咪康唑
Miconazole
1-[2-(2,4-dichlorophenyl)-2-[(2,4-dichlorophenyl)methoxy]ethyl]-1H-imidazole
別名: Adaxio · Aurimic · Easotic · Malaseb · Surolan · Daktarin · Miconazolum · Miconazole nitrate
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Fungal otitis | 2-12 drops in affected ear | topical | q12-24h | — | 🌍 EU |
| Fungal otitis | 1 ml per ear | topical | q24h | 5 days | 🌍 EU |
| Fungal otitis | 5 drops in affected ear | topical | q12h | — | 🌍 EU |
| Dermatophytosis | Apply a thin layer of cream topically to affected area | topical | bid | Continue for 2 weeks after a clinical cure and negative fungal cultures | 🌍 EU |
| Malassezia dermatitis | Shampoo twice weekly until the clinical signs subside and weekly thereafter or as necessary | topical | twice weekly | Until clinical signs subside, then weekly | 🌍 EU |
| Small localized skin infections | Apply a few drops to affected skin | topical | q12h | — | 🌍 EU |
- Fungal otitis: Surolan formulation
- Fungal otitis: Easotic formulation
- Fungal otitis: Aurimic formulation
- Dermatophytosis: Daktarin formulation
- Malassezia dermatitis: Malaseb, Adaxio formulations
- Small localized skin infections: Aurimic formulation
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Fungal otitis | 2-12 drops in affected ear | topical | q12-24h | — | 🌍 EU |
| Fungal otitis | 1 ml per ear | topical | q24h | 5 days | 🌍 EU |
| Fungal otitis | 5 drops in affected ear | topical | q12h | — | 🌍 EU |
| Dermatophytosis | Apply a thin layer of cream topically to affected area | topical | bid | Continue for 2 weeks after a clinical cure and negative fungal cultures | 🌍 EU |
| Dermatophytosis (generalized) | Shampoo twice weekly | topical | twice weekly | — | 🌍 EU |
| Malassezia dermatitis | Shampoo twice weekly until the clinical signs subside and weekly thereafter or as necessary | topical | twice weekly | Until clinical signs subside, then weekly | 🌍 EU |
| Small localized skin infections | Apply a few drops to affected skin | topical | q12h | — | 🌍 EU |
- Fungal otitis: Surolan formulation
- Fungal otitis: Easotic formulation
- Fungal otitis: Aurimic formulation
- Dermatophytosis: Daktarin formulation
- Dermatophytosis (generalized): Concurrent systemic itraconazole administration is required
- Malassezia dermatitis: Malaseb, Adaxio formulations
- Small localized skin infections: Aurimic formulation
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
咪康唑是一種廣譜咪唑類抗真菌藥物，主要用於局部治療真菌性皮膚和耳部感染，包括皮膚癬菌病（錢癬）和馬拉色菌性皮炎。它經常與其他藥物（如氯己定、皮質類固醇或抗生素）聯合配製，以在治療外耳炎和膿皮症時提供協同效應。
臨床提示： 雖然局部使用非常有效，但由於潛在的毒性以及有更安全的全身性替代藥物（如伊曲康唑或氟康唑），咪康唑在獸醫學中極少用於全身性治療。
作用機制
Miconazole works by inhibiting the cytochrome P450-dependent enzyme 14-alpha-demethylase in fungal cells.
Inhibition of 14-alpha-demethylase → depletion of ergosterol (a vital component of the fungal cell membrane) → accumulation of toxic sterol precursors → increased cell wall permeability → leakage of cellular contents and subsequent fungal cell death.
It has potent activity against Malassezia, Cryptococcus, Candida, and Coccidioides.
安全性與警告
禁忌症
- Hypersensitivity to miconazole or other azole antifungals
- Ruptured tympanic membrane (for certain otic preparations)
不良反應
- Local irritation
- Erythema
- Pruritus (rare)
注意事項
Normal precautions should be observed. Avoid contact with the patient's eyes. For otic preparations, ensure the tympanic membrane is intact before application.
Warning: When treating dermatophytosis in cats with miconazole shampoo, concurrent systemic therapy (e.g., itraconazole) is required for effective clearance.
監測
- Resolution of clinical signs (pruritus, erythema, scaling)
- Fungal cultures (for dermatophytosis)
- Cytology (for Malassezia)
藥物動力學
半衰期
吸收
Minimal systemic absorption occurs following topical application to intact skin.
分佈
Remains primarily localized in the stratum corneum of the skin.
代謝
Hepatic (if systemically absorbed).
排除
Feces and urine (if systemically absorbed).
過量
Overdose is highly unlikely with topical administration. Accidental ingestion of shampoos or creams may cause mild gastrointestinal upset (hypersalivation, vomiting, diarrhea). Treatment is symptomatic and supportive.
可用產品
劑型
- 2% shampoo
- 2% cream/powder
- 15.1 mg/ml suspension (with hydrocortisone and gentamicin)
- 23 mg/ml suspension (with prednisolone and polymyxin)
獸醫用
- Adaxio 2% shampoo
- Aurimic 23 mg/ml suspension
- Easotic 15.1 mg/ml ear drops (with hydrocortisone and gentamicin)
- Malaseb 2% shampoo (with chlorhexidine)
- Surolan 23 mg/ml ear drops (with prednisolone and polymyxin)
人用標示
- Daktarin 2% cream/powder
各地核准狀態
Available as POM-V and P in the UK depending on formulation.
POM-V, P
暫無法規資料: 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store at room temperature (15-25°C). Protect from light and freezing.
飼主須知
咪康唑是一種用於治療皮膚和耳部感染的局部抗真菌藥物。
- 使用方法： 請仔細遵循獸醫的指示。使用洗毛精時，請讓泡沫在皮膚上停留10分鐘後再徹底沖洗。
- 滴耳液： 除非獸醫指示，否則在滴藥後不要立即清潔耳朵。
- 安全注意事項： 在治療部位完全乾燥之前，請防止寵物舔舐。塗抹藥物後請徹底洗手。
- 錢癬（皮膚癬菌病）： 如果是治療錢癬，即使皮膚看起來已經恢復正常，也請務必完成整個療程，以防止復發。
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