Candoral
Generic Name
Miconazole
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| candoral 2 w oral gel | ৳ 52.00 | N/A |
Description
Overview of the medicine
Candoral 2% w/w Oral Gel contains Miconazole, an antifungal medication used to treat fungal infections of the mouth and throat, such as oral thrush.
Uses & Indications
Dosage
Adults
Apply 2.5 ml of gel four times daily after meals. Hold the gel in the mouth for as long as possible before swallowing.
Elderly
Same as adult dosage.
Renal_impairment
No dosage adjustment needed as systemic absorption is minimal.
How to Take
Apply the gel to the affected areas in the mouth with a clean finger. It is important to hold the gel in the mouth for as long as possible before swallowing to maximize local contact time. Use after meals.
Mechanism of Action
Miconazole inhibits the biosynthesis of ergosterol, an essential component of the fungal cell membrane. This disruption leads to increased permeability and eventual lysis of the fungal cell, resulting in its death.
Pharmacokinetics
Onset
Clinical improvement typically seen within a few days of consistent application.
Excretion
Excreted mainly in the feces (primarily unchanged drug) and urine (metabolites).
Half life
Systemic half-life is around 20-25 hours, but topical action is localized and sustained.
Absorption
Minimal systemic absorption (less than 1%) occurs following oral application, with most remaining in the mouth.
Metabolism
Primarily metabolized in the liver via the CYP450 enzyme system (CYP2C9, CYP3A4).
Side Effects
Contraindications
- Hypersensitivity to Miconazole or other azole antifungal agents.
- Co-administration with terfenadine, astemizole, cisapride, triazolam, oral midazolam, or statins metabolized by CYP3A4.
Drug Interactions
Warfarin
May increase the anticoagulant effect, requiring careful monitoring of INR.
Phenytoin
May increase plasma concentrations of phenytoin, requiring dose adjustment.
CYP3A4 Substrates
Miconazole is a potent inhibitor of CYP3A4 and can increase plasma levels of co-administered drugs like terfenadine, astemizole, cisapride, triazolam, midazolam, and certain statins (e.g., simvastatin, lovastatin), potentially leading to serious adverse effects.
Oral Sulfonylureas
May enhance the hypoglycemic effect, leading to lower blood glucose levels.
Storage
Store below 30°C in a dry place, protected from light and moisture. Do not freeze. Keep out of reach of children.
Overdose
Systemic overdose is unlikely due to minimal oral absorption. In case of accidental ingestion of a large amount, symptomatic and supportive treatment should be given. Gastric lavage may be considered in appropriate situations.
Pregnancy & Lactation
Use during pregnancy and lactation should be with caution and only if the potential benefit outweighs the potential risk. Minimal systemic absorption suggests low risk, but consult a doctor.
Side Effects
Contraindications
- Hypersensitivity to Miconazole or other azole antifungal agents.
- Co-administration with terfenadine, astemizole, cisapride, triazolam, oral midazolam, or statins metabolized by CYP3A4.
Drug Interactions
Warfarin
May increase the anticoagulant effect, requiring careful monitoring of INR.
Phenytoin
May increase plasma concentrations of phenytoin, requiring dose adjustment.
CYP3A4 Substrates
Miconazole is a potent inhibitor of CYP3A4 and can increase plasma levels of co-administered drugs like terfenadine, astemizole, cisapride, triazolam, midazolam, and certain statins (e.g., simvastatin, lovastatin), potentially leading to serious adverse effects.
Oral Sulfonylureas
May enhance the hypoglycemic effect, leading to lower blood glucose levels.
Storage
Store below 30°C in a dry place, protected from light and moisture. Do not freeze. Keep out of reach of children.
Overdose
Systemic overdose is unlikely due to minimal oral absorption. In case of accidental ingestion of a large amount, symptomatic and supportive treatment should be given. Gastric lavage may be considered in appropriate situations.
Pregnancy & Lactation
Use during pregnancy and lactation should be with caution and only if the potential benefit outweighs the potential risk. Minimal systemic absorption suggests low risk, but consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture when stored correctly.
Availability
Pharmacies, hospitals
Approval Status
Approved by DGDA
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Miconazole oral gel has been extensively studied in clinical trials and has demonstrated efficacy in treating oral and oropharyngeal candidiasis across various patient populations.
Lab Monitoring
- Routine laboratory monitoring is generally not required for miconazole oral gel due to its minimal systemic absorption. However, if concomitant use with warfarin or other highly protein-bound drugs is necessary, monitoring of INR or drug levels may be advised.
Doctor Notes
- Counsel patients on the proper application technique, emphasizing holding the gel in the mouth for an extended period to maximize local action.
- Be vigilant for potential drug interactions, especially with warfarin and other CYP3A4 substrates, and monitor accordingly.
Patient Guidelines
- Complete the full course of treatment even if symptoms improve to prevent recurrence.
- Do not share the medicine with others, even if they have similar symptoms.
- Maintain good oral hygiene during treatment.
Missed Dose Advice
If a dose is missed, apply it as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose.
Driving Precautions
Candoral 2% w/w Oral Gel is unlikely to affect the ability to drive or operate machinery due to minimal systemic absorption and localized action.
Lifestyle Advice
- Avoid sugary foods and drinks during treatment as they can encourage fungal growth.
- Practice good dental hygiene, including regular brushing and flossing.
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