AlternativeDaktarin · Gyno-Daktarin
Miconazole
Imidazole antifungal (topical)
Topical alternative to clotrimazole for VVC in pregnancy.
Topical creamPessary
First-line for
- Vulvovaginal candidiasis (alternative)
- Tinea/cutaneous candidiasis
- Nipple candidiasis in lactation
Mechanism
Inhibits fungal CYP51 → blocks ergosterol synthesis → cell-membrane disruption.
“Latex-degrader — counsel barrier methods”
- Petrolatum base weakens condoms/diaphragms
- Use 7-d course in pregnancy
Dosing
- Vaginal
- 2% cream 5 g intravaginal × 7 nights, or 100 mg pessary × 7 nights
- Nipples
- 2% cream after each feed × 10–14 d
Contraindications
- AbsoluteImidazole hypersensitivity
- CautionLatex condom/diaphragm degradation (oil base)
Side effects
- Local burning, irritation
- Contact dermatitis (rare)
Fetal & maternal notes
- • Topical use safe across pregnancy and lactation
Key interactions
Warfarin (vaginal absorption!)
Caution↑ INR — case reports
Clinical pearls
- 💡 Acceptable substitute when clotrimazole unavailable
- 💡 Always treat the dyad in breastfeeding thrush
Content last reviewed: REPLACE_ME (e.g. 2026-07)
Spotted something out of date? See our disclaimer or use Report an Error above.