(hydrocortisone · DailyMed)
MICOVAR CREAM
HYDROCORTISONE; MICONAZOLE NITRATE
What it does
Hydrocortisone is a corticosteroid used to reduce inflammation and treat various conditions.
Commonly used for: Inflammation, Allergic reactions, Skin conditions, Adrenal insufficiency (Addison's disease)
Read more in plain English ↓Plain-language summary for general understanding - not medical advice. Always follow your pharmacist/doctor.
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Answers come only from this medicine's registration record, BNF monograph and interaction data - not medical advice.
Medicine sourcing is available in Kenya only. We don't sell or dispense medicines - licensed pharmacies do.
Sourcing - Kenya onlyRegistration & product details
Source: Medicines Control Authority of Zimbabwe · fetched 2026-04-18 08:22:08 · updated 2026-09-16 04:30:08
Drug Interactions
85Pharmacodynamic Warnings
Hydrocortisone appears in TABLE 17: Drugs that reduce serum potassium
Severe (6)
Antihistamines,non-Sedating - increases exposure
Miconazole is predicted to increase the exposure to antihistamines, non-sedating (mizolastine). Avoid.
Ergometrine - increases exposure
Miconazoleispredictedtoincreasetheexposureto ergometrine.Avoid.oTheoretical
Ergotamine - increases exposure
Miconazoleispredictedtoincreasetheexposureto ergotamine.Avoid.oTheoretical
Mifamurtide - decreases efficacy
Corticosteroidsarepredictedtodecreasetheefficacyof mifamurtide.Avoid.rTheoretical
Mizolastine - increases exposure
Miconazole is predicted to increase the exposure to antihistamines, non-sedating (mizolastine). Avoid.
Oral Benzodiazepines - increases exposure
Miconazole is predicted to increase the exposure to oral benzodiazepines (midazolam). Avoid.
Moderate (53)
Alfentanil - increases exposure
Miconazole is predicted to increase the exposure to opioids (alfentanil). Use with caution and adjust dose.
Alkylating Agents - increases concentration
Miconazole is predicted to increase the concentration of alkylating agents (busulfan). Use with caution and adjust dose.
Alprazolam - increases exposure
Miconazole is predicted to increase the exposure to benzodiazepines (alprazolam). Use with caution and adjust dose.
Amlodipine - increases exposure
Miconazole is predicted to increase the exposure to calcium channel blockers (amlodipine, felodipine, lacidipine, lercanidipine, nicardipine, nifedipine, nimodipine, verapamil). Use with caution and a
Antiarrhythmics - increases exposure
Miconazole is predicted to increase the exposure to antiarrhythmics (disopyramide). Use with caution and adjust dose.
Unknown (26)
Aminoglycosides - decreases exposure
Miconazole potentially decreases the exposure to aminoglycosides (tobramycin).
Aspirin - decreases concentration
Corticosteroids are predicted to decrease the concentration of aspirin (high-dose) and aspirin (high-dose) increases the risk of gastrointestinal bleeding when given with corticosteroids.
Choline Salicylate - decreases concentration
Corticosteroids are predicted to decrease the concentration of cholinesalicylate. Ciclesonide → see corticosteroids Ciclosporin → see TABLE 2 p. 1517 (nephrotoxicity), TABLE 16 p. 1521 (increased seru
Cobimetinib - increases exposure
Miconazoleispredictedtoincreasetheexposureto cobimetinib.rTheoretical
Corticosteroids - increases exposure
Cobicistat is predicted to increase the exposure to corticosteroids (beclometasone) (risk with beclometasone is likely to be lower than with other corticosteroids).
Data from BNF 85 (British National Formulary). This is not a substitute for professional medical advice. Matched via: exact
About hydrocortisone
Hydrocortisone is a corticosteroid used to reduce inflammation and treat various conditions.
What it treats
- Inflammation
- Allergic reactions
- Skin conditions
- Adrenal insufficiency (Addison's disease)
How it works
It works by decreasing inflammation and suppressing the immune system.
Who it's for
Hydrocortisone is for people dealing with severe inflammation or conditions related to hormone deficiency.
Drug class
Corticosteroids
Cautions
- • Be cautious if you are taking medications that lower potassium levels in your blood.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
About miconazole
Miconazole is an antifungal medication used to treat fungal infections on the skin and in the mouth.
What it treats
- fungal infections of the skin
- oral thrush (fungal infection in the mouth)
How it works
It works by stopping the growth of fungi, helping to clear the infection.
