Terconazole

INTRODUCTION

Indications

Treatment of vulvovaginal candidiasis.

Action

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

• Monitor patient's symptoms to help document drug effectiveness.

Interventions

• Always wash hands thoroughly and disinfect equipment (whirlpools, electrotherapeutic devices, treatment tables, and so forth) to help prevent the spread of infection.

Patient/Client-Related Instruction

• 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.

Pharmacokinetics

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.

Contraindications/Precautions

Contraindicated in: Hypersensitivity to active ingredients, additives, or preservatives.

Use Cautiously in: OB/Lactation: Safety not established.

Interactions

Drug-Drug: Not known.

Route/Dosage

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.