Hydrocortisone + Miconazole: Indication, Dosage, Side Effect, Precaution

Generic Medicine Info Patient Medicine Information

This information is not country-specific. Please refer to the Singapore prescribing information.

Generic Medicine Info

Indications and Dosage

Topical/Cutaneous
Infected eczema

Adult: As oint containing hydrocortisone 1% and miconazole 2%: Apply to the affected area bid to tid. Rub gently until absorbed by the skin. Once inflammation have disappeared (after approx 7 days), continue treatment w/ miconazole nitrate 20 mg/g cream or powd.
Child: Same as adult dose.

Topical/Cutaneous
Candidal intertrigo, Tinea pedis

Adult: As cream containing hydrocortisone 1% and miconazole 2%: Apply to affected area bid. Rub gently until absorbed by the skin. Max treatment duration: 7 days.
Child: ≥10 yr Same as adult dose.

Contraindications

Hypersensitivity to hydrocortisone or miconazole. Tubercular or viral infections of the skin or those caused by gm-ve bacteria.

Special Precautions

Childn.

Adverse Reactions

Severe hypersensitivity reactions, including anaphylaxis and angioedema; skin irritation, burning sensation, urticaria, pruritus, rash, contact dermatitis, erythema, skin inflammation, skin hypopigmentation; adrenal suppression, irritability.

Patient Counseling Information

This drug may damage latex contraceptive agents (e.g. condoms or diaphragms).

Drug Interactions

May increase the effect of oral anticoagulants (e.g. warfarin).

Action

Description:
Mechanism of Action: Hydrocortisone is an anti-inflammatory steroid which exerts its action through reduction in the vascular component of the inflammatory response, suppression of migration of polymorphonuclear leukocytes, and reversal of increased capillary permeability; it also has a vasoconstrictive action. Miconazole is a potent broad-spectrum antifungal and antibacterial agent w/ marked activity against dermatophytes, pathogenic yeasts and many gm+ve bacteria.
Pharmacokinetics:
Absorption: Hydrocortisone: Absorbed after topical application (approx 3%). Miconazole: Remains in the skin for up to 4 days after topical application. Bioavailability: <1%.
Distribution: Hydrocortisone: Plasma protein binding: >90%. Miconazole: Plasma protein binding: 88.2%; also bound to RBC (10.6%).
Metabolism: Hydrocortisone: Undergoes metabolism in the liver and tissues.
Excretion: Hydrocortisone: Via urine, as metabolites (mostly glucuronides), w/ small amounts as unchanged drug. Half-life: Approx 100 min. Miconazole: Mainly via faeces and small amounts in urine, as unchanged drug and metabolites.

Chemical Structure

Storage

Store at or below 25°C.

MIMS Class

Topical Anti-Infectives with Corticosteroids

References

Daktacort 2%/1% w/w Ointment (Janssen-Cilag Ltd). eMC. https://www.medicines.org.uk/emc/. Accessed 08/04/2016 .

Daktacort Hydrocortisone Cream (McNeil Products Ltd). eMC. https://www.medicines.org.uk/emc/.

Joint Formulary Committee. Hydrocortisone With Miconazole. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/04/2016 .

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