Daktarin Oral Gel

The cell membranes of fungi are vital for their survival. They keep unwanted substances from entering the cells and stop the contents of the cells from leaking out. By making holes in the membranes, miconazole allows essential constituents of the fungal cells to leak out, which kills the fungi and clears up the infection.

Miconazole also has some antibacterial action and kills certain bacteria that may also be present in the infection.

How do I use Daktarin oral gel?

• Daktarin oral gel should be used four times a day at regular intervals. Follow the instructions given by your doctor or pharmacist regarding how much gel to use and how long to use it for.
• Daktarin oral gel should be used after eating.
• If the infection is just in the mouth, the gel should be applied directly to the affected area(s) with a clean finger. Keep the gel in the mouth for as long as possible before swallowing it.
• For infections of the mouth, throat and gut you should take the measured amount of gel from the spoon, but keep the gel in your mouth for as long as possible before swallowing it.
• If you are giving the gel to a child, make sure that you don't put the gel near the back of their throat, as this can be a choking hazard (see below). Each dose should also be divided into smaller portions.
• If you have false teeth (dentures) and are treating oral thrush you should also brush the gel onto your dentures after you take them out at night. This is to kill any fungus that may be on the dentures.
• If you forget to take a dose don't worry, just leave out the missed dose and take the next dose when it is due. Do not take a double dose to make up for a missed dose.
• You should keep using Daktarin oral gel for seven days after the symptoms have cleared up. This will make sure the infection is fully treated and thus help prevent it coming back.
• If your symptoms persist despite using Daktarin oral gel you should consult your doctor.

What should I know before using Daktarin oral gel?

• Daktarin oral gel is sticky. Make sure that the gel doesn't obstruct the throat, as this can cause choking, particularly in children. The gel should not be put at the back of the throat, and for children under two years of age, each dose should be divided into smaller portions. If you are giving Daktarin oral gel to a child who is breastfeeding you should not apply the medicine to your nipple to give it, as the baby can choke on the gel if it is given this way.
• If you get a skin rash or any blistering or peeling of the skin or inside of the mouth while using Daktarin oral gel, it is important to stop using it and consult a doctor.

Who should not use Daktarin oral gel?

• Babies under four months of age, or those whose swallowing reflex is not yet fully developed (for example babies born prematurely who may not fully develop the swallowing reflex until they are five or six months of age).
• People with liver problems.
• People with rare hereditary blood disorders called porphyrias.
• People who are allergic to any ingredient. If you feel you have experienced an allergic reaction, stop using Daktarin oral gel and inform your doctor or pharmacist immediately.

Can I use Daktarin oral gel while pregnant or breastfeeding?

• Daktarin oral gel is not recommended for use during pregnancy unless considered essential by your doctor. It should only be used if the expected benefit to the mother is greater than any possible risk to the developing baby. Get medical advice from your doctor before using this medicine if you are or think you could be pregnant.
• It is not known if miconazole passes into breast milk. Daktarin oral gel should be used with caution in nursing mothers, and only if the benefits to the mother outweigh any risks to the nursing infant. Get medical advice from your doctor before using this medicine if you are breastfeeding.

What are the possible side effects of Daktarin oral gel?

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with miconazole. Just because a side effect is stated here does not mean that all people using Daktarin oral gel will experience that or any side effect.

Common

• Feeling sick and vomiting.
• Regurgitating the medicine.
• Dry mouth.
• Mouth discomfort.

Uncommon 

• Change in sense of taste.

Unknown frequency

• Choking.
• Diarrhoea.
• Tongue discolouration.
• Sore mouth.
• Allergic skin reactions.
• Inflammation of the liver (hepatitis).

Talk to your doctor, nurse or pharmacist if you want any more information about the possible side effects of Daktarin oral gel. 

Can I use Daktarin oral gel with other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.

The manufacturer states that Daktarin oral gel should not be used by people who are taking any of the following medicines. This is because miconazole can reduce the breakdown of these medicines in the body and hence increase the risk of their side effects:

• astemizole
• cisapride
• ergot alkaloids, eg ergotamine, methysergide
• midazolam taken by mouth
• mizolastine
• pimozide
• quetiapine
• quinidine
• sertindole
• statins for lowering cholesterol, eg atorvastatin, simvastatin and lovastatin (except pravastatin which is unaffected). Your doctor may decide to prescribe you this medicine even if you are taking a statin. In this case you should look out for possible side effects of the statin and tell your doctor straight away if you notice any signs of unexplained muscle pain, tenderness or weakness or dark coloured urine.
• terfenadine
• triazolam.

Miconazole increases the anti-blood-clotting effect of anticoagulant medicines such as warfarin, nicoumalone and phenindione, which may increase the risk of bleeding. If you are taking an anticoagulant your doctor may want to monitor your blood clotting time (prothrombin time or INR) during and after a course Daktarin oral gel, and may need to alter the dose of your anticoagulant as a result.

Miconazole may increase the blood levels of the following medicines, which could increase the risk of their side effects:

• benzodiazepines such as alprazolam
• buspirone
• busulfan
• calcium channel blockers such as felodipine, nifedipine
• carbamazepine
• ciclosporin
• cilostazol
• disopyramide
• nateglinide
• phenytoin
• protease inhibitors for HIV infection, eg saquinavir
• ranolazine
• reboxetine
• rifabutin
• sirolimus
• sulphonylureas used for diabetes, eg glibenclamide, gliclazide, glipizide and tolbutamide (the blood sugar lowering effect of these medicines may be enhanced, which may cause hypoglycaemia)
• tacrolimus.

References:

https://www.hpra.ie/img/uploaded/swedocuments/2166546.PA0823_059_001.e7f468f0-d44d-4c6f-8bc5-9273dffadc86.000001Product%20Leaflet%20Approved%20Cream.151029.pdf

http://www.medicines.ie/medicine/1952/SPC/Daktarin+2++w+w+Cream/

http://www.news-medical.net/drugs/Daktarin-Cream.aspx

http://www.netdoctor.co.uk/medicines/mouth-and-teeth/a6504/daktarin-oral-gel-miconazole/