Affects the permeability of the fungal cell wall, allowing leakage of cellular contents. Not active against bacteria.
Therapeutic effects:
Inhibited growth and death of susceptible Candida, with decrease in accompanying symptoms of vulvovaginitis (vaginal burning, itching, discharge).
Pharmacokinetics⬆⬇
Absorption: Minimal through intact skin.
Distribution: Unknown. Action is primarily local.
Metabolism/Excretion: Negligible with local application.
Half-Life: Not applicable.
Time/Action Profile⬆⬇
ROUTE
ONSET
PEAK
DURATION
Intravag
unknown
unknown
unknown
Contraind./Precautions⬆⬇
Contraindicated in:
Hypersensitivity to active ingredients, additives, or preservatives;
OB: /Safety not established.
Use Cautiously in:
Patients with recurrent vulvovaginal yeast infections.
Adv. Reactions/Side Effects⬆⬇
GU: irritation, vulvovaginal burning
Interactions⬆⬇
Drug-drug:
Not known.
Route/Dosage⬆⬇
(Adults and Children ≥12 yr): Vaginal ointment: 1 applicatorful (4.6 g) at bedtime as a single dose.
Availability⬆⬇
Vaginal ointment: 6.5%OTC
Assessment⬆⬇
Inspect involved areas of skin and mucous membranes before and frequently during therapy. Increased skin irritation may indicate need to discontinue medication.
Implementation⬆⬇
Consult physician or other health care professional for proper cleansing technique before applying medication.
An applicator is supplied for vaginal administration.
Patient/Family Teaching⬆⬇
Advise patient to avoid using tampons, douches, spermicides, or other vaginal products while using this therapy.
Instruct patient on proper use of vaginal applicator. Medication should be inserted high into the vagina at bedtime. Instruct patient to remain recumbent for at least 30 min after insertion. Advise use of sanitary napkins to prevent staining of clothing or bedding.
Advise patient to consult health care professional regarding intercourse during therapy. Vaginal medication may cause minor skin irritation in sexual partner. Advise patient to refrain from sexual contact during therapy. Advise patient that this medication may weaken latex condoms or diaphragms. Separate use by 3 days. Another method of contraception should be used during treatment.
Advise patient to report to health care professional increased skin irritation or lack of response to therapy. A second course may be necessary if symptoms persist.
Advise patient to dispose of applicator after use.
Evaluation/Desired Outcomes⬆⬇
Decrease in skin irritation and vaginal discomfort. Therapeutic response is usually seen after 1 wk. Diagnosis should be reconfirmed with smears or cultures before a second course of therapy to rule out other pathogens associated with vulvovaginitis. Recurrent vaginal infections may be a sign of systemic illness.