Who it's for
This medication is for adults and children who have fungal infections.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
Clinical monograph: Hydrocortisone
BNF-referencedHydrocortisone is a corticosteroid that exhibits both glucocorticoid and mineralocorticoid activities, making it effective in managing various inflammatory and autoimmune conditions. It is commonly used as a replacement therapy in adrenal insufficiency and as an anti-inflammatory agent in a range of disorders.
Indications
- Adrenocortical insufficiency
- Inflammatory bowel disease
- Severe acute asthma
- Acute hypersensitivity reactions
- Congenital adrenal hyperplasia
- Replacement therapy in adrenal insufficiency
Dosage
Children: For children aged 1-5 months: Initially 25 mg 3 times a day, adjusted according to response. For children aged 6 months-5 years: Initially 50 mg 3 times a day, adjusted according to response. For children aged 6-11 years: Initially 100 mg 3 times a day, adjusted
Adults: 100-500 mg 3-4 times a day or when required. For replacement in adrenocortical insufficiency, 20-30 mg once daily, adjusted according to response.
Mechanism of action
Hydrocortisone binds to the glucocorticoid receptor, leading to decreased vasodilation and permeability of capillaries, inhibition of leukocyte migration to inflammation sites, and changes in gene expression that promote anti-inflammatory pathways. It inhibits phospholipase A2, NF-kappa B, and other inflammatory transcription factors, stabilizing leukocyte lysosomal membranes and reducing the release of destructive enzymes. High doses can raise sodium levels and decrease potassium levels through mineralocorticoid receptor activity.
Pharmacodynamics
Hydrocortisone's pharmacodynamic profile includes the inhibition of various inflammatory mediators and the promotion of anti-inflammatory cytokines. Its effects are dose-dependent, with lower doses providing anti-inflammatory benefits, while higher doses exhibit immunosuppressive effects. It has a wide therapeutic index and moderate duration of action.
Pharmacokinetics
Hydrocortisone is metabolized primarily in the liver, with its effects lasting for several hours to days. The onset of action varies with the route of administration, being more rapid when given intravenously. Its half-life is influenced by factors such as dose and administration route, and it is excreted through urine as metabolites.
Contra-indications
- Systemic fungal infections
- Hypersensitivity to hydrocortisone or any excipients
Adverse effects
- Increased risk of infections
- Hyperglycemia
- Hypertension
- Fluid retention and edema
- Gastrointestinal disturbances
- Mood changes
- Osteoporosis
- Peptic ulcer disease
- Cushing's syndrome with long-term use
Interactions
- Mitotane: Moderate decrease in hydrocortisone exposure
- Rifampicin: Moderate decrease in hydrocortisone exposure
- Cobicistat: Unknown effect, potential increase in hydrocortisone exposure
- Idelalisib: Unknown effect, potential increase in hydrocortisone exposure
- Clarithromycin: Unknown effect, potential increase in hydrocortisone exposure
Precautions
- Use with caution in patients with diabetes
- Monitor for signs of infection during therapy
- Consider dose adjustment in patients with hepatic impairment
- Gradual withdrawal is recommended to avoid adrenal insufficiency after prolonged therapy
Pregnancy
Hydrocortisone is categorized as category C. Use only if the potential benefit justifies the potential risk to the fetus.
Breast-feeding
Hydrocortisone is excreted in breast milk. Caution is advised when administering to nursing mothers.
Storage
Store at room temperature, away from moisture and heat. Protect from light.
Formulations
- Injectable form (sodium succinate)
- Modified-release tablets
- Immediate-release tablets
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Clinical monograph: Miconazole
BNF-referencedMiconazole is an azole antifungal agent utilized for the treatment of various fungal infections, particularly those caused by Candida species. It acts primarily by inhibiting the synthesis of ergosterol, a key component of fungal cell membranes, thereby compromising the integrity and function of the fungal cell. Miconazole can be administered topically, orally, or intravaginally, making it versatile for treating conditions such as oropharyngeal candidiasis, vaginal candidiasis, and superficial skin infections.
Indications
- Vaginal candidiasis
- Oropharyngeal candidiasis
- Vulvovaginal infections
- Superficial fungal infections
Dosage
Adults: For vaginal candidiasis, miconazole cream is typically applied twice daily, using 5 g inserted into the vagina for 7 days. For oropharyngeal candidiasis, the oral gel is usually administered as 2.5 mL four times a day.
Mechanism of action
Miconazole primarily acts through the inhibition of the CYP450 14α-lanosterol demethylase enzyme, leading to disrupted ergosterol production in fungal cell membranes. This disruption results in increased cell membrane permeability and leakage of essential cellular constituents. Additionally, miconazole inhibits fungal peroxidase and catalase, increasing the production of reactive oxygen species (ROS) which contribute to fungal cell death. Miconazole also elevates intracellular levels of farnesol, which disrupts quorum sensing in Candida, preventing the transition to more virulent forms.
