Vaginal Cream Inserts

Clotrimazone vaginal inserts each contain 100 mg clotrimazole with inactive ingredients benzyl alcohol, cetostearyl alcohol, cetyl esters wax, octyldodecanol, polysorbate 60, 

Combine the contents of the two vessels with agitation, maintaining at 70°C. 

In a separate vessel dissolve the remaining ceteth 20 in the remaining water at 65°C with agitation. 

Cool to room temperature and slurry the clotrimazole with vigorous agitation until smooth uniform slurry is obtained. 

Add the slurry to the previous emulsion mixture and agitate while cooling to room temperature. 

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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)... 

Miconazole (2%, 4% vaginal cream 100 mg, 200 mg vaginal suppositories) see comments for dosage Monistat-7, Monistat-3 Insert one applicatorful intravaginally at bedtime for 7 consecutive days (2%) or 3 consecutive days (4%). Alternatively insert one... 

Vaginal candidiasis is treated by clotrimazole, econazole, isoconazole, ketoconazole, miconazole or nystatin as pessaries or vaginal tablets or cream inserted once or twice a day with cream or ointment on surrounding skin. Failure may be due to a concurrent intestinal infection causing reinfection and nystatin tablets may be given by mouth... 

Clotrimazole is available as a 1% cream, lotion, and solution (Lotrimin, Mycelex, others), 1% or 2% vaginal cream or vaginal tablets of 100, 200, or 500 mg (Gyne-Lotrimin, Mycelex-G, others), and 10-mg troches (Mycelex, others). On the skin, applications are made twice a day. For the vagina, the standard regimens are one 100-mg tablet once a day at bedtime for 7 days, one 200-mg tablet daily for 3 days, one 500-mg tablet inserted only once, or 5 g of cream once a day for 3 days (2% cream) or 7 days (1% cream). For nonpregnant females, one 200-mg tablet may be used once a day for 3 days. Troches are to be dissolved slowly in the mouth live times a day for 14 days. 

Terconazole and butoconazole Terconazole is a ketal triazole with structural similarities to ketoconazole. The mechanism of action of terconazole is similar to that of the imidazoles. The 80-mg vaginal suppository is inserted at bedtime for 3 days, whereas the 0.4% vaginal cream is used for 7 days, and the 0.8% cream for 3 days. Clinical efficacy and patient acceptance of both preparations are at least as good as for clotrimazole in patients with vaginal candidiasis. Butoconazole is an imidazole that is pharmacologically quite comparable to clotrimazole. 

Discuss the need to douche 30 minutes prior to inserting the vaginal cream. 

Miconazole If the drug (cream or tablet) is administered vaginally, insert the drug high in the vagina using tiie applicator provided with the product. 

Clinical trials (60,61) have shown that TRA can be safely delivered topically using the cervical cap and collagen device. In these studies the TPA was applied as a cream to the sponge, which was then inserted into the vaginal vault. A new device was used daily for up to 4 days. Systemic effects were minimal, and local toxicity was dose-related and acceptable. 

Vaginal pessaries and creams are medications directly inserted into the vagina, either with or without the aid of an applicator. Vaginal pessaries and creams are used for a number of purposes ... 

Resistance to azole antifungals should be considered in individuals who have persistently positive yeast cultures and fail to respond to therapy despite adherence to prescribed regimens. These infections can be treated with boric acid or 5-flucytosine. Boric acid is administered as a 600-mg intravaginal capsule daily for 14 days of induction therapy, followed by a maintenance regimen of one capsule intravaginally twice weekly. Boric acid is toxic if administered orally. 5-Flucytosine cream is administered vaginally, 1000 mg inserted nightly for 7 days. 

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