ANTIFUNGALS,AZOLE (Vaginal)
Some commonly used brand names are:
In the U.S.?
- FemCare 2
- Femizol-M 4
- Femstat 3 1
- Gyne-Lotrimin 2
- Gyne-Lotrimin Combination Pack 2
- Gyne-Lotrimin3 2
- Gyne-Lotrimin3 Combination Pack 2
- Miconazole-7 4
- Monistat 1 6
- Monistat 1 Combination Pack 4
- Monistat 3 4
- Monistat 3 Combination Pack 4
- Monistat 5 Tampon 4
- Monistat 7 4
- Monistat 7 Combination Pack 4
- Mycelex-7 2
- Mycelex-G 2
- Mycelex Twin Pack 2
- Terazol 3 5
- Terazol 7 5
- Vagistat-1 6
In Canada?
- Canesten Combi-Pak 1-Day Therapy 2
- Canesten Combi-Pak 3-Day Therapy 2
- Canesten 1-Day Cream Combi-Pak 2
- Canesten 1-Day Therapy 2
- Canesten 3-Day Therapy 2
- Canesten 6-Day Therapy 2
- Clotrimaderm 2
- Ecostatin Vaginal Ovules 3
- GyneCure 6
- GyneCure Ovules 6
- GyneCure Vaginal Ointment Tandempak 6
- GyneCure Vaginal Ovules Tandempak 6
- Micozole 4
- Monazole 7 4
- Monistat 3 Dual-Pak 4
- Monistat 3 Vaginal Ovules 4
- Monistat 7 4
- Monistat 7 Dual-Pak 4
- Monistat 7 Vaginal Suppositories 4
- Myclo-Gyne 2
- Novo-Miconazole Vaginal Ovules 4
- Terazol 3 5
- Terazol 3 Dual Pak 5
- Terazol 3 Vaginal Ovules 5
- Terazol 7 5
Note: | For quick reference, the following azole antifungals are numberedto match the corresponding brand names. |
Category
- Antifungal, vaginal?Butoconazole; Clotrimazole; Econazole; Miconazole; Terconazole; Tioconazole
Description
Vaginal azoles (A-zoles) are usedto treat yeast (fungus) infections of the vagina.
For first-time users, make sure your doctor has checked and confirmed thatyou have a vaginal yeast infection before you use the vaginal azole antifungalmedicines that do not require a prescription. Vaginal yeast infections canreoccur over time and, when the same symptoms occur again, self-treating withthese medicines is recommended. However, you should see your doctor if thesymptoms occur again within 2 months.
Some vaginal azoles are available only with your doctor's prescription.Most are available without a prescription; however, your doctor may have specialinstructions on the proper use of this medicine.
Vaginal azoles are available in the following dosage forms:
Vaginal- Butoconazole
- Clotrimazole
- Cream (U.S. and Canada)
- Tablets (U.S. and Canada)
- Econazole
- Miconazole
- Cream (U.S. and Canada)
- Suppositories (U.S. and Canada)
- Tampons (U.S.?California only)
- Terconazole
- Cream (U.S. and Canada)
- Suppositories (U.S. and Canada)
- Tioconazole
- Ointment (U.S. and Canada)
- Suppositories (Canada)
Before Using This Medicine
In deciding to use a medicine,the risks of using the medicine must be weighed against the good it will do.This is a decision you and your doctor will make. For vaginal azoles, thefollowing should be considered:
Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to any of the azoles. Also tell your health care professionalif you are allergic to any other substances, such as foods, preservatives,or dyes.
Pregnancy?Studies have not been done in humans for use of allazole antifungals during the first trimester of pregnancy. These medicinesare safe and effective when used for at least 7 days during the second andthird trimesters of pregnancy. However, check with your doctor before usingthis medicine during the first trimester of pregnancy. Also, use of 1- and3-day treatments may not be effective during pregnancy.
Breast-feeding?It is not known whether vaginal azoles pass intothe breast milk. However, these medicines have not been shown to cause problemsin nursing babies.
Children?Studies on these medicines have been done only inadult patients, and there is no specific information comparing use of vaginalazoles in children with use in other age groups. It is recommended that thesemedicines not be used in children up to 12 years of age.
Older adults?Many medicines have not been studied specificallyin older people. Therefore, it may not be known whether they work exactlythe same way they do in younger adults. Although there is no specific informationcomparing use of vaginal azoles in the elderly with use in other age groups,they are not expected to cause different side effects or problems in olderpeople than they do in younger adults.
Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. Tell your health careprofessional if you are using any other vaginal prescription or nonprescription(over-the-counter [OTC]) medicine. When you are taking miconazole, it is especiallyimportant that your health care professional know if you are taking any ofthe following:
- Warfarin (e.g., Coumadin; Warfilone)?Using with warfarin maycause bleeding and/or bruising
Proper Use of This Medicine
Vaginalazoles usually come with patient directions. Read them carefully before usingthis medicine.
Use this medicine at bedtime, unless otherwise directed by your doctor.The vaginal tampon form of miconazole should be left in the vagina overnightand removed the next morning.
This medicine is usually inserted into the vagina with an applicator. However,if you are pregnant, check with your doctor before using the applicator.
Some of the vaginal suppositories or tablets come packaged with a smalltube of cream. This cream can be applied outside of the vagina in the genitalarea to treat itching. The packages are called combination, dual, or twinpacks.
To help clear up your infection completely, it isvery important that you keep using this medicine for the full time of treatment, even if your symptoms begin to clear up after a few days. If youstop using this medicine too soon, your symptoms may return. Do not miss any doses. Also, do not stop usingthis medicine if your menstrual period starts during the time of treatment.
Dosing?The dose of these medicines will be differentfor different patients. Follow your doctor's orders orthe directions on the label. The following information includes onlythe average doses of these medicines. If your dose isdifferent, do not change it unless your doctor tells you to do so.
For butoconazole- For yeast infection:
- For vaginal cream dosage form:
- Adults and teenagers:
- Women who are not pregnant: 100 milligrams (mg) (one full applicator)of 2% cream inserted into the vagina at bedtime for three nights in a row.
- Pregnant women, after the third month: 100 mg (one full applicator)of 2% cream inserted into the vagina at bedtime for six nights in a row.
- Children up to 12 years of age?Use and dose must be determinedby your doctor.
- For vaginal suppository dosage form:
- Adults and teenagers:
- Women who are not pregnant: 100 mg (one suppository) inserted intothe vagina at bedtime for three nights in a row.
- Children up to 12 years of age?Use and dose must be determinedby your doctor.
For clotrimazole- For yeast infection:
- For vaginal cream dosage form:
- Adults and teenagers?The dose depends on the strength of thecream.
- 1% cream: 50 milligrams (mg) (one full applicator) inserted intothe vagina at bedtime for six to fourteen nights in a row.
- 2% cream: 100 mg (one full applicator) inserted into the vagina atbedtime for three nights in a row.
- 10% cream: 500 mg (one full applicator) inserted into the vaginaat bedtime for one night only.
- Children up to 12 years of age?Use and dose must be determinedby your doctor.
- For vaginal tablet dosage form:
- Adults and teenagers?The dose depends on the strength of thevaginal tablet.
- Women who are not pregnant:
- 100-mg tablet: Insert one tablet into the vagina at bedtime for sixor seven nights in a row.
- 200-mg tablet: Insert one tablet into the vagina at bedtime for threenights in a row.
- 500-mg tablet: Insert one tablet into the vagina at bedtime for onenight only.
- Pregnant women: 100 mg (one vaginal tablet) inserted into the vaginaat bedtime for seven nights in a row.
- Children up to 12 years of age?Use and dose must be determinedby your doctor.
For econazole- For yeast infection:
- For vaginal suppository dosage form:
- Adults and teenagers?150 milligrams (mg) (one vaginal suppository)inserted into the vagina at bedtime for three nights in a row.
- Children up to 12 years of age?Use and dose must be determinedby your doctor.
For miconazole- For yeast infection:
- For vaginal cream dosage form:
- Adults and teenagers?20 milligrams (one full applicator) insertedinto the vagina at bedtime for seven nights in a row. Treatment may be repeatedif needed.
- Children up to 12 years of age?Use and dose must be determinedby your doctor.
- For vaginal suppository dosage form:
- Adults and teenagers?The dose depends on the strength of thesuppository.
- 100-milligram (mg) suppository: Insert one vaginal suppositoryinto the vagina at bedtime for seven nights in a row. Treatment may be repeatedif needed.
- 200-mg suppository or
- 400-mg suppository: Insert one vaginal suppository into the vaginaat bedtime for three nights in a row. Treatment may be repeated if needed.
