To the Editor.—
We would like to point out a potentially misleading dosage table printed in the ketoconazole (Nizoral) section of the 1983 edition of the Physicians' Desk Reference, page 1027. This table lists dosages for various fungal diseases from 200 to 3,600 mg/day. It has no heading and is placed in columns with text entirely devoted to ketoconazole, but in fact refers to the preceding product, miconazole (Monistat i.v.).While ketoconazole dosages as high as 1,200 mg/day have been reported in the literature,1 the benefit and safety of these dosages have not been established. The standard dosage and that recommended in the package insert is 200 to 400 mg/day. This drug is increasingly being prescribed by physicians, many of whom may not be familiar with its usual dosage. This placement of the miconazole table may lead to serious prescribing errors and consequent adverse effects, particularly hepatotoxicity.
Moores KG, Davis AM, Murray MF. Misplaced Table Regarding Dosage of Miconazole (Monistat i.v.). JAMA. 1983;249(22):3015. doi:10.1001/jama.1983.03330460015008