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 Drug Name
Monistat Cream (Miconazole Nitrate)
Drug Uses
Monistat is available in several formulations, including Monistat 3 vaginal suppositories, Monistat 7 vaginal cream and suppositories, and Monistat-Derm skin cream. Monistat's active ingredient, Miconazole, fights fungal infections.
Monistat 3 and Monistat 7 are used for vaginal yeast infections. Monistat-Derm is used for skin infections such as athlete's foot, ringworm, jock itch, yeast infection on the skin (cutaneous candidiasis), and tinea versicolor (a common skin condition that produces patches of white, tan, or brown finely flaking skin over the neck and trunk).
How Taken
Use Monistat exactly as prescribed.
Keep all forms of this medicine away from your eyes.
Before applying Monistat-Derm to your skin, be sure to wash your hands. Massage the medication gently into the affected area and the surrounding skin.
If you are using the vaginal cream or suppository, follow these steps:
- Load the applicator to the fill line with cream, or unwrap a tablet, wet it with warm water, and place it in the applicator as shown in the instructions you received with the product.
- Lie on your back with your knees drawn up.
Gently insert the application high into the vagina and push the plunger.
- Withdraw the applicator and discard it if disposable, or wash with soap and water.
To keep the vaginal medication from getting on your clothing, wear a sanitary napkin. Do not use tampons because they will absorb the medicine. Wear cotton underwear--avoid synthetic fabrics such as rayon or nylon. Do not douche unless your doctor tells you to do so.
Dry the genital area thoroughly after a shower, bath, or swim. Change out of a wet bathing suit or damp workout clothes as soon as possible. Yeast is less likely to flourish in a dry environment.
Do not scratch if you can help it. Scratching can cause more irritation and can spread the infection.
Drug Class and Mechanism
Depending upon concentration, miconazole exhibits broad spectrum in vitro fungistatic or fungicidal activity against species of the genus Candida. Miconazole also inhibits several other genera of fungi, including dermatophytes and yeasts, as well as Gram-positive bacteria.
Miconazole inhibits the biosynthesis of ergosterol or other sterols, damaging the fungal cell wall membrane and altering its permeability. In fungi, it also inhibits biosynthesis of triglycerides and phospholipids as well as oxidative and peroxidative enzymes. The latter action results in intracellular buildup of toxic concentrations of hydrogen peroxide, which may contribute to deterioration of subcellular organelles and cellular necrosis.
C. albicans cells have been observed to exhibit progressive cytoplasmic deterioration and prominent shape changes resulting in complete cell necrosis depending on the dose and duration of exposure to miconazole. The sequence of morphologic alterations induced by miconazole at fungistatic doses (106M) are lysis of cytoplasmic organelles, focal to complete loss of cell plasmalemma and irregular thickening of the cell wall containing multiple inclusions. Administration of fungicidal doses (104M) induces a completely necrotic cell interior with an unaltered cell wall.
In C. albicans, miconazole inhibits the transformation of blastospores into invasive mycelial form. Not all species or strains of a particular organism may be susceptible to miconazole.
Miconazole has been clinically effective in treating tinea pedis (athlete's foot), tinea cruris, tinea corporis, and tinea versicolor caused by dermatophytes. Monistat Derm Cream is also effective in cutaneous candidiasis. Among the organisms against which Monistat Derm Cream has been found effective are T. rubrum, T. mentagrophytes, T. interdigitale, E. floccosum, M. canis, M. gypseum, species of Candida including C. albicans, and M. furfur.
To date, no wild strains or fungal mutants with substantial acquired resistance to miconazole have been reported; however, miconazole resistant C. albicans has been isolated from an infant following bladder irrigation with miconazole for the treatment of urinary candidiasis.
Missed Dose
Make up for it as soon as you remember. However, if it is almost time for your next dose, skip the one you missed and go back to your regular schedule.
Storage
Store at room temperature.
Warnings/Precautions
If symptoms persist, or if an irritation or allergic reaction develops while you are using Monistat, notify your doctor.
The hydrogenated vegetable oil base of Monistat 3 may interact with the latex in vaginal diaphragms, so concurrent use of these two products is not recommended.
Your doctor may recommend Monistat 7 Vaginal Cream if you are using a diaphragm. However, you should be aware that the mineral oil in the vaginal cream can weaken the latex in condoms and diaphragms, making them less reliable for prevention of pregnancy or sexually transmitted disease.
If you are using Monistat 3 or Monistat 7 suppositories, you should either avoid sexual intercourse or make sure your partner uses a condom.
Do not give Monistat 7 to girls less than 12 years of age. Also avoid using Monistat 7 if you have any of the following symptoms:
Fever above 100°F orally
Foul-smelling vaginal discharge
Pain in the lower abdomen, back, or either shoulder
If these symptoms develop while you are using Monistat 7, stop treatment and contact your doctor right away. You may have a more serious infection.
If the infection fails to improve or worsens within 3 days, or you do not obtain complete relief within 7 days, or symptoms return within two months, you may have something other than a yeast infection.
Possible Side Effects Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor. Only your doctor can determine whether it is safe for you to continue taking Monistat.
- More common side effects may include:
Burning sensation, cramping, headaches, hives, irritation, rash, vulval or vaginal itching
More Information
Keep using this medicine regularly for the full time of the treatment, even if the infection seems to have disappeared. If you stop too soon, the infections could return. You should continue using the vaginal forms of the medicine even during your menstrual period. |
