its antifungal actions, miconazole, similarly to ketoconazole, is known to act as an antagonist of the glucocorticoid receptor. Pharmacokinetics After application to the skin, miconazole can be measured in the skin for up to four days, but less than 1% is absorbed into the bloodstream. When applied to the oral mucosa (and possibly also for vaginal use), it is significantly absorbed. In the bloodstream, 88.2% are bound to plasma proteins and 10.6% to blood cells. The substance is partly metabolized via the liver enzyme CYP3A4 and mainly eliminated via the faeces. Chemistry The solubilities of miconazole nitrate powder are 0.03% in water, 0.76% in ethanol and up to 4% in acetic acid. Miconazole crystallises as colourless prisms in the monoclinic space group P21/c. Other uses Miconazole is also used in Ektachrome film developing in the final rinse of the Kodak E-6 process and similar Fuji CR-56 process, replacing formaldehyde. Fuji Hunt also includes miconazole as a final rinse additive in their formulation of the C-41RA rapid access color negative developing process. Brands and formulations Oral treatment: (brand names Daktarin in UK, Fungimin Oral Gel in Bangladesh): Oral gel 24 mg/ml (20 mg/g) Oravig 50 mg once daily buccal tablet In 2010, the U.S. Food and Drug Administration approved Oravig (miconazole) buccal tablets once daily for the local treatment of oropharyngeal candidiasis, more commonly known as thrush, in adults and children age 16 and older. Oravig is the only local, oral prescription formulation of miconazole approved for this use in the U.S. External skin treatment (brand names Desenex and Zeasorb in US and Canada, Micatin, Monistat-Derm, Daktarin in India, UK, Australia, Belgium and the Philippines, Daktar in Norway, Fungidal in Bangladesh, Decocort in Malaysia) Topical cream: 2-5% Combination: hydrocortisone/miconazole cream with 1% and 2%, respectively (Daktacort in UK, Daktodor in Greece) Dusting powder: 2% powder with chlorhexidine hydrochloride (mycoDust) Vaginal treatment (brand names Miconazex, Monistat, Femizol or Gyno-Daktarin in UK): Pessaries: 200 or 100 mg Vaginal cream: 2% (7-day treatment), 4% (3-day treatment) Combination: 2% cream with either 100 or 200 mg References External links Kodak process E6 Ektachrome (color transparency) processing manual Z-119 Kodak process E6 Q-LAB processing manual Z-6 (more details than processing manual Z119 above) 21-Hydroxylase inhibitors Antiglucocorticoids Aromatase inhibitors Belgian inventions Chloroarenes CYP17A1 inhibitors CYP2C8 inhibitors CYP3A4 inhibitors Phenylethanolamine ethers Imidazole antifungals Lanosterol 14α-demethylase inhibitors Otologicals World Health Organization essential medicines Wikipedia medicine articles ready to translate