Pharmacodynamics
Miconazole is predominantly applied topically, leading to minimal systemic absorption. Its primary adverse reactions are usually localized to hypersensitivity reactions, with the potential for anaphylaxis in rare cases. Patients using intravaginal miconazole are advised to avoid reliance on other contraceptive methods and not to use tampons simultaneously due to the risk of altered vaginal flora.
Pharmacokinetics
Miconazole is poorly absorbed when applied topically or intravaginally, resulting in low systemic exposure. The pharmacokinetics of miconazole can vary based on the route of administration, but systemic absorption is generally low, thus limiting systemic side effects and interactions. Miconazole is extensively metabolized in the liver, and its metabolites are excreted primarily through the urine.
Contra-indications
- Hypersensitivity to miconazole or any of its excipients
- Recent arterial thromboembolic disease (e.g. angina, myocardial infarction)
- Undiagnosed vaginal bleeding
- Oestrogen-dependent tumors (e.g. breast cancer in first-degree relatives)
- Acute porphyrias
- Severe diabetes (increased risk of heart disease)
Adverse effects
- Dysmenorrhoea
- Skin reactions
- Increased risk of gallbladder disease
- Migraine or migraine-like headaches
- Abdominal pain
- Dysuria
- Nausea
- Pelvic cramps
- Vaginal hemorrhage
- Angioedema
Interactions
- Miconazole + antihistamines (non-sedating): Severe (increases exposure)
- Miconazole + mizolastine: Severe (increases exposure)
- Miconazole + oral benzodiazepines: Severe (increases exposure)
- Miconazole + ergometrine: Severe (increases exposure)
- Miconazole + ergotamine: Severe (increases exposure)
- Miconazole + alkylating agents: Moderate (increases concentration)
- Miconazole + busulfan: Moderate (increases concentration)
- Miconazole + antiarrhythmics: Moderate (increases exposure)
- Miconazole + disopyramide: Moderate (increases exposure)
- Miconazole + benzodiazepines: Moderate (increases exposure)
Precautions
- Caution in patients with history of breast cancer
- Monitor breast status regularly in women on oestrogen therapy
- Risk of endometrial cancer with prolonged use of oestrogens
- Risk of ovarian cancer with long-term use of combined HRT
- Increased risk of venous thromboembolism in women using combined or oestrogen-only HRT
Pregnancy
Pregnant women may require a longer duration of treatment, usually about 7 days, to clear the infection. Caution is advised.
Breast-feeding
Manufacturer advises caution; no specific information available.
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Molecular reference: Hydrocortisone
PubChem CID 5754Molecular formula: C21H30O5
Mechanism of action
The short-term effects of corticosteroids are decreased vasodilation and permeability of capillaries, as well as decreased leukocyte migration to sites of inflammation. Corticosteroids binding to the glucocorticoid receptor mediates changes in gene expression that lead to multiple downstream effects over hours to days. Glucocorticoids inhibit neutrophil apoptosis and demargination; they inhibit phospholipase A2, which decreases the formation of arachidonic acid derivatives; they inhibit NF-Kappa B and other inflammatory transcription factors; they promote anti-inflammatory genes like interleukin-10. Lower doses of corticosteroids provide an anti-inflammatory effect, while higher doses are immunosuppressive. High doses of glucocorticoids for an extended period bind to the mineralocorticoid receptor, raising sodium levels and decreasing potassium levels. Following topical application, corticosteroids produce anti-inflammatory, antipruritic, and vasoconstrictor actions. The activity of the drugs is thought to result at least in part from binding with a steroid receptor. Corticosteroids decrease inflammation by stabilizing leukocyte lysosomal membranes, preventing release of destructive acid hydrolases from leukocytes; inhibiting macrophage accumulation in inflamed areas; reducing leukocyte adhesion to capillary endothelium; reducing capillary wall permeability and edema formation; decreasing complement components; antagonizing histamine activity and release of kinin from substrates; reducing fibroblast proliferation, collagen deposition, and subsequent scar tissue formation; and possibly by other mechanisms as yet unknown. Corticosteroids, especially the fluorinated corticosteroids, have antimitotic activity on cutaneous fibroblasts and the epidermis. /Corticosteroids/ Reactive oxygen species (ROS) generation by polymorphonuclear leukocytes (PMNL) and mononuclear cells (MNC) is inhibited following the intravenous administration of hydrocortisone. This is associated with a parallel decrease in intranuclear NFkappaB, known to modulate inflammatory responses including ROS generation. Plasma levels of interleukin-10 (IL-10), an anti-inflammatory and immunosuppressive cytokine produced by TH2 cells, are also increased after hydrocortisone administration. In this study, we have investigated the effect of hydrocortisone on p47(phox) subunit, a key component of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, in MNC and the pharmacodynamics of this effect with ROS generation and plasma IL-10 levels /were investigated/. p47(phox) subunit protein levels in MNC showed a progressive decrease after hydrocortisone administration. It reached a nadir at 4 hours and increased thereafter to a baseline level at 24 hours. ROS generation also decreased, reached a nadir between 2 and 4 hours, and returned to a baseline level at 24 hours. IL-10 concentrations increased, peaked at 4 hours, and reverted to the baseline levels at 24 hours. In conclusion, p47(phox) subunit suppression may contribute to the inhibition of ROS generation in MNC after hydrocortisone administration. This suppression occurs in parallel with the suppression of NFkappaB and an increase in IL-10 plasma levels. Therefore, it would appear that the decrease in intranuclear NFkappaB and an increase in IL-10 may cause the inhibitory modulation on p47(phox) subunit and ROS generation by MNC following hydrocortisone and other glucocorticoids.
