Affects the permeability of the fungal cell wall, allowing leakage of cellular contents. Not active against bacteria.
Therapeutic effects:
Inhibits growth and causes death of susceptible Candida, with decrease in accompanying symptoms of vulvovaginitis (vaginal burning, itching, discharge).
Pharmacokinetics⬆⬇
Absorption: Minimal through intact skin.
Distribution: Action is primarily local.
Metabolism/Excretion: Negligible with local application.
Half-Life: Not applicable.
Time/Action Profile⬆⬇
(symptoms)
ROUTE
ONSET
PEAK
DURATION
Topical
Unknown
8–24 hr
Unknown
Contraind./Precautions⬆⬇
Contraindicated in:
Hypersensitivity to active ingredients, additives, or preservatives.
Use Cautiously in:
Recurrent vulvovaginal yeast infections;
Lactation: Safety not established in breastfeeding.
Adv. Reactions/Side Effects⬆⬇
GU: itching, soreness, vulvovaginal burning
Interactions⬆⬇
Drug-drug:
None reported.
Route/Dosage⬆⬇
Vag (Adults and Children ≥12 yr): 1 applicatorful (5 g) of 1% cream at bedtime for 7 days or 1 applicatorful (5 g) of 2% cream at bedtime for 3 days.
Availability⬆⬇
(Generic available)
Cream: 1%OTC; 2%OTC; 10%OTC
Assessment⬆⬇
Inspect involved areas of skin and mucous membranes before and frequently during therapy. If local irritation occurs, consider discontinuing therapy. If vaginal symptoms continue after completing therapy, consider the needed for reassessment and systemic treatment.
Implementation⬆⬇
Use provided applicator . Wash hands thoroughly prior to and after administration.
Patient/Family Teaching⬆⬇
Explain purpose and side effects of medication. Advise patient to read Patient Information before starting therapy.
Instruct patient to continue full course of therapy, even if feeling better. Therapy should be continued during menstrual period.
Instruct patient on proper use of vaginal applicator. Medication should be inserted high into the vagina at bedtime. Instruct patient to remain recumbent for ≥30 min after insertion. Advise use of sanitary napkins to prevent staining of clothing or bedding.
Advise patient to refrain from sexual contact during therapy. Advise patient that this medication may weaken latex or rubber contraceptive products, including condoms and diaphragms. Another method of contraception should be used during treatment.
Caution patient to avoid using tampons, douches, spermacides, or other vaginal products during therapy.
Advise patient to notify health care professional if ↑ skin irritation or lack of response to therapy occurs.
Advise patient that therapeutic response is usually seen after 1 wk. Before a second course of therapy is initiated, diagnosis should be reconfirmed with smears or cultures to rule out other pathogens associated with vulvovaginitis. Recurrent vaginal infections may be a sign of systemic illness.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other medications, especially intravaginal preparations.
Rep: Advise women of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
Evaluation/Desired Outcomes⬆⬇
Decrease in skin irritation and vaginal discomfort.