Clotrimazole during pregnancy

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

[1], [2], [3]

Main pharmacological properties of clotrimazole

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

Clotrimazole is a broad-spectrum antifungal drug. The main mechanism of action of the drug is a violation of the structure of the cell membrane of fungi and their function. This is due to the fact that the active substance of clotrimazole disrupts the normal synthesis of the main cellular 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 - this disrupts the work of all cell elements and loses its contents. Clotrimazole also contributes to the disruption of the mitochondrial complex and the peroxide yields premature peroxide oxidation of hydrogen. This is an additional mechanism of disruption of the cells 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. With increasing doses to large, the drug may have a fungicidal effect, that is, it kills fungi. This also applies to certain streptococci and staphylococci, trichomonads and amoebas, since their cell contains the same substance - ergosterol.

Pharmacokinetic features of the drug

Clotrimazole has only a pronounced local effect, is not absorbed into the systemic circulation in the case of using local forms. It manifests its effect due to the ability to accumulate in the stratum corneum, which in turn contributes to its long-term action, 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 can not be measured. The drug is metabolized in the liver and excreted by the kidneys and partly with feces. This low absorption of the drug and virtually zero bioavailability suggests that clotrimazole may be used during pregnancy.

Contraindications to use and side effects of the action

The drug is contraindicated for admission, especially during pregnancy in the first trimester, in the presence of allergic reactions in the anamnesis or in case of allergies to additional constituent components of the drug. Adverse events occur very rarely precisely because of the peculiarities of pharmacodynamics, since the drug is not absorbed and does not affect the system organs. An overdose of clotrimazole can cause dyspeptic abnormalities in the form of abdominal pain, nausea, malaise, vomiting, dizziness. There may be local manifestations when applying clotrimazole suppositories in the form of itching, discomfort in the vagina, burning, and also certain secretions. Side effects of clotrimazole during pregnancy in case of its use in the first trimester are violations of differentiation of the fetal tissues and violation of placentation.

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Features of clotrimazole during pregnancy

Suppositories clotrimazole are used vaginally. Before taking the toilet, you must hold the genitals. Apply one candle once a day - in the evening, while using suppositories is not recommended to avoid damage to the mucous cervix and cervical canal. The candle should be soaked in water and inserted by hand. The course of treatment is six days. For a better effect in parallel, you can use clotrimazole ointment. Such a local treatment of candidiasis does not contribute to the effect on the fetus because of minimal absorption.

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

Overdosing with clotrimazole is rare, which is due to the fact that the drug is not absorbed. There may be a slight local manifestation.

Interaction with other drugs is to reduce their effectiveness when used concurrently with other antifungal or hormonal drugs.

The storage conditions for suppositories are as follows: shelf life of two years. Store at a relative temperature of no higher than 28 degrees, avoiding direct action of high and low temperatures, and also to exclude high humidity.

Having studied the basic pharmacological features of clotrimazole, it can be precisely said that the drug has no systemic effect on the body even during pregnancy because of its minimal absorption. In this case, the drug is contraindicated in the first trimester, because in the process of laying the fetal organs any influence, even with local treatment, can be teratogenic. Therefore, clotrimazole can be used during pregnancy, because it is very effective in many fungal diseases, but it should be used only in the second and third trimester. Each case of treatment should be studied individually and taken only according to the doctor's prescription, because you need to be careful not only to your health, but also to the health of your unborn child.

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Basic principles of clotrimazole during pregnancy

Pregnancy is the period when another woman's life develops in the female body and at this time one should take a very careful attitude to the nutrition and reception of any pharmacological preparations. 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. Fetus is an agent alien to the body of a woman, in fact 50% of the information it contains from the pope. The immune system of a woman perceives it as an antibody to some extent, so until the formation of its placenta with an individual barrier and blood flow, a state of relative immunosuppression develops. Such a state of a pregnant woman helps to change all the reactions of the female body, which before could be normal. That is, pharmacological transformation reactions of drugs also occur in a different way, which in this way can significantly affect the child. This especially applies to the first trimester of pregnancy, when there is still no placenta, as an individual protective mechanism.

The condition of relative immunosuppression of the pregnant woman's organism promotes the development and reproduction of the conditionally pathogenic flora, which entails many unpleasant moments. The vagina is a place that has its own biocenosis and functions normally due to a conditionally pathogenic microflora that normally inhibits the multiplication of pathogenic microorganisms. When a woman's general immunity decreases, local defenses also decrease, which reduces the activity of beneficial bacteria. Thus, one of the frequent diseases that worries pregnant women - fungal vaginitis or else it is called milkmaids - develops . This pathology, which is characterized by the multiplication of fungal flora of the vagina with the development of appropriate clinical manifestations. This occurs against the background of the fact that the number of lactobacilli of the vagina and Dodderlein sticks decreases, which normally in the vagina during the splitting of glucose form lactic acid and thus contribute to the maintenance of a weakly acidic environment of the vagina. This is one of the main local mechanisms for protecting the vagina, which is disrupted in pregnant women with candidiasis or fungal vaginitis.

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

The issue of harm or benefit of any medicine during pregnancy is widely debated, including the use of clotrimazole. To determine the effectiveness and possible harm of the drug during pregnancy, you need to know some of its pharmacological features.

Clotrimazole is an antifungal drug that has local effects and is a derivative of imidazole. This drug is one of the oldest drugs and has efficacy against all possible fungi. It is effective against yeast-like, mold fungi, dermatophytes, actinomycetes, blastomycoses, which contributes to its wide use not only for treatment of thrush, but also for fungal infections of other localization - fungal lesions of the skin, mucous membranes, hair of the head. Also, the drug is effective against certain 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, candidomycosis of the oral cavity and urogenital fungal lesions. Due to local action and different forms of release, clotrimazole can be used topically in lesions of various locations. There are different trade names of the drug - Funginal, Kandibene, Kanesten, Antifungol, Imidil, Ovis, Lotrimin, Dignotrimanol.

[6], [7]