Since thrush (candidiasis) is a consequence of the effects of a particular fungal infection, then any remedy against the symptoms of the disease (rash, redness, itching, maceration, discharge) are not suitable. An effective ointment from the thrush is needed, that is, etiotropic treatment with the help of external agents acting directly on the causative agent of the yeast-like fungus-saprophyte Candida albicans.
Indications of ointments from thrush
The main indications for using ointments from yeast: candidiasis different localization in skin and mucous membrane lesions C. Albicans (much less frequently cause pathology are fungus C. Tropicalis, C. Glabrata, C. Parapsilosis and C. Krusei), including thrush or urogenital candidiasis - candida vulvovaginitis, balanitis, balanoposthitis. They use such external agents and kandidamikoticheskih lesions perianal area, axillae, nail plate and skin okolonogtevogo roller (onychomycosis).
Some Ointments thrush, are used for other species of fungal diseases, particularly provoked by yeast fungi Rhodoturola mucilaginosa, Rhodotorula glutinis, Malassezia furfur, Torulopsis glabrata, and Aspergillus and dermatophyte Microsporum, Trichophyton, Epidermophyton.
It should be noted that the ointment from yeast to women has no differences in "gender" of the patient, and the ointment of the yeast infection in men is not different. So the required simultaneous treatment of urogenital candidosis in both partners (her - candidosis vulvovaginitis, he - balanitis) is carried out with the same drugs.
In the list of the most effective antifungal agents appointed by gynecologists and dermatologists, you can include such names for ointments from thrush, such as:
ointment Clotrimazole, as well as other trade names of ointments with the same active substance: Candide ointment, Kanesten, Kanison, Agisten, Lotrimin, Yenamazol, Antifungol, Oronazol;
Miconazole ointment (Daktar, Daktarin, Mikozon, Surolan and others);
But the ointments that are not used in the treatment of thrush include:
Acriderm ointment (contains corticosteroid betamethasone and antibiotic gentamycin, not acting on C. Albicans);
ointment Acyclovir (designed to treat lesions of the skin with herpesvirus);
Methyluracil ointment (used for radiation injuries of the skin, poorly healing burns, wounds and ulceration);
tetracycline ointment (used for infectious lesions of the skin and subcutaneous tissue, accompanied by suppuration);
sintomycin ointment and its synonym - Levomekol ointment (contains chloramphenicol antibiotic and is used in the treatment of pustular lesions and purulent-necrotic skin inflammations, wounds, cracks, burns and ulcers);
streptotsidovaya ointment (used for abscesses of the skin and subcutaneous tissue, boils, phlegmon, erysipelas, burns and wounds);
ointment of calendula (helps with minor skin damage);
zinc ointment (antiseptic, anti-inflammatory and anti-exudative, but does not work on Candida albicans);
oxolin ointment (used for viral inflammation of the nasal mucosa, as well as for bladder and squamous lishy).
Clotrimazole ointment (Candide ointment, Kanesten and other synonyms) contains an imidazole derivative clotrimazole that inactivates mitochondrial peroxidase enzymes in candidate cells, reduces the biosynthesis of sterols necessary for the formation of the glycoproteinadegine membrane of the fungal cells, which multiplies not by spores but by budding. As a result of a lack of sterols, the plasma membranes of the fungal cells lose their impermeability, and together in it the ability to multiply and exist.
The drug Lomexin in the form of a vaginal cream acts in the same way, but already due to another imidazole derivative - fenticonazole, in zalain ointment an active antifungal agent is the antimycotic sertaconazole, and the pharmacodynamics of the ointment from the thrush Miconazole is based on the action of miconazole nitrate.
Thanks to nystatin (antibiotic-polyene mycosaminilistinistanolide), Nystatin ointment also acts on the cell membrane of the fungi, and, integrating into it at the molecular level, irreversibly increases the intracellular osmotic concentration of electrolytes, lowers the pH level and disrupts the oxygen consumption of fungal cells. All this in aggregate provokes coagulation of cytoplasmic proteins, leading to lysis of C. Albicans cells.
An antifungal action similar to nystatin is provided by an ointment from thrush Levorin (with a heptaenic aromatic antibiotic levorin).
Ointment Pimafucin contains polyene natamycin, the pharmacodynamics of which is similar to clotrimazole. Ointment Pimafukort, in addition to natamycin, has in its active against many bacteria antibiotic neomycin and hydrocortisone, which removes inflammation and itching of the skin with thrush.
The Tridentum ointment includes corticosteroid betamethasone, antibiotic gentamicin and clotrimazole. The action of clotrimazole has been described above; gentamycin prevents the attachment of a bacterial infection, and a corticosteroid helps to relieve inflammation and itching.
And although all of these remedies reduce the appearance of symptoms of candidiasis, due to corticosteroids in the composition of Pimafukort and Triderm, both of the itching from itching with thrush is most effective.
