Gyno-Pevaril

Gyno-Pevaril is an antimycotic drug for the treatment of fungal infections, the active ingredient of which, econazole nitrate, acts against dermatophytes, yeasts and mold fungi, as well as some bacteria. After vaginal administration, about 5% of the dose is absorbed. The drug is available in the form of vaginal suppositories. Side effects may include burning, itching, skin irritation and hyperemia. It is not recommended to use in the first trimester of pregnancy without consulting a doctor.

When choosing a drug, you should be guided by the principles of evidence-based medicine, relying on results of randomized clinical trials and meta-analyses.

Indications Gyno-Pevaril

Gyno-Pevaril (GP) is used for the treatment of vulvovaginal mycoses caused by fungi sensitive to the active substance of the drug - econazole nitrate. This antifungal drug has a wide range of antimycotic activity, effective against dermatophytes, yeasts, mold fungi, as well as some Gram-positive and Gram-negative bacteria. It acts by disrupting the structure of cell membranes of fungi, which leads to their death.

Its main indication is to treat vaginal infections caused by microorganisms sensitive to the drug. Vaginal mycoses often cause discomfort such as itching, discharge and irritation, and Gyno-Pevaril effectively helps to manage these symptoms by restoring the health of the vaginal microflora.

Gyno-Pevaril was studied for its clinical efficacy in the treatment of acute and chronic candidal vulvovaginitis during pregnancy. The study showed clinical and laboratory confirmed recovery in 80.0% of patients with acute candidal vulvovaginitis and 76.3% of patients with chronic candidal vulvovaginitis at the end of treatment with GP. This indicates that Gyno-Pevaril is an effective topical treatment for both acute and chronic candidal vulvovaginitis during pregnancy (Simchera, Kira, & Dobrynin, 1998).

Thus, Gyno-Pevaril showed its efficacy in the treatment of candidal vulvovaginitis in pregnant women, with a significant percentage of patients achieving recovery.

Release form

Gyno-Pevaril comes in several forms designed for topical application to provide effective treatment for fungal infections of the vulva and vagina. Here are the main dosage forms of Gyno-Pevaril:

1. Vaginal suppositories (ovules) or capsules: These forms of the drug contain the active substance econaozole nitrate and are intended for insertion directly into the vagina. They come in different dosages, most commonly 150 mg or 50 mg of econazole. The package may contain from 1 to 3 capsules, depending on the recommended course of treatment.
2. Vaginal cream: Also contains econazole nitrate and is used for topical administration into the vagina using a special applicator that is usually included in the package. The cream may be convenient for those who prefer a more controlled and gentle administration of the medicine.
3. External Cream: Although Gyno-Pevaril is primarily used to treat vaginal infections, there is also an external cream form that can be prescribed to treat vulvar infections or skin fungal infections in the genital area.

Pharmacodynamics

Pharmacodynamics of Gyno-Pevaril is due to its ability to inhibit the synthesis of ergosterol, which is an important component of the cell membrane of fungi. This leads to a change in the permeability of the cell membrane, loss of cellular components and, ultimately, to the death of fungal cells.

The mechanism of action of Gyno-Pevaril is as follows:

1. Inhibition of ergosterol synthesis: Econazole disrupts the activity of the cytochrome P450 enzyme, leading to a lack of ergosterol, which is necessary for the formation of the cell membrane of fungi. Without sufficient ergosterol, the cell membrane becomes unstable and easily damaged.
2. Increased membrane permeability: In addition to inhibiting ergosterol synthesis, econazole promotes leakage of important intracellular substances, thereby disrupting cellular metabolism and leading to fungal death.

Gyno-Pevaril is applied topically, in the form of creams or suppositories, and is highly active against most fungi causing infections in the vaginal area, including Candida. Due to its mechanism of action, Gyno-Pevaril is effective for the treatment of vaginal fungal infections, providing rapid relief of symptoms and helping to restore normal vaginal flora.

Pharmacokinetics

The pharmacokinetics of econazole, especially when used in the form of Gyno-Pevaril for the treatment of vaginal candidiasis, focus on local antifungal activity rather than systemic absorption, making it a safe and effective option for the treatment of vulvovaginal candidiasis, including use in pregnant women, where its use has been evaluated and has shown recovery in a significant percentage of patients.

• Gyno-Pevaril (econazole) is effective for the treatment of acute and chronic candidal vulvovaginitis, including pregnancy, with high rates of recovery in treated patients (Simchera et al., 1998).
• Econazole, found in products such as Ecostatin, Pevaryl, and Gyno-Pevaryl, is a topical antimycotic effective against dermatophytes and yeasts and offers a treatment option similar to clotrimazole and miconazole (Drug and Therapeutics Bulletin, 1980).

Dosing and administration

1. Vaginal suppositories: Usually inserted deep into the vagina at night, using an applicator (if provided) to maximize the drug's effect overnight. The course of treatment can vary from a few days to 1-2 weeks, depending on your doctor's instructions.
2. Vaginal cream: Similarly applied intravaginally with an applicator, preferably before bedtime to ensure prolonged contact of the drug with the mucosa. The course of treatment is similar to the use of suppositories.

