Apply miconazole gel four times a day, after meals. Space your doses out evenly throughout the day.
You will be prescribed a course of treatment - continue to use the gel until the course is finished.
Common side-effects include feeling sick, an unusual taste, and a dry mouth.
About miconazole for oral thrush
|Type of medicine||An antifungal medicine|
|Used for||Fungal mouth infections|
|Available as||Oral gel|
Oral thrush is an infection in the mouth caused by a yeast germ called Candida. Yeasts are a type of fungus, and the mouth is a common site where Candida causes infection. Certain situations or conditions can cause an overgrowth of Candida which can lead to a bout of oral thrush. These include being a baby, having a dry mouth, wearing dentures, after a course of antibiotics, using corticosteroid inhalers, having diabetes or anaemia, being in poor health, and smoking.
The symptoms of oral thrush are that the mouth becomes red, and white spots sometimes develop. Although some mild infections are painless, oral thrush can make your mouth quite sore and can make eating and drinking uncomfortable. Some babies with oral thrush may not be able to feed properly because of the soreness. Miconazole eases these symptoms by killing the Candida fungus.
Miconazole oral gel is available on a prescription from a doctor, and smaller packs can be bought at pharmacies without a prescription.
Miconazole is a medicine which is also used to treat vaginal thrush and fungal infections in other parts of the body. There is information about this in the separate medicine leaflets called Miconazole for vaginal thrush and Miconazole for fungal skin infections.
Before using miconazole for oral thrush
To make sure this is the right treatment for you, before you start using miconazole make sure that your doctor or pharmacist knows:
- If you are pregnant or breast-feeding. This is because, while you are expecting or feeding a baby, you should only use medicines on the recommendation of a doctor.
- If you have problems with the way your liver works.
- If you are taking any other medicines. This includes any medicines which are available to buy without a prescription, such as herbal and complementary medicines. This is important because miconazole gel can alter the way some medicines work. It is particularly important that you speak with a doctor or pharmacist before you use miconazole gel if you are taking warfarin tablets.
- If you have ever had an allergic reaction to a medicine.
- If you have a rare inherited blood condition called porphyria.
How to use miconazole for oral thrush
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about miconazole and will provide you with a full list of the side-effects which you may experience from using it. If you have been given any additional information by your doctor, read this also.
- Use miconazole gel exactly as your doctor tells you to. Use it four times a day after meals unless your doctor tells you otherwise.
- Using a finger, smear a small amount of the gel on to the affected areas of your mouth - allow it to remain on the areas for as long as possible before you swallow. Ideally, you should not eat or drink for about 30 minutes after using the gel, as this helps to prevent the medicine from being washed away too soon. If the infection has spread down your throat, your doctor may ask you to swallow the gel like a medicine rather than apply it to your mouth.
- If you are giving miconazole to a baby or an infant, check the label carefully to make sure you are using the correct dose for the age of your child. Apply the gel a little at a time after a feed, or a meal. To avoid the risk of choking, do not apply the gel near to the back of your child's throat and keep a check on your child for a short while after the gel has been applied.
- A typical course of treatment will last for a week, although sometimes a two-week course is needed. Keep using the gel regularly for as long as you have been directed. It is likely you will need to continue using miconazole for several days after your symptoms have eased.
- If you forget to apply a dose of the gel, don't worry, just remember to apply the next dose when it is due. Do not 'double up' to make up for a missed dose.
Getting the most from your treatment
- If you wear dentures, make sure that you clean your dentures each day. Remove them at bedtime and brush them with the miconazole gel. Not taking dentures out at night is thought to be a common cause of oral thrush.
- If you have diabetes, test your blood sugar regularly to check that your diabetes is well controlled. Good control of blood sugar levels can help to reduce the risk of thrush infections.
- If you use a steroid inhaler, remember to use a good inhaler technique (your asthma nurse can check this for you). Rinse out your mouth with water after using your inhaler as this can help to remove any medicine particles left in your mouth, and will reduce the risk of fungal infections. Using a spacer device attached to your inhaler can also help to reduce the risk of thrush.
- If you are a smoker, stopping smoking will help to prevent further bouts of oral thrush. Ask your doctor if you need help with quitting.
- If your symptoms do not improve despite using miconazole, speak with your doctor. Your doctor may suggest that a sample (swab) be taken from inside your mouth so that the cause of the infection can be investigated further.
Can miconazole cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with miconazole, although these are usually mild and do not last long. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common miconazole gel side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Feeling sick||Stick to simple foods - avoid rich or spicy meals|
|Unusual taste, dry mouth||Drink plenty of water. If this becomes troublesome, speak with your doctor|
|Mouth discomfort, regurgitation||If troublesome, speak with your doctor|
If you experience any other symptoms which you think may be due to the medicine, discuss them with your doctor or pharmacist for further advice.
How to store miconazole
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
If you buy any medicines check with a pharmacist that they are safe to take with your other medicines.
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Daktarin® Oral Gel; Janssen-Cilag Ltd, The electronic Medicines Compendium. Dated March 2014.
- British National Formulary; 68th Edition (Sep 2014) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Adrian Bonsall