Pharmacodynamics
Hydrocortisone binds to the glucocorticoid receptor leading to downstream effects such as inhibition of phospholipase A2, NF-kappa B, other inflammatory transcription factors, and the promotion of anti-inflammatory genes. Hydrocortisone has a wide therapeutic index and a moderate duration of action. Patients should stop taking the medication if irritation or sensitization occurs.
Biological pathways
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.
Molecular reference: Miconazole
PubChem CID 4189Molecular formula: C18H14Cl4N2O
Mechanism of action
Miconazole is an azole antifungal used to treat a variety of conditions, including those caused by _Candida_ overgrowth. Unique among the azoles, miconazole is thought to act through three main mechanisms. The primary mechanism of action is through inhibition of the CYP450 14α-lanosterol demethylase enzyme, which results in altered ergosterol production and impaired cell membrane composition and permeability, which in turn leads to cation, phosphate, and low molecular weight protein leakage. In addition, miconazole inhibits fungal peroxidase and catalase while not affecting NADH oxidase activity, leading to increased production of reactive oxygen species (ROS). Increased intracellular ROS leads to downstream pleiotropic effects and eventual apoptosis. Lastly, likely as a result of lanosterol demethylation inhibition, miconazole causes a rise in intracellular levels of farnesol. This molecule participates in quorum sensing in _Candida_, preventing the transition from yeast to mycelial forms and thereby the formation of biofilms, which are more resistant to antibiotics. In addition, farnesol is an inhibitor of drug efflux ABC transporters, namely _Candida_ CaCdr1p and CaCdr2p, which may additionally contribute to increased effectiveness of azole drugs.
Pharmacodynamics
Miconazole is an azole antifungal that functions primarily through inhibition of a specific demethylase within the CYP450 complex. As miconazole is typically applied topically and is minimally absorbed into the systemic circulation following application, the majority of patient reactions are limited to hypersensitivity and cases of anaphylaxis. Patients using intravaginal miconazole products are advised not to rely on contraceptives to prevent pregnancy and sexually transmitted infections, as well as not to use tampons concurrently.
Biological pathways
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.
This drug in other countries
The same active ingredient registered across other registries we cover - including different brands.
- ANOMEX OINTMENT · Theralife Pharma
- ANOMEX PLUS · Theralife Pharma
- ANOMEX SUPPOSITORY · Theralife Pharma
- ANUSTAT OINTMENT · Madawa Pharmaceuticals
- BECLOMIN LOTION · Unisel
- BECLOMIN OINTMENT · Unisel
- ANOMEX OINTMENT (Each gram contains Hydrocortisone Acetate/Lidocaine/Zinc Oxide/Allantoin 0.25%w/w/3%w/w/5%w/w/0.5%w/w) · Kremoint Pharma
- BLUCORT INJECTION (Each vial contains Hydrocortisone Sodium Succinate 100mg) · Pharmax India
- CORRENT CREAM (Each 30g contains Hydrocortisone 1%) · Kremoint Pharma
- CORTISONE 1% CREAM ( · Hovid
- DAKTACORT 2% CREAM ( Miconazole/ Hydrocortisone 2%w/w/ 1%w/w) · Janssen Pharmaceutica
- DAKTARIN ORAL GEL · Janssen-Cilag