Vaginal applicator

Remain recumbent for at least 30 minutes after vaginal application and do not use tampons during estropipate therapy... 

Assess the patient for increased irritation with topical application or increased vaginal discharge with vaginal application... 

Pharmacokinetics Negligible absorption from vaginal application. 

Einer-Jensen, N. 1993. Rapid adsorption and local redistribution after vaginal application in gilts. Acta Vet Scand 34 1. 

Conventional formulations intended for vaginal application include solutions, foams, creams, gels, tablets, and suppositories, in particular pessaries. 

A topical powder product may be marketed in a sifter-top container made of flexible plastic tubes or as part of a sterile dressing (e.g., antibacterial product). The topical formulations in a collapsible tube can be constructed from low-density polyethylene (LDPE), with or without a laminated material. Normally, there is no product contact with the cap during storage. Thus usually there is no cap liner, especially in collapsible polypropylene screw caps. Normally separate applicator devices are made from LDPE. Product contact is possible if the applicator is part of the closure, and therefore an applicator s compatibility with the drug product should be established, as appropriate (e.g., vaginal applicators). 

Brache, V., Cohen, J. A., Cochon, L., and Alvarez, F. (2006), Evaluating the clinical safety of three vaginal applicators A pilot study conducted in the Dominican Republic, Contraception, 73,72-77. 

Disposition in the Body. About 10% of a topical dose is absorbed and after vaginal application about 5% of the dose is absorbed. Following oral administration, about 40% of the dose is excreted in the urine and 30% is eliminated in the faeces, in 5 days. 

Coppi, G. Silingardi, S. Girardello, R. De Aloysio, D. Manzardo, S. Pharmacokinetics of ciclopirox olamine after vaginal application to rabbits and patients. J. Chemotherapy 1993, 5, 302-306. 

A drug is supplied with a dropper, throat brush or vaginal applicator Several flavours of the same preparation are supplied... 

Miconazole readily penetrates the stratum comeum and persists there for >4 days after application. Less than 1% is absorbed into the blood. Systemic absorption from the vagina is <1.3%. Adverse effects from vaginal application include burning, itching, or irritation in -7% of recipients, and infrequently, pelvic cramps (0.2%), headache, hives, or skin rash. Irritation, burning, and maceration are rare after cutaneous application. Miconazole is considered safe for use during pregnancy. 

Significant side effects are those associated with its abortifacient properties and other smooth muscle contraction effects, e.g., diarrhea and abdominal pain. Misoprostol also is an effective cervical ripening agent (by vaginal application) for the induction of labor. Other unlabeled uses include the treatment of postpartum hemorrhage and, with mifepristone, termination of pregnancy. 

Teach the client not to insert the vaginal applicator very far into the vagina. 

The filled vaginal applicator should be inserted as far into the vaginal canal as possible, and then the client should push the plunger, depositing the medication in the vagina. 

Rectal and vaginal dosage forms aimed to obtain a local effect are, from a biopharmaceutical viewpoint, comparable with dermal preparations. However it should be known that after rectal and vaginal application a greater part of the active substance may reach the general circulation than after cutaneous application. This may result in significant blood levels and unwanted systemic effects. 

For rectal application ointments and creams are common, for vaginal application creams and gels are used. They act locally and the design and preparation hardly differ from corresponding dosage forms for cutaneous use. In the subsequent sections some aspects of semisolid preparations for rectal and vaginal use will be discussed that are not encotmtered in cutaneous use. 

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