Ketoconazole supp vag. 400mg #10

Ketoconazole instruction

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Composition

    In a single suppository, Ketoconazole contains 200 mg of the same drug substance. Additional substances: semi-synthetic glycerides (up to the total weight of the suppository 2000 mg), butylhydroxyanisole.

Form of issue

    White, cylindrical vaginal suppositories with a yellowish hue of color, on the cut, the presence of an air rod or deepening of the funnel-like shape is allowed. 5 suppositories in a contour package, 1 pack of cells in a pack of paper.

pharmachologic effect

Antifungal, fungicidal, fungistatic, antiandrogenic effect.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Ketoconazole is an artificial derivative of imidazole. It has fungistatic and fungicidal action. It inhibits the biosynthesis of ergosterol and disrupts the normal lipid composition of the fungal cell wall.
Effects on Epidermophyton floccosum, dermatophytes of the genera Microsporum, Trichophyton, as well as on fungi of the genus Pityrosporum and Candida.

Pharmacokinetics of suppositories

Absorption into the systemic blood stream with intravaginal application is extremely small.

Indications for the use of Ketoconazole suppositories

    Therapy of vaginal recurrent candidiasis, both acute and chronic.
    Prevention of the development of fungal vaginal lesions with a reduced protective function of the body and against therapy with antibacterial agents and other drugs that alter the normal microflora.

Contraindications

    The first trimester of pregnancy.
    Hypersensitivity to the components of the drug.
    Age is less than 12 years.
Ketoconazole suppositories are used with caution during lactation, in the second and third trimesters of pregnancy and in children over 12 years of age.

Side effects

    Local reactions: itching of the vagina, irritation of the mucous membranes of the vagina.
    Allergic reactions: urticaria, skin rash.

Instructions for suppositories

suppositories are used intravaginally. Before releasing the suppository from the package, it is inserted into the vagina as deep as possible in a horizontal position. Use one suppository a day for 3-5 days depending on the severity of the disease.
In the treatment of chronic candidiasis, treatment is carried out for 10 days while maintaining the indicated frequency of administration.

Overdose when using cream or suppositories

As these formulations of the drug do not reach the systemic blood flow, the appearance of signs of an overdose is unlikely.
When swallowing cream or suppositories, you should rinse the stomach and begin symptomatic treatment.

Interaction

When used according to the instructions, suppositories and cream (ointment) of Ketoconazole are almost not absorbed into the systemic circulation and interaction with other medicines is unlikely.

Storage conditions

Store in a dry dark place, at a temperature of 15-25 degrees Celsius. Keep away from children.
Shelf life - three years.

special instructions

The cream is not intended for use in ophthalmic practice, it is also recommended to avoid it getting into the eyes.
When applying the cream immediately after prolonged use of external glucocorticosteroids, skin irritation is possible, for the relief of which it is recommended to continue treatment with local glucocorticosteroids in the morning, and in the evening apply cream with Ketoconazole. For the next 3 weeks, you need to lower the dose of corticosteroid until it is completely eliminated.
In fungal lesions of the scalp, it may be more preferable to use a shampoo with Ketoconazole.
In very rare cases, when using suppositories, it is possible to develop a local allergy of the external genitalia in the partner.
To reduce the risk of recurrence of the disease when using suppositories, it is recommended to simultaneously perform therapy with a sexual partner.
The use of suppositories can reduce the reliability of barrier contraception.
The use of tablet forms of the drug is inappropriate in the treatment of fungal meningitis, because Ketoconazole poorly passes through the blood-brain barrier.
Because of the high risk of developing hepatotoxicity, the drug tablets should be used only in special cases if there are indications and with the appointment of a doctor.
Before the beginning of therapy with tablets, it is necessary to assess the level of liver function in order to exclude diseases, and during the treatment it is necessary to regularly monitor the blood counts, kidneys, adrenals and liver so as not to miss the signs of hepatotoxicity.
If glucocorticosteroids were used to treat skin diseases, then Ketoconazole is prescribed in tablets only 14 days after their complete withdrawal.
The intake of acidic drinks increases the absorption of Ketoconazole.
The drug Ketoconazole does not affect the ability to drive vehicles.

Children

suppositories are not used in children under 12 years old.
In the treatment of children weighing 15-30 kg, the daily dose is 100 mg, and in the treatment of children weighing more than 30 kg adult doses are used. To prevent fungal infections in children, the drug is prescribed at the rate of 4-8 mg / kg of body weight per day.
Tablets are not used in children under 3 years of age.

With alcohol

At the use of alcohol on a background of treatment by a preparation development of disulfiram-like reaction and strengthening of a hepatotoxicity is possible, therefore similar episodes should be avoided.

In pregnancy and lactation

The cream is allowed to be used in all specified periods.
suppositories are forbidden to apply in the first trimester of pregnancy, in other two trimesters it is possible to use this form of the drug with extreme caution.
Tablets are not allowed to be used in all specified periods.

Reviews of Ketoconazole

Reviews of ointments (cream) and suppositories with Ketoconazole characterize them from a positive angle. There are rare cases of side effects when they are used. Reviews of shampoo with Ketoconazole characterize it from an even better side in the treatment of fungal damage to the hairy parts of the body.
Tablets of the same name are appointed extremely rare because of their high ability to provoke side effects, so you can not make a full picture of the effectiveness of this form of release of the remedy based on feedback.