Antibiotic Formulary

Chelitis

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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

Miconazole 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].

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