MICONAZOLE (OPHTHALMIC)

Indications/Pharmacology

Miconazole is a broad spectrum imidazole antifungal agent with someantibacterial activity. Miconazole will penetrate the intact corneal epithelium. Topical miconazole therapyhas been a favorite first choice agent for treatment of fungal keratitis in the horse by veterinaryophthalmologists for several years. Miconazole may be delivered by subconjunctival route, but with somelocal irritation, and topical use is the most commonly employed treatment method.Suggested Dosages/Precautions/Adverse Effects - Miconazole is formulated at 10 mg/ml for IV use inhumans. It can be directly taken from the glass ampule for IV use and applied to the cornea of horses. It isa clear solution readily delivered through subpalpebral lavage apparatus systems. The medication issignificantly less expensive compared with natamycin and its corneal penetration is more favorable, although still less than optimal. Treatment is generally delivered hourly or bi-hourly during the firstseveral days of treatment. Once clinical improvement is noted and cytology specimens and repeatedcultures indicate eradication of fungal organisms, the treatment frequency is gradually reduced. Mostfungal keratitis cases are treated 4 to 6 weeks.Dosage Forms/Preparations/FDA Approval Status - Veterinary-Approved Products: None

Human-Approved Products:

Miconazole Injection 10 mg/ml in 20 ml glass ampules Monistat-i.v.® (Janssen); Rx