Therapeutic: antifungals (vaginal)
Treatment of vulvovaginal candidiasis.
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 ↓ in accompanying symptoms of vulvovaginitis (vaginal burning, itching, discharge).
Adverse Reactions/Side Effects
GI: abdominal pain. GU: dysmenorrhea, irritation, itching, vulvovaginal burning. Misc: fever.
PHYSICAL THERAPY IMPLICATIONS
Examination and Evaluation
Always wash hands thoroughly and disinfect equipment (whirlpools, electrotherapeutic devices, treatment tables, and so forth) to help prevent the spread of infection.
Advise patient to report any increased local sensitivity to this drug (pain, burning, itching, swelling) or other adverse reactions (fever, abdominal pain, menstrual problems).
Therapeutic response for vaginal infections is usually seen after 1 wk. Advise patient that application is typically continued throughout the full course of therapy even if feeling better. Therapy should be continued during menstrual period.
Advise patient to seek medical help if infections persist or recur after the full treatment. Recurrent fungal infections may be a sign of systemic illness.
Absorption: 5–16% is systemically absorbed following intravaginal administration.
Distribution: Unknown. Action is primarily local.
Metabolism and Excretion: Negligible with local application.
Half-life: Not applicable.
TIME/ACTION PROFILE (plasma concentrations)
|ROUTE ||ONSET ||PEAK ||DURATION |
|intravaginal ||unknown ||6.6 hr ||unknown |
Contraindicated in: Hypersensitivity to active ingredients, additives, or preservatives.
Use Cautiously in: OB/Lactation: Safety not established.
Vag (Adults): Vaginal cream—1 applicatorful (5 g) of 0.4% cream hs for 7 days or 1 applicatorful (5 g) of 0.8% cream hs for 3 days. Vaginal suppositories—1 suppository (80 mg) hs for 3 days.
Availability (generic available)
Vaginal cream: 0.4% Rx, 0.8% Rx. Vaginal suppositories: 80 mg Rx.