- 1200-mg suppository: Insert one vaginal suppository into the vaginaat bedtime for one night.
- Children up to 12 years of age?Use and dose must be determinedby your doctor.
- For tampon dosage form:
- Adults and teenagers?100 mg (one tampon) inserted into thevagina at bedtime and then removed the next morning. This is repeated everynight for five nights in a row.
- Children up to 12 years of age?Use and dose must be determinedby your doctor.
For terconazole- For yeast infection:
- For vaginal cream dosage form:
- Adults and teenagers?The dose depends on the strength of thecream.
- 0.4% cream: 20 milligrams (mg) (one full applicator) inserted intothe vagina at bedtime for seven nights in a row.
- 0.8% cream: 40 mg (one full applicator) inserted into the vaginaat bedtime for three nights in a row.
- Children up to 12 years of age?Use and dose must be determinedby your doctor.
- For vaginal suppository dosage form:
- Adults and teenagers?80 mg (one vaginal suppository) insertedinto the vagina at bedtime for three nights in a row.
- Children up to 12 years of age?Use and dose must be determinedby your doctor.
For tioconazole- For yeast infection:
- For vaginal ointment dosage form:
- Adults and teenagers?300 milligrams (mg) (one full applicator)of 6.5% ointment inserted into the vagina at bedtime for one night only.
- Children up to 12 years of age?Use and dose must be determinedby your doctor.
- For vaginal suppository dosage form:
- Adults and teenagers?300 mg (one vaginal suppository) insertedinto the vagina at bedtime for one night only.
- Children up to 12 years of age?Use and dose must be determinedby your doctor.
Missed dose?If you miss a dose of this medicine, insert itas soon as possible. However, if it is almost time for your next dose, skipthe missed dose and go back to your regular dosing schedule.
Storage?To store this medicine:
- Keep out of the reach of children.
- Store away from heat and direct light.
- Do not store the vaginal suppository or vaginal tablet form of thismedicine in the bathroom, near the kitchen sink, or in other damp places.Heat or moisture may cause the medicine to break down.
- Keep the vaginal cream, ointment, and suppository forms of this medicinefrom freezing.
- Do not keep outdated medicine or medicine no longer needed. Be surethat any discarded medicine is out of the reach of children.
Precautions While Using This Medicine
If yoursymptoms do not improve within 3 days or have not disappeared in 7 days, orif they become worse, check with your doctor. The 1- or 3-day treatments maytake up to 7 days to completely clear up your infection. However, not allvaginal infections are caused by yeast. If symptoms occur again within 2 months,check with your doctor.
Vaginal medicines usually will come out of the vagina during treatment.To keep the medicine from getting on your clothing, wear a minipad or sanitarynapkin. The use of nonmedicated tampons (like those used for menstrual periods)is not recommended since they may soak up the medicine.
To help clear up your infection completely and to helpmake sure it does not return, good health habits are also required.
- Wear cotton panties (or panties or pantyhose with cotton crotches)instead of synthetic (for example, nylon or rayon) panties.
- Wear only clean panties.
If you have any questions about this, check with your health care professional.
Vaginal yeast infections are not usually spread by having sex and yoursex partner does not need to be treated. However, if the sex partner has symptomsof local itching or skin irritation of the penis, he may benefit by beingtreated also.
If you use latex or rubber birth control devices (condoms,diaphragms, or cervical caps), you should wait 3 days after treatment withazole antifungal agents before using them again. Many brands of vaginalazoles contain oils in the product that can weaken these devices. This increasesthe chances of a condom breaking during sexual intercourse. The rubber incervical caps or diaphragms may break down faster and wear out sooner. Checkwith your health care professional to make sure the vaginal azole productyou are using can be used with latex rubber birth control devices.
Check with your doctor before douching to obtain adviceabout whether you may douche and, if allowed, the proper method.
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects.Although not all of these side effects may occur, if they do occur they mayneed medical attention.
Check with your doctor as soon as possible if any of the following sideeffects occur:
Other side effects may occur that usually donot need medical attention. These side effects may go away during treatmentas your body adjusts to the medicine. However, check with your doctor if anyof the following side effects continue or are bothersome:
Other side effectsnot listed above may also occur in some patients. If you notice any othereffects, check with your doctor.
Revised: 01/19/2005
