AVOCOM-M CREAM 30G

Indications

Approved Uses

Topical treatment of inflammatory superficial fungal infections (dermatophyte tinea such as tinea corporis/cruris/pedis and cutaneous candidiasis) where concomitant anti-inflammatory therapy is indicated.

Dosage & Administration

Dosing by Condition

Inflammatory tinea corporis/cruris: apply a thin layer once daily for ~2 weeks (may extend up to 2-4 weeks if needed); tinea pedis: once daily for ~4 weeks; cutaneous candidiasis: once daily for ~2 weeks (up to 2-4 weeks based on response).

Initial Dose

Apply a thin layer to the affected area and immediate surrounding skin once daily

Maintenance Dose

Not intended for long-term maintenance therapy.

Maximum Dose

Apply a thin layer to affected skin only, typically once daily; avoid large surface areas and occlusion; do not use longer than 2 weeks (up to 3 weeks in some guidance) unless directed by a clinician.

Dose Adjustment Notes

No renal/hepatic dose adjustment is generally required with topical use; however, limit duration/area, avoid occlusion, and reassess if not improving (typically within ~2 weeks) to minimize systemic corticosteroid absorption and inappropriate prolonged steroid use.

How to Take

Clean and dry the affected area, then apply a thin layer to the affected skin (and a small margin of surrounding skin) and rub in gently; wash hands after application; avoid eyes/mucosa and do not use occlusive dressings unless directed.

Side Effects

Common Side Effects

Application-site burning, stinging, pruritus/itching, erythema/redness, irritation, dryness; less commonly peeling and folliculitis.

Safety & Warnings

Contraindications

Hypersensitivity to miconazole, mometasone, or any excipient; viral skin infections (e.g., herpes simplex, varicella); cutaneous tuberculosis; rosacea; perioral dermatitis; acne vulgaris; avoid ophthalmic use.

Warnings & Precautions

External use only; avoid eyes/face and do not use periocularly; avoid prolonged use, large areas, or occlusive dressings; stop and reassess if irritation/sensitization occurs or if infection worsens/no improvement; avoid use in diaper area unless specifically directed; treat confirmed fungal infection and avoid use on untreated bacterial/viral infections.

Driving Warning

Safe

Drug Interactions

Drug Interactions

Warfarin/other coumarin anticoagulants (topical miconazole may increase INR, especially with large-area/occlusive use); strong CYP3A4 inhibitors (e.g., ritonavir, ketoconazole) may increase systemic corticosteroid effects if absorption occurs; additive effects with other topical/systemic corticosteroids on large areas/occlusion.

Food Interaction

No restriction

Alcohol Interaction

Safe

Special Populations

Pregnancy

Consult Doctor

Breastfeeding

Caution

Elderly

Standard adult dosing; use with caution due to increased risk of skin atrophy with corticosteroid component in elderly patients with thinner skin

Kidney Impairment

No adjustment needed

Liver Impairment

No dose adjustment is required for topical use.

Storage & Patient Advice

Missed Dose

Apply when remembered; if it is close to the next scheduled application, skip the missed dose and resume the regular schedule; do not apply extra to make up for a missed dose.

Monitoring Requirements

Short courses on limited areas: no routine labs; monitor clinically for local adverse effects (irritation, skin atrophy/striae, secondary infection) and treatment response; with prolonged/extensive use, occlusion, or pediatric use: monitor for HPA-axis suppression and systemic corticosteroid effects.

Pharmacology

Mechanism of Action

Miconazole inhibits fungal 14-α-demethylase (CYP450-dependent), reducing ergosterol synthesis and disrupting the fungal cell membrane; mometasone binds glucocorticoid receptors to downregulate inflammatory mediator transcription, producing anti-inflammatory, antipruritic, and vasoconstrictive effects.

Half-Life

Topical half-life is not well-defined because systemic exposure is minimal; when systemically available, mometasone furoate has an elimination half-life around ~5-6 hours, while miconazole’s systemic half-life is variable by route/formulation and is not clinically meaningful for topical therapy.

Bioavailability

Systemic absorption is minimal with topical use on intact skin: miconazole is typically <1% absorbed; mometasone furoate is low (about ~0.4% from cream and ~0.7% from ointment in studies), but increases with damaged skin, large surface area, prolonged use, or occlusion.

Metabolism

If absorbed systemically: mometasone furoate is extensively metabolized in the liver primarily via CYP3A4; miconazole is also hepatically metabolized and is a clinically relevant CYP inhibitor (notably CYP3A4/2C9) when systemic exposure occurs.

Product Information

Available Dosage Forms

Cream (30 g tube).

Composition per Dose

Per gram of cream: Miconazole nitrate 20 mg (2%) + Mometasone furoate 1 mg (0.1%)

Skin Condition

Fungal

Steroid Potency

Potent

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