MICONAZOLE
Formtopical
Apply 2% oral gel thin layer to labial commissures 4 times daily after meals, continuing for at least a week after symptoms disappear x 10-14 days, continuing for a week after the corners have healed
Age restriction: minimum 4 months
(Child >4 months: apply a thin layer of 2% oral gel to labial commissures 4 times daily after meals)
Alternatives. The entry's rationale names miconazole first-line: it covers both the Candida that usually causes angular cheilitis and the staphylococci that often accompany it.
Daktarin Sugar Free 2% Oral Gel SmPC sections 4.2-4.5 (eMC product 6597)
First-line topical antifungal with potent inherent Gram-positive antibacterial activity against staphylococci
- Miconazole oral gel interacts significantly with oral anticoagulants (Warfarin) causing severe bleeding risk; avoid co-administration.
- Investigate underlying predisposing factors: ill-fitting dentures, iron deficiency anemia, B12/folate deficiency, diabetes.
- The oral gel is barred under 4 months, and at any age if the swallowing reflex is not fully developed. It has choked infants. Never put it at the back of the throat: divide the dose, smear it on with a clean finger, and watch the child.
- Continue a week past the point the corners look healed. Stopping the day they clear is why it returns.
- Avoid in liver dysfunction.
| Egyptian brand | Manufacturer | Indicative price |
|---|---|---|
| MICONOL 2% CREAM 15 GM | MEMPHIS | 5.00 EGP |
| DERMOZOL 2% GEL 15 GM | PHARCO | 6.00 EGP |
| MICO ORAL 2% ORAL GEL 30 GM | ALFACURE PHARMACEUTICALS | 6.25 EGP |
| BUCCAZOLE 2% ORAL GEL 20 GM | PHARCO | 12.00 EGP |
| MICONAZ 2% ORAL GEL 20 GM | MUP | 23.00 EGP |
| DAKTARIN 2% CREAM 15 GM | MINA PHARM > JANSSEN CILAG | 28.00 EGP |
| DAKTARIN 2% ORAL GEL 40 GM | JANSSEN CILAG > SOFICOPHARM | 53.50 EGP |
| ADCOZOLE 2% TOPICAL CR. 15 GM | ARAB DRUG COMPANY (ADCO) | 7.25 EGP |