ibuprofen + miconazole

Ibuprofen + miconazole is a non-standard, compounded topical combination of two small molecule drugs—ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), and miconazole, an azole antifungal. Ibuprofen acts as a non-selective cyclooxygenase (COX) inhibitor to reduce pain, inflammation, and fever[4]. Miconazole inhibits fungal CYP450 14α-lanosterol demethylase activity to disrupt ergosterol synthesis in fungal cell membranes, leading to broad-spectrum antifungal effects[1]. This combination has been used in compounded preparations for topical application (such as ointments for nipple pain during breastfeeding) to provide both anti-inflammatory and antifungal benefits[8]. There is also evidence that NSAIDs like ibuprofen may have direct antifungal activity and can act synergistically with azoles against Candida species when applied topically[6].