Oravig (Miconazole) – Buccal Mucosa: Uses, Side Effects, Dosages - Verywell Health

What Is Oravig?

Oravig (miconazole) is a localized treatment option for fungal infections of the oropharynx (mouth) caused by Candida albicans. It contains the active drug miconazole, which belongs to the class of drugs called imidazoles.

Miconazole works by blocking the release of certain enzymes to stop the formation of an essential component of the fungal cell membrane. It also increases the amount of reactive oxygen species within the cell.

Oravig is a prescription medicine available in the form of buccal tablets to be used locally. 

Drug Facts

Generic Name: Miconazole

Brand Name(s): Oravig

Drug Availability: Prescription

Therapeutic Classification: Antifungals, imidazoles

Available Generically: No

Controlled Substance: N/A

Administration Route: Buccal mucosa

Active Ingredient: Miconazole

Dosage Form(s): Buccal tablets

What Is Oravig Used For?

Oravig is indicated for the local treatment of oropharyngeal candidiasis (OPC) in people 16 years and older.

Oropharyngeal candidiasis (OPC) is a prevalent localized infection of the mucus membranes of the mouth caused by Candida species. OPC can cause different symptoms, including white patches inside the mouth, mouth irritation, a cotton-like feeling in the mouth, and loss of taste.

How to Take Oravig

Always follow the directions on the Food and Drug Administration (FDA)–approved label of your medication. Apply Oravig in the morning after brushing your teeth.

Follow these guidelines when taking Oravig:

• Remove the tablet from the bottle when you are ready to use it.
• Do not crush, chew, or swallow the tablets. 
• Stick the round side of the tablet to the cheek, inside the lip on the gum above the incisor tooth.
• Hold it in place for 30 seconds with a slight pressure of the finger over the upper lip to make the tablet stick to the gum properly.
• Apply subsequent doses to alternate sides of the gum.
• The tablets should dissolve slowly in the mouth by absorbing moisture.
• If the buccal tablet does not stick to the application site or falls off within the first six hours, reposition the same tablet immediately. 
• If the tablet does not adhere, use a new tablet.

Avoid situations that interfere with the sticking of the tablet, including:

• Touching or pressing the tablet after placement
• Wearing an upper denture 
• Chewing gum
• Hitting tablet when brushing teeth
• Rinsing mouth too vigorously
  

Storage

Keep your medications tightly closed and out of the reach of children and pets, ideally locked in a cabinet or closet.

Do not pour unused and expired drugs down the drain or in the toilet. Visit the FDA website to learn where and how to discard all unused and expired drugs. Look for disposal boxes in your area. Your local pharmacist can be a great resource if you have questions about the best way to throw away your medications.

If you travel with Oravig, get familiar with your final destination's regulations. In general, be sure to make a copy of your Oravig prescription. Keep your medication in its original container from your pharmacy with your name on the label. Ask your pharmacist or healthcare provider any questions you have about traveling with your medicine.

Off-Label Uses

There are no reported off-label uses of buccal miconazole.

How Long Does Oravig Take to Work?

Buccal miconazole is usually prescribed for seven to 14 days to get rid of the infection. The time it takes to work may be different for everyone. You should take the medication for the full treatment course, even if you begin to feel better soon after starting it.

What Are the Side Effects of Oravig?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Some common side effects of Oravig are:

Call your healthcare provider if any of the symptoms worsen.

Severe Side Effects

Contact your healthcare provider immediately if you develop any signs of a severe reaction. Call 911 if your symptoms feel life-threatening.

Oravig may cause severe hypersensitivity, and the symptoms include:

• Hives
• Rashes
• Itching
• Trouble breathing or swallowing
• Swelling of the face, throat, tongue, lips, or eyes
• Swelling or pain at the site of application

Report Side Effects

Oravig may cause other side effects. Call your healthcare provider if you have unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Oravig Should I Take?

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For buccal dosage form (tablets):
  • For fungus infection in the mouth and throat:
    • Adults and teenagers 16 years of age and older—One tablet placed on the upper gum once a day for 14 days.
    • Teenagers and children younger than 16 years of age—Use and dose must be determined by your doctor.

