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​​Angular Cheilitis 
 
 
First Line
​Alternative first line
Second Line
Antimicrobial
Miconazole 2% cream 
Sodium fusidate 2% ointment
Miconazole 2% cream
and
Hydrocortisone 1% ointment
 Dose
 
 Apply twice a day
Apply four times a day
 Apply twice a day
Route
 Topical
​Topical
 Topical
Duration
 10 days after lesions healed
​10 days after lesions healed
 10 days after lesions healed


Additional Information
  • M​iconazole is systemically absorbed when administered topically, and exhibits inhibitory action on hepatic enzymes responsible for the metabolism of many drugs1.  A clinically significant drug interaction exists between miconazole and warfarin, resulting in increased anticoagulant effects - INR should be closely monitored.  Please check with pharmacy for advice on potential drug interactions. 


1. Medicines and Healthcare products Regulatory Agency (MHRA) 2016.  Drug Safety Update: Topical miconazole, including oral gel: reminder of potential for serious interactions with warfarin [online].  Available at https://www.gov.uk/drug-safety-update/topical-miconazole-including-oral-gel-reminder-of-potential-for-serious-interactions-with-warfarin [Accessed 27/7/2016].    ​