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Miconazole and Zinc Oxide

Generic name: miconazole/zinc oxide topical

Brand names: Daktozin, Vusion, Rash Relief Antifungal

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Ointment, topical:

Vusion®: Miconazole nitrate 0.25% and zinc oxide 15% (50 g)


Mechanism of Action

Miconazole inhibits the biosynthesis of ergosterol, damaging the fungal cell wall membrane.

Zinc oxide is a mild astringent with weak antiseptic properties.



Topical: Miconazole: Undetectable to 3.8 ng/mL in infants with dermatitis

Use: Labeled Indications

Adjunctive treatment of diaper dermatitis complicated by Candida albicans infection


There are no contraindications listed within the manufacturer’s labeling.

Dosage and Administration

Dosing: Pediatric

Diaper dermatitis: Topical: Children ≥4 weeks: Apply to affected area with each diaper change for 7 days. Treatment should continue for 7 days, even with initial improvement. Do not use for >7 days.


Store at 20°C to 25°C (68°F to 77°F); excursions permitted to 15°C to 30°C (59°F to 86°F).

Drug Interactions

Progesterone: Antifungal Agents (Vaginal) may diminish the therapeutic effect of Progesterone. Avoid combination

Vitamin K Antagonists (eg, warfarin): Miconazole (Topical) may increase the serum concentration of Vitamin K Antagonists. Consider therapy modification

Adverse Reactions

<1%, postmarketing, and/or case reports: burning sensation of skin, contact dermatitis, dermatitis, erythema, exfoliation of skin, pain, pruritus, skin blister, skin rash, vomiting, xeroderma


Concerns related to adverse effects:

  • Irritation: Discontinue if sensitivity or irritation occurs, or if condition worsens.

Special populations:

  • Immunocompromised patients: Has not been studied in immunocompromised patients.
  • Incontinent adults: Safety and efficacy have not been established in incontinent adults and should not be used to prevent diaper dermatitis in this population; drug resistance may occur.
  • Pediatric: Safety and efficacy have not been established in very low-birth-weight infants.

Other warnings/precautions:

  • Appropriate use: For topical use only; avoid contact with eyes or vagina. For use with a candidal infection documented by microscopic evaluation; not for prophylactic use.
  • Duration of therapy: Safety and efficacy have not been established for use >7 days.


Pregnancy Risk Factor


Pregnancy Considerations

Reproduction studies have not been conducted with this combination. See individual agents.

Patient Education

  • Discuss specific use of drug and side effects with caregiver as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
  • Have patient report immediately to prescriber skin irritation (HCAHPS).
  • Educate caregiver about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Caregiver should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.

Source: Wolters Kluwer Health. Last updated July 27, 2016.