Modifications

The following modifications (changes) should be kept in mind when using Oravig.

Severe allergic reaction: Avoid using Oravig if you have a known allergy to it or its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Pregnancy: Based on animal data, Oravig may cause fetal harm. Not enough is known about the safety and effectiveness of Oravig in pregnant people. Discuss with your healthcare provider if you plan to become pregnant or are pregnant, and weigh the benefits and risks of taking Oravig during your pregnancy.

Local topical treatment of oropharyngeal candidiasis is usually preferred during pregnancy due to its minimal systemic absorption.

Breastfeeding: Not enough is known about the safety of Oravig in human breast milk and nursing babies. Talk with your healthcare provider if you plan to breastfeed, weigh the benefits and risks of taking Oravig while nursing, and discuss other ways to feed your baby.

Adults over age 65: Clinical studies haven't included a large enough sampling of people in this age group to detect whether they respond differently than younger adults. Older adults with other medical conditions or those taking several medications should consult their healthcare provider before using Oravig.

Children: The safety and effectiveness of Oravig have not been established in children.

Other modifications: Oravig should be cautiously administered in people with liver impairment. No adjustment to therapy is necessary for people with kidney impairment.

Missed Dose

If you accidentally forgot your Oravig dose, take it as soon as you remember. If it's already close to your next scheduled dose, skip the missed dose and take the following dose at your next scheduled dosing time. Don't try to double up to make up for the missed dose.

Try to find ways to help yourself remember to routinely keep your appointments and take your medication. If you miss too many doses, Oravig might be less effective at treating your condition.

Overdose: What Happens If I Take Too Much Oravig?

There is limited information available about Oravig overdose.

If you think that you're experiencing an overdose or life-threatening symptoms, however, seek immediate medical attention.

What Happens If I Overdose on Oravig?

If you think you or someone else may have overdosed on Oravig, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Oravig, call 911 immediately.

Precautions

It is very important that your doctor check your progress at regular visits. This will allow your doctor to make sure the medicine is working properly and to check for any unwanted effects that may be caused by the medicine.

This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth while you are using this medicine.

If your symptoms do not improve, or if they become worse, check with your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn't Take Oravig?

Oravig should not be used in people with known hypersensitivity (e.g., anaphylaxis) to miconazole, milk protein concentrate, or another product ingredient.

What Other Medications Interact With Oravig?

Use caution when taking Oravig with the following medications:

Be sure to talk with your healthcare provider about any other medicines you take or plan to take, including over-the-counter (OTC), nonprescription products, vitamins, herbs, or plant-based medicines.

Ask your pharmacist or healthcare provider for more detailed information about medication interactions with Oravig.

What Medications Are Similar?

Oravig belongs to the class of azole antifungals that inhibit the growth of a wide range of fungi. 

Some other antifungals used to treat Candidiasis, and various other conditions and different dosages forms are:

The active antifungal drug miconazole in Oravig is available in several dosage forms to treat various other fungal infections.

Frequently Asked Questions

• Oravig is an antifungal medicine used as a local treatment for oropharyngeal candidiasis, a fungal infection of the mouth.

• Oravig belongs to the class of drugs imidazoles, and it works by inhibiting the growth of fungi that causes infection.

• Some common side effects of Oravig are diarrhea, headache, nausea, upper stomach pain, change in or loss of taste, dry mouth, toothache, or cough.
  

• No, there is no generic alternative to Oravig that is approved for this indication.

How Can I Stay Healthy While Taking Oravig

Candida is a fungal infection in the mouth and is associated with underlying issues such as immunosuppression, diabetes, taking broad-spectrum antibiotics, and corticosteroid drug use. In most people, untreated candidiasis persists for months or years unless associated risk factors are treated or eliminated.

Fungal infections generally take a long time to get rid of. Use your prescribed medication regularly to get maximum therapeutic benefits. Take care of your oral health to prevent bacterial and fungal infections from developing in the first place. Good oral hygiene, which includes regularly brushing your teeth, and avoiding smoking tobacco can lower your risk.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.