Intravaginal

Do not double Hie dosage if a dose is missed. Instead, skip Hie dose and resume treatment Hie next day (see Fhtient and Family Teaching Checklist Self-Administering Intravaginal Estrogen). 

Miconazole (Monistat) 2% cream, 5 g intravaginally for 7 days 100-mg vaginal suppository daily for 7 days ... 

Misoprostol (Cytotec) Mastitis 25 meg intravaginally every 3-6 hours Contraindicated if previous cesarean section... 

Avoid systemic (parenteral, oral, TD) vaginal tablet, cream, intravaginal ring Estradiol 25 meg vaginal tablets (insert one PV daily x 14 days, then one PV twice weekly)... 

Intravaginal clindamycin 2% cream once daily for 7 days... 

It is unclear whether treating pregnant women for BV is beneficial. If treatment is initiated, the drugs of choice are oral or intravaginal metronidazole or oral clindamycin. 

Butoconazole 2% sustained-release cream, 5 g intravaginally as a single application... 

The goal of treating recurrent WC is control of the infection, rather than cure. First, any acute episodes are treated, followed by maintenance therapy. For the treatment of acute episodes, intravaginal or oral azoles can be utilized. Although acute episodes of recurrent WC will respond to azole therapy, some patients may require prolonged therapy in order to achieve remission. To achieve remission, a second dose of oral fluconazole 150 mg repeated 3 days after the first dose or 14 days of topical azole therapy can be used. The practitioner should consider that non-albicans infections are more common in recurrent WC therefore fluconazole and itraconazole resistance may make these agents less effective. 

Response rates are lower for non-albicans infections. Although an optimal regimen is unknown, use of intravaginal azole therapy for 7 to 14 days is recommended. Terconazole may prove more effective than other azoles in the treatment of non-albicans infections since C. glabrata and C. tropicalis are more susceptible to terconazole.17 For second-line therapy, boric acid 600 mg in a gelatin capsule administered vaginally twice daily for 2 weeks followed by once daily during menstruation is effective.18 Local irritation often limits the use of boric acid. Topical 4% flucytosine is also effective but use should be limited due to the potential for resistance. 

Egawa et al. [103] by using a microbial assay method reported that miconazole was not detected in the blood after human subjects were given 100 mg tablets of miconazole intravaginally for 14 days. Six species of 12 strains of human vaginal Lactobacillus were insensitive to miconazole. 

Other routes of administration sometimes used in monkey safety assessment studies are intravaginal dosing, topical application, inhalation, and nasal administration. 

Specihc poly anions such as dextran sulfate (DS) appear to exhibit strong anti-HIV activity in vitro [36,37]. Human oral administration of DS is poorly absorbed, but intravaneous administration does result in increased plasma lipolytic activity [38]. Poly anions that have been considered for intravaginal anti-HIV activity include DS, carrageenan, heparin, heparan sulfate, dermatan sulfate, pentosan polysulfate, fucoidan chondroitin sulfate, keratan sulfate, and PAVAS [21,22,39,40],... 

Neyts, J. and De Clercq, E. Effect of polyanionic componnds on intracntaneons and intravaginal herpesvirns infection in mice impact on the search for vaginal microbiocides with anti-HfV activity. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology 1995, 10, 8-12. 

Phillips, D. M. Intravaginal formulations to prevent HIV infection. Perspectives in Drug Discovery and Design 1996, 5, 213-224. 

The benzyl ester of hyaluronic acid (HYAFF 11) is a highly mucoadhesive polymer which can be processed into microspheres. Such microspheres containing salmon calcitonin were intravaginally administered to rats as a dosage form for the prevention of ovariectomy osteopenia [65]. In recent studies, HYAFF 11-salmon calcitonin microspheres were formulated as single-dose pessaries, resulting in sustained plasma concentrations of calcitonin [67]. 

Miconazole nitrate (Monistat-3, Antifungal Monistat-3 suppository 200rT [3/pal One suppository intravaginally qhs x 3... 

Monistat-7, Monistat, Micatin) Monisfat-7 suppository 100mg[7/pal Monistat cr 2% [45 gm] Micatin cr 2% [15, 30 gm] One 1 suppository intravaginally qhs x 7 One applicatorful intravaginally qhs x 7 Apply to affected areas bid. 

Conjugated estrogens Administer cyclically 3 weeks on and 1 week off. For short-term use only. Give 0.5 to 2 g/day intravaginally, depending on the severity of the condition. 

Uterine rupture has been reported when misoprostol was administered intravaginally in pregnant women to induce labor or to induce abortion beyond the first trimester of pregnancy. 

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