Please check your internet connection and try again.
# Miconazole Vaginal Pessary
## Overview
Miconazole is an imidazole antifungal agent. The vaginal pessary formulation is used for the topical treatment of vaginal yeast infections.
## Primary Indications
Vulvovaginal candidiasis (yeast infection).
## Adult Dosing
* **100 mg vaginal pessary:** Insert one pessary vaginally once daily at bedtime for 7 days.
* **200 mg vaginal pessary:** Insert one pessary vaginally once daily at bedtime for 3 days.
* **150 mg vaginal pessary:** Insert one pessary vaginally once daily at bedtime as a single dose.
Actual regimen dependent on product availability and local protocol.
## Pediatric Dosing
Safety and efficacy in pediatric patients under 12 years of age have not been established. Use in this population is generally not recommended unless specifically directed by a healthcare provider.
## Dose Adjustments
No dose adjustment is typically required for renal or hepatic impairment as systemic absorption is minimal.
## Contraindications
* Hypersensitivity to miconazole or any component of the formulation.
## Adverse Effects
* **Common:** Vaginal burning, itching, irritation, pelvic cramps.
* **Less Common:** Headache, rash.
## Key Drug Interactions
* **Warfarin:** Miconazole can inhibit CYP2C9, increasing the anticoagulant effect of warfarin. Monitor INR closely if co-administered.
* **CYP3A4 Substrates:** Although systemic absorption is minimal, potential exists for inhibition of CYP3A4, which could affect levels of other CYP3A4 substrates.
## Monitoring
* Symptom resolution.
* INR if co-administered with warfarin.
## Clinical Pearls
* Patients should be advised to complete the full course of therapy, even if symptoms improve.
* Lubrication may be needed for insertion.
* Avoid sexual intercourse during treatment.
* Latex condoms and diaphragms may be damaged by the pessary base, leading to contraceptive failure or increased risk of sexually transmitted infections.
***
**Disclaimer:** This information is intended for healthcare professionals. Always consult the current official prescribing information and relevant guidelines before making clinical decisions.
