infants with poor swallowing (potential for airway obstruction)
  -Treatment should be reviewed at 5 days. If there has been a clinical success, treatment should be discontinued. Otherwise, treatment should be continued for up to a total of 12 days. If treatment has been unsuccessful at this point, an alternative treatment should be considered.
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  Supplied as :
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  Daktarin 2% Gel 20 g tube.
  Cream: 2% (20mg/g)
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  Dilution :
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  Stability :
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  Stable at room temperature.
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  Storage :
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  Room temperature.
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  Compatibility:
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  Not Applicable.
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  Incompatibility :
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  Nil.
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  Serum Levels :
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  References:
  1. Australian Medicines Handbook. Miconazole. In: Australian Medicines Handbook [Internet]. Adelaide (South Australia): Australian Medicines Handbook; 2019. Available from: https://amhonline.amh.net.au/
  2. MIMS Australia. Daktarin, Daktozin. In: MIMS Online [Internet]. St Leonards (New South Wales): MIMS Australia; 2019. Available from: https://www.mimsonline.com.au
  3. Auckland newborn services drug protocol. Available from: http://www.adhb.govt.nz/newborn/DrugProtocols/MiconazoleAdministration.htm#5
  4. King Edward Memorial Hospital & Perth Children’s Hospital medication manual. Available from: https://www.kemh.health.wa.gov.au/~/media/Files/Hospitals/WNHS/For%20health%20professionals/Clinical%20guidelines/NCCU/Drug%20Protocols/Miconazole.pdf
  Original version Date: 2014
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  Author: AK/JD
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  Current Version number: 2
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  Current Version Date: 2/3/2020
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  Risk Rating: Low
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  Due for Review: 2/3/2025
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  Approval by: DTC
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  Approval Date: TBA
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