Clion D at pregnancy in 1, 2, 3 trimester

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

And as an answer to the question - is it possible to Clion D in pregnancy - in the official instruction for the drug there is a standard formulation, the meaning of which is that: the use of Clion 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).

[1], [2], [3], [4], [5]

Indications of the clion D during 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: protozoa Trichomonas vaginalis and yeast-like fungi Candida albicans.

So, if the patient does not have trichomoniasis at the same time, it is irrational to prescribe Clion D during pregnancy with thrush ( candidal vaginitis or vulvovaginitis).

In the presence of trichomonadal vaginitis, Metronidazole (synonymous with Trichopolum) is used, but it is absolutely contraindicated in pregnancy for 1 trimester (and lactating women), like metronidazole-containing Clion D and Clion D 100 in pregnancy at the same time.

[6],

Release form

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

[7]

Pharmacodynamics

The mechanism of pharmacological action of Clion D is due to the constituent metronidazole and miconazole nitrate.

Metronidazole - like all other nitroimidazole derivatives - acts on the DNA of the cells of the simplest parasites (trichomonads, 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 candidate fungus, the synthesis of ergosterol of its cell walls from lanosterol is suspended and then completely blocked. In the membranes and cytoplasm of blastoconidia irreversible changes occur, as a result of which new cells of the fungus become unviable.

[8]

Pharmacokinetics

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

Metronidazole cleavage occurs in the liver with the formation of an active metabolite; Elimination from the body is carried out by the kidneys and partly through the intestine.

[9], [10], [11]

Dosing and administration

Vaginal tablet Clion D (Clion D 100) should be administered inside the vagina - once a day (at night).

[14], [15], [16], [17]

Contraindications

General contra-indications of Clion D include, as already noted, the first trimester of pregnancy and lactation period, as well as a low level of leukocytes in the blood, central nervous system pathologies of an organic nature (congenital and acquired), liver failure, renal dysfunction.

[12], [13],

Side effects of the clion D during pregnancy

Local side effects, which are possible with the use of this drug, are manifested by vaginal itching and burning, vaginal discharge, rapid urination.

Do not exclude rashes on the skin, nausea and vomiting, headache and dizziness, dryness and taste of metal in the mouth, spasms of the intestine and problems with its emptying.

Overdose

Information regarding the excess dose of Clion D is not given in the manual.

Interactions with other drugs

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

[18], [19]

Storage conditions

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

[20], [21], [22]

Shelf life

The drug is suitable for five years.

Metronidazole FDA is assigned category B, which means: studies of the reproductive functions of animals failed to demonstrate a risk to the fetus, but adequate controlled studies of the effect of the drug among pregnant women have not been conducted. However, it causes mutations in bacteria, and for rats it is a carcinogen.

[23],

Reviews

At one time, negative feedback about metronidazole (in women taking the drug inside, there were premature births or babies with low birth weight and congenital anomalies were born) were forced to make a retrospective meta-analysis of all studies.

And although, as the American Journal of Obstetrics and Gynecology wrote, previous studies in people who used metronidazole orally or intravaginally did not provide evidence of its carcinogenicity or teratogenic effects, concerns about metronidazole treatment during pregnancy may persist.