Adults

Apply a thin layer to the affected skin area and surrounding healthy skin twice daily (morning and evening) for 2-4 weeks, or as directed by a healthcare professional.

Elderly

No specific dosage adjustment is generally required for elderly patients; use as per adult dosage.

Renal_impairment

No dosage adjustment required for topical use due to minimal systemic absorption.

Onset

Symptomatic improvement typically begins within 2-3 days of treatment; however, the full course should be completed.

Excretion

Primarily excreted in feces (approximately 50%), with a smaller portion excreted in urine (approximately 10-20%), mainly as inactive metabolites.

Half life

Not clinically relevant for topical application due to minimal systemic absorption; systemically, plasma half-life is approximately 24 hours.

Absorption

Minimal systemic absorption after topical application to the skin. Less than 1% of the applied dose is absorbed systemically.

Metabolism

Systemically absorbed miconazole is extensively metabolized in the liver to inactive metabolites.

Warfarin

Although systemic absorption is minimal, there have been rare reports of interactions with oral anticoagulants like warfarin, leading to increased anticoagulant effect and bleeding. Monitor INR if concomitant use is necessary.

Phenytoin

May increase phenytoin levels; monitor for toxicity if used concomitantly.