When applied to the mucous membranes with vaginal candidiasis (thrush), the absorption of clotrimazole, which contains the ointment Clotrimazole, Candida ointment and Triderm ointment, does not exceed 5-10%, and its concentration in the vaginal mucus (with intravaginal application) is much higher than in plasma blood, and persists for 2-3 days. Clotrimazole is transformed in the liver and is excreted through the intestine.
Nystatin ointment through the mucous membranes is not absorbed and poorly penetrates through intact skin, so the system adsorption of the drug is not noted.
In the absence of damage to the skin and mucous membranes, the Pimafukort ointment is also poorly absorbed; adsorption of hydrocortisone ranges from 1 to 5%. There are no data on biotransformation of ointment components in the instructions.
In the description of the pharmacokinetics of Lomexin, it is indicated that fenticonazole is practically not absorbed and its content is not detected in the blood.
Instructions for ointments Pimafutsin, Levorin and Triderm do not contain information on adsorption, systemic metabolism and excretion of these drugs.
Use of ointments from thrush during pregnancy
Use of ointments from thrush Pimafukort, Miconazole, Levorin, Zalain and Triderm are not recommended to pregnant and lactating women; ointment Clotrimazole should not be used in the first three months of pregnancy.
It is permissible to use Pimafucin ointment in the treatment of thrush in pregnant women, and nystatin ointment and Lomexin may be prescribed during pregnancy only on condition that the expected benefit for the mother will exceed the potential risk for the fetus.
Ointments from thrush have the following contraindications for use:
ointment Clotrimazole (Candida ointment, etc.), Pimafucin, Lomexin, Zalain should not be used if hypersensitivity to the components of these drugs.
inexpensive ointment from the yeast infection - nystatin and miconazole - is also not used in case of individual intolerance, which is manifested by dermatological allergic reactions.
ointment Pimafukort and Ointment Triderm (because of the hydrocortisone content) are contraindicated in case of increased reaction of the organism to exogenous steroids and are not used in skin forms of venereal diseases, propensity to acne, ulceration and other open lesions of the skin and mucous membranes.
ointment Leworin contraindication in the presence of anamnesis of any manifestations of allergy.
Side effects of ointments from thrush
Among the most typical application of the local side effects from virtually any ointment thrush, first of all, may cause local irritation, hyperemia and edema of the skin and mucosa. This is typical of such preparations as clotrimazole ointment (ointment Candid) and Mikazol Pimafutsin ointments, salves levorin, Lomeksin. A Zalain drug can provoke erythema and temporary contact dermatitis.
Intravaginal application of ointments containing imidazole derivatives may be accompanied by a burning sensation, pruritus, increased secretions, and edema of soft tissues and mucous membranes. It does not preclude the emergence of headaches and stomach aches, discomfort during urination and more frequent.
Prolonged use of ointments or pimafukort Triderm can lead to the formation at the point of application of strip-skin atrophy (striae), pigment lightening skin application site of the preparation and enhance cutaneous capillaries as vascular mesh.
Dosing and administration
Any ointment from thrush should be applied to the affected area with a thin layer twice within a day. When applying the ointment is recommended to capture 5-10 mm of the surface of intact skin surrounding the area of damage.
Ointment Clotrimazole (Candide ointment, etc.) is used for about a month; nystatin ointment is used for a maximum of 10 days; Pimafucin ointment is applied within 15-20 days. Women Limexin and Pimafucin ointments should be injected deep into the vagina 1-2 times a day (morning and evening), and men - applied to the genital area and anus. Ointment is used until the symptoms of thrush disappear completely, and for about a week - as an ointment for the prevention of thrush.
Apply Pimafukort ointment twice a day for 14-28 days, 4-part application is allowed per day (with acute forms of candidiasis or dermatoses), adults can apply a bandage.
Miconazole ointment is recommended after applying slightly to rub into the affected area; the course of treatment for this drug is an average of 4 weeks.
Overdose of ointments from thrush, according to the statements of the manufacturers, was not noted.
Interactions with other drugs
Applying the ointment Clotrimazole (Candida ointment), you can not use other external antimycotics with polyene antibiotics (nystatin ointment, Pimafucin), as the therapeutic effect of the drugs decreases.
Data on drug interactions of other ointments from thrush indicated in the review are not given in the instructions.
Miconazole ointment, Triderm ointment should be stored away from light, at a temperature of no higher than + 25 ° C.
Nystatin ointment and ointment Leworin - at a temperature not higher than + 5-6 ° C.
Clotrimazole ointment (. Candid etc.) nistatinovaya ointment, ointment Pimafutsin, Lomeksin, Zalain, levorin and Triderm are suitable for use for 3 years; ointment pimafukort - 4 years.
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To simplify the perception of information, this instruction for use of the drug "Ointments from thrush" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.
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