Clotrimazole during pregnancy

A drug that is widely used in gynecological practice due to its high efficiency is clotrimazole during pregnancy. But there is no clear opinion regarding the use of this drug during pregnancy and its effect on the fetus. Therefore, it is necessary to understand the issue of the main pharmacological features of the drug and the possibility of its use during pregnancy, taking into account the pharmacological characteristics.

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Main pharmacological properties of clotrimazole

The drug is available in vaginal tablets of 100 milligrams, six tablets per package per course of treatment, as well as 1% cream and ointment in a tube of 20 grams. For local action, various forms are used, depending on the affected area.

Clotrimazole is a broad-spectrum antifungal drug. The main mechanism of action of the drug is to disrupt the structure of the cell membrane of fungi and their function. This occurs due to the fact that the active substance of clotrimazole disrupts the normal synthesis of the main cell component of the fungal wall - ergosterol. As a result, the work of potassium-sodium pumps is disrupted and sodium can freely enter the cell, attracting water with it - this disrupts the work of all elements of the cell and lysis of its contents occurs. Clotrimazole also contributes to the disruption of the mitochondrial complex and peroxide is released with premature hydrogen peroxide oxidation. This is an additional mechanism for disrupting the cell of fungi and some microorganisms. In moderate therapeutic doses, the effect of the drug is to temporarily block the reproduction of fungi, that is, it has a fungistatic effect. When doses are increased to large ones, the drug can also have a fungicidal effect, that is, it kills fungi. This also applies to some streptococci and staphylococci, trichomonads and amoebas, since their cells contain the same substance – ergosterol.

Pharmacokinetic properties of the drug

Clotrimazole has only a pronounced local effect, is not absorbed into the systemic bloodstream in the case of using local forms. It manifests its effect due to the ability to accumulate in the stratum corneum of the skin, which in turn contributes to its long-term effect, but at the same time, it is not absorbed into the blood vessels. When determining the drug in the blood, its amount is so small that it cannot be measured. The drug is metabolized in the liver and excreted by the kidneys and partly with feces. Such low absorption of the drug and almost zero bioavailability allows us to assume the possible use of clotrimazole during pregnancy.

Contraindications for use and features of side effects

The drug is contraindicated for use, especially during pregnancy in the first trimester, in the presence of allergic reactions in the anamnesis or allergy to additional components of the drug. Side effects occur very rarely precisely because of the peculiarities of pharmacodynamics, since the drug is not absorbed and does not affect systemic organs. Overdose of clotrimazole can cause dyspeptic disorders in the form of abdominal pain, nausea, malaise, vomiting, dizziness. There may be local manifestations when using clotrimazole suppositories in the form of itching, discomfort in the vagina, burning, and certain discharge. Side effects of clotrimazole during pregnancy in case of its use in the first trimester are disorders of differentiation of fetal tissues and placentation disorders.

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Features of the use of clotrimazole during pregnancy

Clotrimazole suppositories are used vaginally. Before taking them, it is necessary to wash the genitals. Use one suppository once a day - in the evening, while it is not recommended to use suppositories to avoid damage to the mucous membrane of the cervix and cervical canal. In this case, the suppository must be soaked in water and inserted by hand. The course of treatment is six days. For a better effect, you can use clotrimazole ointment in parallel. Such local treatment of candidiasis does not contribute to the effect on the fetus due to minimal absorption.

Clotrimazole cream is used for skin lesions, and clotrimazole tablets are for systemic use, but they are contraindicated during pregnancy.

Overdose with clotrimazole is rare, due to the fact that the drug is not absorbed. There may be minor local manifestations.

Interaction with other drugs consists of a decrease in their effectiveness when used simultaneously with other antifungal or hormonal drugs.

Storage conditions for candles are as follows: shelf life is two years. Store at a relative temperature of no more than 28 degrees, avoiding direct exposure to high and low temperatures, and also exclude high humidity.

Having studied the main pharmacological features of clotrimazole, we can say for sure that the drug has no systemic effect on the body even during pregnancy due to its minimal absorption. At the same time, taking the drug is contraindicated in the first trimester, since in the process of laying down the fetal organs, any effect, even with local treatment, can be teratogenic. Therefore, clotrimazole can be used during pregnancy, since it is very effective for many fungal diseases, but it should be used only in the second and third trimesters. Each case of treatment should be studied individually and taken only as prescribed by a doctor, because you need to be attentive not only to your health, but also to the health of the unborn child.

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Basic principles of using clotrimazole during pregnancy

Pregnancy is a period when another life develops in a woman's body and at this time it is necessary to be very careful about nutrition and taking any pharmacological drugs. The process of organogenesis begins in the first trimester, and then the growth and differentiation of tissues continues, which also requires increased attention to taking any medications. The fetus is an agent foreign to the woman's body, because it contains 50% of the information from the father. The woman's immune system perceives it as an antibody to some extent, therefore, until the formation of its placenta with an individual barrier and blood flow, a state of relative immunosuppression develops. This condition of a pregnant woman contributes to a change in all reactions of the female body, which could have been normal before. That is, the reactions of pharmacological transformation of drugs also occur differently, which can thus significantly affect the child. This is especially true for the first trimester of pregnancy, when there is no placenta yet, as an individual defense mechanism.

The state of relative immunosuppression of the pregnant woman's body promotes the development and proliferation of opportunistic flora, which entails many unpleasant moments. The vagina is a place that has its own biocenosis and functions normally due to opportunistic microflora, which normally inhibits the proliferation of pathogenic microorganisms. When a woman's general immunity decreases, local defenses also decrease, which contributes to a decrease in the activity of beneficial bacteria. Thus, one of the common diseases that worries pregnant women develops - fungal vaginitis, or thrush. This is a pathology that is characterized by the proliferation of fungal flora of the vagina with the development of corresponding clinical manifestations. This occurs against the background of a decrease in the number of vaginal lactobacilli and Doderlein bacilli, which normally form lactic acid in the vagina when breaking down glucose and thus help maintain a slightly acidic environment in the vagina. This is one of the main local mechanisms of vaginal defense, which is impaired in pregnant women with candidiasis or fungal vaginitis.

Read also about the treatment of thrush with clotrimazole in this article.

The question of harm or benefit of any medication during pregnancy is widely discussed, including the question of the use of clotrimazole. To determine the effectiveness and possible harm of the drug during pregnancy, it is necessary to know some of its pharmacological features.

Clotrimazole is an antifungal drug that has a local effect and is a derivative of the imidazole substance. This drug is one of the oldest drugs and is effective against all possible fungi. It is effective against yeast-like, mold fungi, dermatophytes, actinomycetes, blastomycosis, which contributes to its widespread use not only for the treatment of thrush, but also for fungal infections of other localizations - fungal lesions of the skin, mucous membranes, scalp. The drug is also effective against some gram-negative staphylococci and streptococci, trichomonads and amoebas.

Therefore, the indications for the use of clotrimazole are very wide - these are fungal skin lesions caused by these pathogens, secondary infectious mycoses, oral candidomycosis and urogenital fungal lesions. Due to the local action and different forms of release, clotrimazole can be used locally for lesions of various localizations. There are different trade names of the drug - "Funginal", "Candibene", "Canesten", "Antifungol", "Imidil", "Ovis", "Lotrimin", "Dignotrimanol".

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