DAKTARIN ORAL GEL 2%

Daktarin Oral Gel is a treatment for fungal infections in your mouth and throat – most commonly oral thrush. You may know oral thrush as those creamy white patches that can appear on your tongue, the inside of your cheeks, your gums, or the roof of your mouth. It often feels sore and can make eating and swallowing uncomfortable. Daktarin is available from a pharmacy without a prescription for adults and children aged 4 months and older. The gel contains the active ingredient miconazole, an antifungal medicine that works by directly killing the fungi responsible for the infection. Daktarin is also sometimes used to prevent fungal infections in the mouth, particularly in people who are at higher risk, such as those wearing dentures, people taking long-term steroid inhalers for asthma, or individuals whose immune system is weakened. Your doctor or pharmacist will advise you if preventative use is appropriate for your situation.

Daktarin works in two important ways. First, it kills the Candida fungus that causes oral thrush. It does this by breaking down the cell walls of the fungus, causing it to die. Second, Daktarin also has some activity against certain bacteria that can sometimes be involved in mouth infections, which makes it particularly useful when there is a mixed infection. Because the gel is applied directly to the affected area, it goes to work exactly where you need it.

Using Daktarin correctly is essential for it to work properly. Here is the step‑by‑step method: Prepare your mouth. Eat or drink something first – you should apply the gel after meals. Avoid eating or drinking for at least 30 minutes afterwards. Wash your hands. Before you handle the gel, wash your hands thoroughly with soap and water. Measure the correct dose. Use the measuring spoon that comes with the bottle. For adults and children aged 2 years and over: 2.5ml – that is half of the measuring spoon. For infants aged 4 months to 2 years: 1.25ml – that is one quarter of the measuring spoon. Apply the gel to the affected areas. Put the gel onto a clean finger and spread it gently over the white patches inside your mouth. Do not swallow it straight away. The gel needs time to work, so keep it in your mouth for as long as you can. Swish it around gently so that it covers all the affected areas. Be careful not to put it at the back of your throat. This is especially important for children, as the gel is sticky and could cause choking if it gets stuck in the throat. Wash your hands again when you have finished applying the gel.

You should apply the gel four times a day – for example, after breakfast, lunch, tea and before you go to bed. The key point is that you must continue treatment for at least a week after all your symptoms have disappeared. This means that even if your mouth looks and feels better, you should keep using the gel for another 7 days. The reason for this is simple: if you stop too soon, any remaining fungus can grow back and the infection can return. If you are treating oral thrush and you wear dentures, you should remove your dentures at night and brush the gel onto them before putting them away. This kills any fungus that may be lurking on the dentures themselves. If you have been using Daktarin exactly as directed for a full course and the infection has not cleared, or if it comes back shortly after you stop, speak to your doctor or pharmacist. You may need a different type of antifungal treatment.

Most people use Daktarin without any problems, especially when they follow the instructions. However, side effects can sometimes occur. Common side effects (affecting fewer than 1 in 10 people) include: A mild burning or stinging sensation in your mouth when you apply the gel. This usually settles down after the first few uses. Nausea or an upset stomach, particularly if you swallow the gel too quickly. An unusual taste in your mouth – the gel has an orange flavour, but some people find it unpleasant. Vomiting or regurgitation of food or liquid. When to stop and speak to your doctor: If you develop an allergic reaction – such as a rash, swelling of your face or throat, or difficulty breathing. This is rare, but you should stop using the gel and seek medical help immediately if it happens. If you notice any signs of bleeding, such as unusual bruising, nosebleeds, blood in your urine, or black tarry stools – these could be signs of a drug interaction with a blood‑thinning medicine called warfarin. I will explain this in detail shortly.

There are several important situations where you should not use Daktarin. Do NOT use Daktarin if: You are taking warfarin (a blood‑thinning medicine used to prevent blood clots). This is extremely important. The MHRA, the UK medicines regulator, has warned that using miconazole oral gel together with warfarin can increase the blood‑thinning effect of warfarin, leading to a serious risk of bleeding. Fatal bleeding has been reported. Do not buy Daktarin over the counter if you are taking warfarin. Even if your GP prescribes it, they will need to monitor you very closely. You have liver problems (liver dysfunction). Daktarin is absorbed into your bloodstream in small amounts and processed by your liver. If your liver is not working properly, the medicine could build up to higher levels than intended. You are allergic to miconazole or to any of the other ingredients in the gel. You are taking any of the following medicines: certain antihistamines (astemizole, terfenadine), the heartburn medicine cisapride, the cholesterol‑lowering medicines simvastatin or lovastatin, certain medicines for mental health conditions (pimozide, sertindole), or the migraine medicines ergotamine and dihydroergotamine. You can check with your pharmacist if you are unsure about any of your current medicines. You are pregnant or breastfeeding, unless your doctor has told you it is safe. I will explain this in more detail below.