The dosage and duration of treatment may vary:

• For the treatment of acute infection, short-term use may be sufficient.
• Chronic infections or frequent recurrences may require longer treatment or repeated courses.

It is important to observe the following precautions:

• Do not interrupt the course of treatment, even if symptoms disappear quickly, in order to completely eliminate the infection and reduce the risk of recurrence.
• Avoid sexual intercourse or use barrier methods of contraception during treatment for vaginal infection.
• Maintain hygiene and avoid using scented personal care products, which can aggravate symptoms.

Use Gyno-Pevaril during pregnancy

The use of Gyno-Pevaril during pregnancy is possible, but requires caution. Although vaginal administration of the drug results in minimal systemic absorption of the active substance, its use is recommended only when the expected benefit to the mother outweighs the potential risk to the fetus. It is important to consult a physician before using Gyno-Pevaril during pregnancy to ensure the safety and efficacy of treatment.

Contraindications

1. Hypersensitivity or allergic reaction to econazole or any other component of the product. If you have a history of allergic reactions to antimycotic agents, especially those in the azole group, it may not be safe to use Gyno-Pevaril.
2. First trimester of pregnancy. Although the use of the drug may be acceptable in subsequent trimesters, its use in the first trimester of pregnancy is usually not recommended due to the lack of sufficient safety data.
3. Period of lactation. The active substance of the drug may be excreted with breast milk, which may potentially pose a risk to the child. The decision to use Gyno-Pevaril during breastfeeding should be made in conjunction with a physician, who can assess the ratio of potential benefit to the mother and risk to the child.
4. Pediatric age. Use of the drug in children requires caution and should be carried out only under the supervision of a physician.

In the presence of chronic diseases, especially those associated with impaired liver or renal function, consult a physician before starting the use of Gyno-Pevaril, as metabolism and excretion of the drug may be impaired.

It is also important to consider possible interactions with other medicines. Some medicines may alter the effectiveness or increase the risk of Gyno-Pevaril side effects.

Side effects Gyno-Pevaril

Side effects associated with the use of Gyno-Pevaril are usually mild and go away on their own. Here are some of the most commonly reported side effects:

1. Local reactions: Include burning, itching, irritation, redness or swelling at the application site. These symptoms are usually temporary and disappear after discontinuing use of the product.
2. Allergic reactions: Although rare, some people may experience allergic reactions to the ingredients of Gyno-Pevaril, which may manifest as a rash, hives, itching, swelling of the face, lips, tongue, or difficulty breathing. If signs of an allergic reaction occur, stop using the product immediately and seek medical attention.
3. Vaginal discomfort: Some women may experience vaginal irritation or discomfort, including a dry or slightly burning sensation after insertion.
4. Headache: In some cases, the use of Gyno-Pevaril may be accompanied by headaches, although this is not common.

Overdose

When applied topically, systemic absorption of the active ingredient is minimal, but side effects may occur with overuse or accidental ingestion.

Symptoms of overdose may include:

• Irritation and redness in the area of application.
• Possible allergic reactions such as rash, itching.
• In case of accidental ingestion: nausea, vomiting, diarrhea.

It is important to follow the dosage and usage instructions set out in the instructions or recommended by your doctor. In case of overdose or symptoms associated with overuse, medical attention should be sought immediately.

Interactions with other drugs

Gyno-Pevaril should not be used concomitantly with other gynecological preparations for intravaginal or topical use, especially those containing oils such as mineral oil, rose oil or petroleum jelly. This is because the components of Gyno-Pevaril may interact with these substances, potentially reducing their efficacy or altering their expected therapeutic effect.

Gyno-Pevaril suppositories also contain a fatty base, which may ruin hum contraceptives such as diaphragms or latex condoms, reducing their contraceptive effectiveness. Therefore, it is not recommended to combine the use of these contraceptives with the use of Gyno-Pevaril without consulting a doctor.

Storage conditions

To ensure the safety and efficacy of Gyno-Pevaril, it is important to follow the storage conditions specified by the manufacturer. Although specific recommendations may vary slightly depending on the form of the drug (vaginal suppositories, cream or capsules), general storage principles usually include:

1. Storage temperature: The preparation should be stored at room temperature, usually not exceeding 25°C. Avoid storing the preparation in places exposed to direct sunlight or humidity, e.g. In the bathroom or kitchen.
2. Protection from light and moisture: Store the drug in its original packaging to protect it from light and moisture to help maintain its stability and prevent deterioration.
3. Children's accessibility: Ensure that Gyno-Pevaril is kept out of the reach of children to prevent accidental swallowing or misuse.
4. Expiration date: Do not use the drug after the expiration date indicated on the package. Expired expiry date may reduce the effectiveness of the drug and safety of its use.