Section 3 OB/GYN

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Date: Spring-Summer 2012
From: MPR Urologists’ Edition(Vol. 9, Issue 1)
Publisher: Haymarket Media, Inc.
Document Type: Article
Length: 2,052 words
Lexile Measure: 670L

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3A Vaginal infections

PRESCRIBING NOTES

For other systemic and topical antifungals see Sections 2C and 11B, respectively.

AVC Jazz R

Antibiotic. Sulfanilamide 15%; vaginal crm.

Indications: Vulvovaginitis caused by Candida albicans.

Adults: 1 applicatorful vaginally 1-2 times daily for 30 days.

Children: Not applicable.

Warnings/Precautions: Discontinue if severe or unusual irritation occurs. Avoid using vaginal applicator after 7th month of pregnancy. Pregnancy (Cat.C). Nursing mother: not recommended.

Adverse reactions: Local irritation.

How supplied: Crm-4oz (w. applicator)

BETADINE DOUCHE OTC

Purdue Products L.P.

Antimicrobial. Povidone-iodine 0.3%; premixed vaginal soln.

Also: BETADINE CONCENTRATE OTC

FOR DOUCHE

Povidone-iodine 10%.

Indications: Trichomonal, candidal, or nonspecific vaginitis symptoms.

Adults: Treatment: douche daily for 5 days. Cleansing: douche once or twice weekly. Conc: use 30mL/quart of water.

Children: Not recommended.

Contraindications: Pregnancy. Nursing mothers.

How supplied: Premixed-8oz Premixed disposable-2 Concentrate kit-8oz Concentrate disposable-2

CLEOCIN VAGINAL R

CREAM Pfizer

Lincosamide. Clindamycin (as phosphate) 2%.

Indications: Bacterial vaginosis.

Adults: 1 applicatorful intravaginally at bedtime. Nonpregnant: treat for 3 or 7 days. Pregnant (2nd or 3rd trimester): treat for 7 days.

Children: Not recommended.

Also: CLEOCIN VAGINAL OVULES R

Clindamycin (as phosphate) 100mg; supp.

Adults: Nonpregnant: 1 supp intravaginally at bedtime for 3 days.

Children: Pre-menarchal: not recommended.

Contraindications: History of enteritis or colitis.

Warnings/Precautions: Monitor for pseudomembranous colitis. Do not use contraceptive diaphragm or condom for at least 72 hours after treatment. Do not have vaginal intercourse or use tampons or douches during treatment with ovules. Pregnancy (Cat.B). Nursing mothers: not recommended.

Interactions: May potentiate neuromuscular blockers.

Adverse reactions: Candidiasis, vaginitis, vulvovaginal disorder, fungal infection, pruritus, abnormal labor.

How supplied: Crm-21g, 40g (w. applicators)

Ovules-3 (w. applicator)

CLINDESSE Ther-Rx R

Lincosamide. Clindamycin (as phosphate) 2%; vag crm.

Indications: Bacterial vaginosis.

Adults: 1 applicatorful intravaginally once.

Children: Not recommended.

Contraindications: History of enteritis or colitis.

Warnings/Precautions: Monitor for pseudomembranous colitis. Do not rely on contraceptive diaphragm or condom concurrently or for 5 days after treatment. Do not have vaginal intercourse or use tampons or douches during treatment. Pregnancy (Cat.B). Nursing mothers: not recommended.

Interactions: May potentiate neuromuscular blockers.

Adverse reactions: Fungal vaginosis, vulvovaginal pruritus, headache.

How supplied: Prefilled applicator (5g)-1

DIFLUCAN 150mg Pfizer R

Azole antifungal. Fluconazole 150mg; tabs.

Indications: Vaginal candidiasis.

Adults: 150mg orally once.

Children: Not recommended.

Contraindications: Concomitant pimozide, quinidine.

Warnings/Precautions: Proarrhythmic conditions. Elderly. Pregnancy (Cat.C). Nursing mothers: not recommended.

Interactions: See Contraindications. Risk of cardiotoxicity with erythromycin; avoid. Concomitant voriconazole: not recommended; if needed, monitor closely esp. when given within 24hrs after fluconazole. Potentiates warfarin, theophylline, oral hypoglycemics, midazolam. May increase serum levels of phenytoin, cyclosporine, zidovudine, sulfonylureas, carbamazepine. Thiazides increase fluconazole levels. Monitor levels and/or effects of cyclosporine, phenytoin, sulfonylureas, rifabutin, tacrolimus, theophylline, warfarin. Cimetidine (oral), rifampin may decrease fluconazole levels. Oral contraceptives: see literature. Avoid other hepatotoxic drugs. Caution with other drugs metabolized by CYP450.

Adverse reactions: Headache, nausea, abdominal pain, GI upset, dizziness, taste perversion; hepatotoxicity, exfoliative dermatitis (rare).

How supplied: Tabs 150mg-1

FEMSTAT 3 Bayer Consumer OTC

Azole antifungal. Butoconazole nitrate 2%; vaginal crm.

Indications: Vulvovaginal candidiasis.

Adults: 1 applicatorful intravaginally...

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Gale Document Number: GALE|A294074736