This is the single most important warning about Daktarin Oral Gel. Warfarin is a medicine that thins your blood to prevent dangerous clots. Daktarin contains miconazole, which is absorbed into your bloodstream through the lining of your mouth in small amounts. Once inside your body, miconazole interferes with the way your liver breaks down warfarin. This causes warfarin to build up to higher levels than intended, making your blood too thin. The result can be severe, even fatal, bleeding. Signs that your blood has become too thin include: Unexplained bruising or bleeding. Nosebleeds that do not stop quickly. Bleeding from the gums when you brush your teeth. Blood in your urine (which may look pink, red or brown). Black or tarry-looking stools (poo). Coughing up blood. Vomiting blood or what looks like coffee grounds. If you are taking warfarin and you have used Daktarin, or if you develop any of these symptoms while using Daktarin, stop the gel immediately and seek urgent medical attention. If you are taking warfarin, you should not buy Daktarin from a pharmacy without a prescription. Your doctor may still prescribe it for you in exceptional circumstances, but they will need to monitor your blood clotting levels (INR) very closely and adjust your warfarin dose if necessary. For most people, however, the advice is very clear: if you are on warfarin, do not use Daktarin Oral Gel.

Pregnancy: You should not use Daktarin during pregnancy unless your doctor has advised you to do so. There is limited safety data on the use of miconazole during human pregnancy, and as a precaution, it is best avoided if possible. If your oral thrush is very uncomfortable and other treatments (such as nystatin, which is not absorbed into the bloodstream) are not suitable, your doctor may decide that the benefit of treating the infection outweighs any small risk. Breastfeeding: The official advice is that you should speak to your doctor or pharmacist before using Daktarin if you are breastfeeding. Miconazole is absorbed into your bloodstream in very small amounts, and it is not known for certain whether it passes into breast milk. The amount that could reach your baby is likely to be extremely low, but as a precaution, the safest approach is to avoid it unless your doctor says it is clearly necessary. If a doctor does prescribe Daktarin while you are breastfeeding, be very careful not to apply the gel to your nipple area, as the baby could swallow it directly.

Yes, Daktarin can interact with a number of other medicines. The most dangerous interaction is with warfarin, which I have already explained. However, there are others: Oral diabetes medicines (sulphonylureas such as gliclazide, glipizide, tolbutamide). Daktarin can increase the blood‑sugar‑lowering effect of these medicines, potentially causing your blood sugar to drop too low (hypoglycaemia). You may need to monitor your blood sugar more closely. Phenytoin (a medicine for epilepsy). Daktarin can increase the level of phenytoin in your blood, which could lead to side effects. Certain anti‑HIV medicines (protease inhibitors such as ritonavir and saquinavir). These can increase the level of miconazole in your blood. Certain medicines for heart rhythm problems (quinidine, dofetilide). Using these together with Daktarin could increase the risk of a dangerous heart rhythm disturbance. If you are taking any of these medicines, or if you are unsure whether your medicines are affected, speak to your doctor or pharmacist before using Daktarin.

If you wear dentures and you have oral thrush, the fungus can live on the dentures themselves. If you treat only your mouth but not the dentures, the infection will simply come back as soon as you put your dentures back in. The correct method is: Remove your dentures at night. Soak them in a denture‑cleaning solution or brush them thoroughly with a soft brush. Apply Daktarin gel to the dentures. Brush a small amount of the gel onto the surfaces of the dentures that come into contact with your mouth. The gel will kill the fungus on the dentures. Continue for at least a week after your mouth looks better. As with the oral gel, you need to keep treating the dentures for a full week after your symptoms have cleared to prevent the infection from returning.

Store Daktarin at room temperature, below 25°C, in a dry place away from direct sunlight and heat. Keep the tube out of the sight and reach of children. Do not use the gel after the expiry date shown on the tube – the active ingredient becomes less effective over time. If you have any leftover gel after you have completed your treatment course, do not throw it away in household waste or pour it down the sink. Take it to your local pharmacy, where they will dispose of it safely for you.