VAGINAL ANTIBACTERIALS

Metronidazole + Nyastatin
Indication: Vaginitis due to Trichomonas vaginalis, Gardnerella vaginalis, bacterial
vaginosis, Candida (Monilia) albicans & other fungal infections.
Contraindication: Hypersensitivity to nystatin. TB of mucous membranes & certain viral
conditions.

Dosing: 1 vag supp before retiring for 7-10 days

Brand/s available in the Philippines: Flagystatin

Tioconazole + Tinidazole
Indication: Treatment of vaginitis caused by Candida, Trichomonas & Gardnerella;
& vaginitis due to mixed infections.
Contraindication: Hypersensitivity. Organic neurologic disorders & history or
existing blood dyscrasia. Virgins & young girls who are not sexually mature.
Pregnancy (1st trimester) & lactation (breastfeeding can be started again 72 hr
after end of treatment). Childn <12 yr.
Dosing: Insert 1 supp high into vag at night for 7 days. Alternatively, 1 supp in the
morning & at night for 3 days.
Brand/s available in the Philippines: Gynomax

Miconazole Nitrate
Indication: Single-dose treatment of vag & vulval candidiasis. Fungal infections of
vag especially originating from Candida & coexistent w/ gm +ve bacteria (Staph,
Strep & Micrococcus bacteria causing secondary infections)
Contraindication: Hypersensitivity. Virgins & young girls who are not sexually
mature. Pregnancy (1st trimester) & lactation. Childn <12 yr.
Dosing: Insert 1 supp high into vag for 1 night before retiring. May be repeated
after 3 days if necessary.
Brand/s available in the Philippines: Micotran

Metronidazole + Miconazole Nitrate

Indication: Treatment of vag candidiasis (due to Candida albicans); bacterial (due
to anaerobic bacteria) & trichomonal (due to Trichomonas vaginalis) vaginitis; mixed
vag infections.
Contraindication: Hypersensitivity. Porphyria, epilepsy & serious liver function
disorders. Virgins & young girls who are not sexually mature. Alcohol use during or
at least 3 days after treatment. Disulfiram use during or w/in 2 wk of treatment.
Pregnant women who have trichomonal vaginitis in the 1st trimester. Pregnancy (1st
trimester) & lactation (breastfeeding can be started again 24-48 hr after end of
treatment). Childn <12 yr.
Dosing: vag supp 1 supp at night & in the morning for 7 days.
Brand/s available in the Philippines: Neo-Penotran

Dinoprostone
Indication: Initiation of cervical ripening at term (from 38th wk of gestation)
Contraindication: Hypersensitivity. If labor has started or oxytocic drugs are being
given. When strong prolonged uterine contractions would be inappropriate eg in
previous major uterine surgery eg caesarean section, myomectomy; cephalopelvic
disproportion; fetal malpresentation; suspicion or evidence of fetal distress; >3 full
term deliveries; previous surgery or rupture of the cervix. Existing pelvic
inflammatory disease unless adequate prior treatment has been instituted; placenta
previa or unexplained vag bleeding during the current pregnancy.
Dosing: 1 vag delivery system administered high into the posterior vag fornix.
Remove vag delivery system if there is insufficient cervical ripening in 24 hr. A
dosing interval of at least 30 min is recommended for the sequential use of oxytocin
following the removal of the vag delivery system.
Brand/s available in the Philippines: Propress

Clotrimazole
Indication: Treatment & prophylaxis of fungal infections.

Contraindication: Hypersensitivity to clotrimazole or azole group. History of

regional enteritis, ulcerative colitis or antibiotic-associated colitis
(pseudomembranous colitis). Childn <2 yr.
Dosing: Insert 1 supp (100 mg) intravag for 6 consecutive days or 200 mg for 3
days or 500 mg as single dose for 1 day before bedtime. Refractory/recurrence:
Double the dose &/or duration.
Brand/s available in the Philippines: Vagid