The Basics

What is Miconazole?

Topical miconazole is used to treat some types of fungus infections

Brand names for Miconazole

Baza Antifungal, Carrington Antifungal, Derma Gran Af, Diabetaid Antifungal Foot Bath, Fungoid, Lotrimin Af, Micatin, Micro-Guard, Mitrazol, Monistat 1, Neosporin Af, Qc Miconazole Nitrate, Secura Antifungal, Soothe Cool Inzo Antifungal, Tetterine Therasoft Antifungal Triple Care Antifungal Triple Care Epc Zeasorb-Af

How Miconazole is classified

Antifungal Agents, Dermatologic Agents

Miconazole During Pregnancy

Miconazole pregnancy category

Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Miconazole while pregnant

Miconazole nitrate administration has been shown to result in prolonged gestation anddecreased numbers of live young in rats and in increased number of resorptions and decreasednumber of live young in rabbits at oral doses of 100 mg/kg/day and 80 mg/kg/day, which are 28and 45 times the maximum possible topical exposure of caregivers, respectively, assuming 100%absorption

Taking Miconazole While Breastfeeding

What are recommendations for lactation if you're taking Miconazole?

Because miconazole has poor oral bioavailability, it is unlikely to adversely affect the breastfed infant, including topical application to the nipples. However, miconazole ointment appears to have no advantage over lanolin for treating sore nipples during breastfeeding[1] and a survey of members of the Academy of Breastfeeding Medicine found topical miconazole is rarely prescribed to nursing mothers to treat thrush.[2] Any excess cream or ointment should be removed from the nipples before nursing. Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[3]

Maternal / infant drug levels

Because miconazole has poor oral bioavailability, it is unlikely to adversely affect the breastfed infant, including topical application to the nipples. However, miconazole ointment appears to have no advantage over lanolin for treating sore nipples during breastfeeding[1] and a survey of members of the Academy of Breastfeeding Medicine found topical miconazole is rarely prescribed to nursing mothers to treat thrush.[2] Any excess cream or ointment should be removed from the nipples before nursing. Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[3]

Possible effects of Miconazole on milk supply

In a randomized, double-bind trial, lanolin was compared to an all-purpose nipple ointment containing mupirocin 1%, betamethasone 0.05%, and miconazole 2% for painful nipples while nursing in the first 2 weeks postpartum. The two treatments were equally effective in reducing nipple pain, nipple healing time, breastfeeding duration, breastfeeding exclusivity rate, mastitis and nipple symptoms, side effects or maternal satisfaction with treatment.[1]

Possible alternatives to Miconazole

Clotrimazole, Fluconazole, Nystatin.

List of References

Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Dennis CL, Schottle N, Hodnett E, McQueen K. An all-purpose nipple ointment versus lanolin in treating painful damaged nipples in breastfeeding women: A randomized controlled trial. Breastfeed Med. 2012;7:473-9. PMID: 22428572
2. Brent NB. Thrush in the breastfeeding dyad: results of a survey on diagnosis and treatment. Clin Pediatr (Phila). 2001;40:503-6. PMID: 11583049
3. Noti A, Grob K, Biedermann M et al. Exposure of babies to C(15)-C(45) mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003;38:317-25. PMID: 14623482

Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.

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