Vaginal irrigator

Fluconazole is very effective in the treatment of infections with most Candida spp. Thrush in the end-stage AIDS patient, often refractory to nystatin, clotrimazole, and ketoconazole, can usually be suppressed with oral fluconazole. AIDS patients with esophageal candidiasis also usually respond to fluconazole. A single 150-mg dose has been shown to be effective treatment for vaginal candidiasis. A 3-day course of oral fluconazole is effective treatment for Candida urinary tract infection and is more convenient than amphotericin B bladder irrigation. Preliminary findings suggest that Candida endophthalmitis can be successfully treated with fluconazole. Stable nonneutropenic patients with candidemia can be adequately treated with fluconazole, but unstable, immunosuppressed patients should initially receive... 

Benzoic acid IM, IV, irrigation, oral, rectal, topical, vaginal Alkalis, heavy metals, kaolin... 

GRAS listed. Accepted as a food additive in Europe. Included in the FDA Inactive Ingredients Guide (IM and IV injections, irrigation solutions, oral solutions, suspensions, syrups and tablets, rectal, topical, and vaginal preparations). Included in nonparenteral medicines licensed in the UK. Included in the Canadian List of Acceptable Non-medicinal Ingredients. 

Vaginal pessaries resemble rectal suppositories in many aspects. Differences from rectal suppositories are discussed. Vaginal solutions are mentioned briefly. They are not frequently used and largely resemble irrigation solutions and solutions for cutaneous use. 

The volume of a vaginal solution varies from 150 to 200 mL. A concentrate for dilution will be diluted by the patient about ten times, depending on the filling marks of the available irrigator. 

A vaginal solution with iodinated povidone is best delivered as a stable concentrate, for instance Betadine -solution 100 mg/mL. The patient should dilute the concentrate ten times in an irrigator. The indication is fluor vaginalis with clinically evident inflammation but without a microbiological diagnosis. 

Method of preparation, release control and quality requirements of sterile vaginal solutions are the same as for irrigation solutions (Preparations for irrigation Ph. Eur., see Sect. 14.7). Preparation method and release controls of non-sterile vaginal solutions are the same as for solutions for cutaneous use (see Sect. 12.6.5). 

Preparations intended for application to other mucous membranes are described in Chaps. 6 Pulmonary, 7 Oropharynx, 8 Nose, 11 Rectal and vaginal, 14 Irrigation and dialysis. 

Eye lotions (irrigations for the eye) are discussed in Sect. 10.6.2. Vaginal solutions that don t need to be sterile are discussed in Sect. 11.12. Whole bowel irrigations are used before diagnostic examination. Those solutions for oral or rectal use are not described in this chapter. 

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