Clion D in pregnancy in the 1st, 2nd, 3rd trimester

The use of the combined antiprotozoal, antimicrobial and fungicidal agent Klion D during pregnancy is extremely limited, and the use of Klion D during pregnancy in the first trimester is strictly prohibited.

And as an answer to the question - is it possible to use Klion D during pregnancy - in the official instructions for the drug there is a standard formulation, the meaning of which is that: the use of the drug Klion D during pregnancy in the 2nd and 3rd trimester is permissible only if the expected therapeutic effect for the mother (determined by the attending physician) is much higher than the possible negative consequences for the fetus (which the doctor must also take into account).

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Indications Cliona D in pregnancy

The main indications for the use of this drug are the treatment of inflammation of the vaginal mucosa ( vaginitis or colpitis) caused by a combined infection: the protozoan Trichomonas vaginalis and the yeast-like fungi Candida albicans.

So, if patients are not simultaneously diagnosed with trichomoniasis, it is irrational to prescribe Klion D during pregnancy for thrush ( candidal vaginitis or vulvovaginitis).

In the presence of trichomonas vaginitis, Metronidazole (synonym Trichopolum) is used, but it is absolutely contraindicated for pregnant women during the first trimester (and lactating women), as are Klion D and Klion D 100, which contain metronidazole, during pregnancy at the same stage.

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Release form

Klion D (and Klion D 100) are produced in the form of vaginal tablets, each containing 100 mg of metronidazole and 100 mg of miconazole nitrate.

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Pharmacodynamics

The mechanism of pharmacological action of Klion D is due to the metronidazole and miconazole nitrate included in its composition.

Metronidazole, like all other nitroimidazole derivatives, acts on the DNA of protozoan parasites (Trichomonas, amoebas, lamblia) and some anaerobic bacteria with free radicals that are formed during the transformation of the nitro group of its molecule and interfere with the biosynthesis of nucleotides, leading to DNA degradation.

And thanks to the azole fungicidal component miconazole, which inhibits the activity of methylase enzymes of the Candida fungus, the synthesis of ergosterol of its cell walls from lanosterol is suspended and then completely blocked. Irreversible changes occur in the membranes and cytoplasm of blastoconidia, as a result of which new fungal cells become non-viable.

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Pharmacokinetics

Miconazole is characterized by minimal absorption into blood plasma, but metronidazole, even when applied locally, enters the systemic bloodstream, overcoming the BBB and placental barrier. Due to the change in the metronidazole molecule, a concentration gradient is created and maintained, which facilitates intracellular transport of the drug.

Metronidazole is broken down in the liver to form an active metabolite; elimination from the body occurs through the kidneys and partly through the intestines.

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Dosing and administration

The vaginal tablet Klion D (Klion D 100) should be inserted into the vagina once a day (at night).

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Contraindications

General contraindications for Klion D include, as already noted, the first trimester of pregnancy and lactation, as well as low levels of leukocytes in the blood, organic pathologies of the central nervous system (congenital and acquired), liver failure, and impaired renal function.

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Side effects Cliona D in pregnancy

Local side effects that may occur when using this drug include vaginal itching and burning, vaginal discharge, and increased urination.

Skin rashes, nausea and vomiting, headaches and dizziness, dry mouth and metallic taste, intestinal spasms and problems with bowel movements are possible.

Overdose

Information regarding exceeding the dose of Klion D is not provided in the instructions.

Interactions with other drugs

Metronidazole, which is part of this drug, can be combined with antibiotics, but it is incompatible with ethanol, lithium preparations and indirect anticoagulants.

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Storage conditions

Kliod D tablets are stored in a dark place at t>+12°C, but <+28°C.

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Shelf life

The drug is valid for five years.

Metronidazole has an FDA category B, meaning that animal reproduction studies have not shown a risk to the fetus, but adequate, controlled studies have not been conducted in pregnant women. However, it does cause mutations in bacteria and is a carcinogen in rats.

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Reviews

At one time, negative reviews of metronidazole (women who took the drug orally experienced premature births or gave birth to children with low birth weight and congenital anomalies) forced a retrospective meta-analysis of all studies.

And although previous studies in people using metronidazole orally or vaginally have found no evidence of carcinogenicity or teratogenicity, as reported in the American Journal of Obstetrics and Gynecology, concerns about metronidazole use during pregnancy may remain.