Version May 2024
Candidiasis, vulvovaginal:
Note: A longer duration of 7 to 14 days may be necessary in patients with complicated infection (ie, recurrent or severe infection, infection with non-albicans Candida, or infection in an immunocompromised host) (Ref). Not effective against Candida glabrata (Ref).
Ointment 6.5%: Intravaginal: Insert 1 applicatorful (~5 g) as a single dose (at bedtime) (Ref).
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
There are no dosage adjustments provided in the manufacturer's labeling. However, dosage adjustment unlikely due to low systemic absorption.
There are no dosage adjustments provided in the manufacturer's labeling. However, dosage adjustment unlikely due to low systemic absorption.
Refer to adult dosing.
Children ≥12 years and Adolescents: Refer to adult dosing
There are no dosage adjustments provided in the manufacturer's labeling. However, dosage adjustment unlikely due to low systemic absorption.
There are no dosage adjustments provided in the manufacturer's labeling. However, dosage adjustment unlikely due to low systemic absorption.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
Frequency not defined.
Central nervous system: Headache
Gastrointestinal: Abdominal pain
Dermatologic: Burning sensation of skin, exfoliation of skin
Genitourinary: Dyspareunia, dysuria, nocturia, vaginal discharge, vaginal pain, vaginitis, vulvar swelling, vulvovaginal irritation, vulvovaginal pruritus
Concerns related to adverse effects:
• Irritation: If irritation or sensitization occurs, discontinue use.
Special populations:
• Pediatric: Vaginal products are not for OTC use in children <12 years of age.
Dosage form specific issues:
• Formulation: Petrolatum-based vaginal products may damage rubber or latex condoms or diaphragms; separate use by 3 days.
• Vaginal product: Consult with health care provider prior to self-medication (OTC use) if experiencing vaginal itching/discomfort, lower abdominal pain, back or shoulder pain, chills, nausea, vomiting, foul-smelling discharge, if this is the first vaginal yeast infection, or if exposed to HIV. Contact health care provider if symptoms do not begin to improve after 3 days or last longer than 7 days.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Ointment, Vaginal:
Monistat 1-Day: 6.5% (4.6 g)
Generic: 6.5% (4.6 g, 8 g)
No
Ointment (Vagistat-1 Vaginal)
6.5% (4.6 g): $10.79
Disclaimer: The pricing data provide a representative AWP and/or AAWP price from a single manufacturer of the brand and/or generic product, respectively. The pricing data should be used for benchmarking purposes only, and as such should not be used to set or adjudicate any prices for reimbursement or purchasing functions. Pricing data is updated monthly.
Intravaginal: For vaginal use only. Administer 1 applicatorful (prefilled) intravaginally. Applicator may be inserted in any comfortable position. Hold the applicator by the barrel, insert gently into the vagina as far as possible without causing discomfort. Press the plunger until it stops and withdraw the applicator. Patients should not use intravaginal products (eg, tampons, douches) or engage in vaginal intercourse for the duration of treatment. Discard applicator after use.
Intravaginal: For vaginal use only. Administer 1 applicatorful (prefilled) intravaginally, preferably at bedtime. Applicator may be inserted in any comfortable position. Hold the applicator by the barrel, insert gently into the vagina as far as possible without causing discomfort. Press the plunger until it stops and withdraw the applicator. Patients should not use intravaginal products (eg, tampons, douches) or engage in vaginal intercourse for the duration of treatment. Discard applicator after use.
Candidiasis, vulvovaginal: Local treatment of vulvovaginal candidiasis
Tioconazole may be confused with terconazole
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Progesterone: Antifungal Agents (Vaginal) may diminish the therapeutic effect of Progesterone. Risk X: Avoid combination
This product may weaken latex condoms and diaphragms (CDC [Workowski 2021]).
Various tioconazole regimens have been evaluated in pregnant patients (Clissold 1986; Henderson 1983). However, only topical azole therapies with 7-day regimens are recommended in pregnant patients with vulvovaginal candidiasis (CDC [Workowski 2021]).
A 1-substituted imidazole derivative with a broad antifungal spectrum against a wide variety of dermatophytes and yeasts, including Trichophyton mentagrophytes, T. rubrum, T. erinacei, T. tonsurans, Microsporum canis, Microsporum gypseum, and Candida albicans. Both agents appear to be similarly effective against Epidermophyton floccosum.
Onset of action: Some improvement: Within 24 hours; Complete relief: Within 7 days.
Absorption: Intravaginal: Systemic 10.6 to 35.8 ng/mL at 8 hours postdose; none detectable at 24 hours (Houang 1985).
Distribution: Vaginal fluid: 24 to 72 hours (Clissold 1986; Jones 1993).
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