Miconazole
Miconazole is a local antifungal used on skin and in selected otic combinations. Specialist ophthalmic formulations have also been used for fungal keratitis.
Group
Imidazole antifungal
Mechanism of Action
Inhibits ergosterol synthesis, impairing fungal membrane integrity.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Otitis externa or superficial fungal dermatitis | Reference only | TOPICAL | Every 12 h | Surolan: a few drops to the cleaned ear or skin lesion twice daily. Otodectes ear treatment: five drops twice daily for 14 days. Inspect eardrum first. |
| Localized superficial fungal skin infection | Reference only | TOPICAL | Every 12–24 h | Suitable spray, cream, lotion or wipe: apply once or twice daily. Do not use alcohol-containing products on very inflamed, eroded or ulcerated skin. |
Cats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Otitis externa or superficial fungal dermatitis | Reference only | TOPICAL | Every 12 h | Surolan: a few drops to the cleaned ear or skin lesion twice daily. Otodectes ear treatment: five drops twice daily for 14 days. Inspect eardrum first. |
| Localized superficial fungal skin infection | Reference only | TOPICAL | Every 12–24 h | Suitable spray, cream, lotion or wipe: apply once or twice daily. Do not use alcohol-containing products on very inflamed, eroded or ulcerated skin. |
Horses
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Fungal keratitis | Reference only | TOPICAL | Every 2–6 h | Specialist ophthalmic formulation: miconazole 1% solution every 2–6 hours, adjusted to examination and organism. A skin cream is not a sterile eye preparation. |
| Intensive fungal keratitis treatment | Reference only | TOPICAL | Every 1–2 h | Use a sterile alcohol-free compounded 1% miconazole solution, initially every 1–2 hours for several days, then reduce after examination, cytology and culture response. Total treatment commonly lasts 4–6 weeks. |
Indications
- Malassezia-associated otitis and superficial fungal infection
- Specialist treatment of fungal keratitis
Contraindications
- Hypersensitivity
- Perforated eardrum for polymyxin-containing Surolan
Interactions
- Avoid additional ototoxic drugs with Surolan.
Adverse effects
- Local irritation
- Rare hearing impairment with otic combinations
- Corticosteroid effects with prolonged combination use
Toxicity
Stop treatment for hearing loss, vestibular signs or marked irritation; assess the contribution of other combination ingredients.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Surolan ear drops and cutaneous suspension Miconazole nitrate strength; combination treatment, not single-active mass dosing. Shake and examine eardrum before ear use. | Other | miconazole nitrate 23 mg / mL + prednisolone acetate 5 mg / mL + polymyxin b sulfate 0.5293 mg / mL | TOPICAL |
Monitoring and Administration
For Surolan, clean the canal, shake thoroughly and massage after instillation. It also contains polymyxin B and prednisolone acetate.
Surolan ears: a few drops twice daily; for Otodectes, five drops twice daily for 14 days. Skin: a few drops twice daily over the cleaned lesion. Continue a few days after clinical resolution; refractory cases may need 2–3 weeks with reassessment.
Specialist ocular treatment has used 1% miconazole solution every 2–6 hours; do not substitute a nonsterile dermatologic product into the eye.
Topical dermatologic miconazole alone may be insufficient for generalized dermatophytosis; systemic treatment and management of underlying disease may be needed.
For shampoo, contact for at least 10 minutes then rinse; frequency is formulation- and response-dependent. Prevent licking for 20–30 minutes.
Dermatologic products may contain alcohols or other cornea-damaging excipients. Ophthalmic therapy requires a specifically sterile alcohol-free formulation; do not substitute a commercial skin spray into a subpalpebral catheter.
Miconazole nitrate mass and miconazole base mass differ. The appendix rounds some product percentages without an exact salt-to-base basis; no equivalence is inferred from that rounding.
Medicated wipes and pads deliver local treatment; a pad is not a mL or gram dose, so its contents are not used for unsupported volume conversion.