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Gonorrhea suppositories
Last reviewed: 04.07.2025
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Among the pharmaceutical preparations used in the treatment of specific gonococcal inflammation of the mucous membrane of the urogenital tract caused by gram-negative beta-proteobacteria Neisseria gonorrhoeae, suppositories for gonorrhea are not listed, since this venereal disease is only amenable to antibiotics used systemically, that is, administered intramuscularly and taken orally.
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Pharmacodynamics and pharmacokinetics
The antiseptic effect of Hexicon suppositories is provided by chlorhexidine bigluconate, a substance capable of disrupting the structure of the cytoplasmic membranes of microbial cells, which causes their death.
The pharmacodynamics of Betadine suppositories, which are also an antiseptic and bactericidal agent, is based on the release of iodine from povidone-iodine included in the suppositories. As a result of the oxidizing effect of iodine, an irreversible disruption of enzymatic metabolism and destruction of the protein structures of pathogenic microorganisms occurs, leading to the end of their biological existence.
In suppositories for gonorrhea, Metronidazole, which is an antibiotic of the nitroimidazole group, the pharmacodynamics are due to the fact that under the influence of the drug, the production of nucleic acids in the cells of bacteria and protozoa (in particular, trichomonads) decreases to a level at which the replication of their DNA becomes impossible, and the reproduction of infectious agents ceases.
The anesthetic and anti-inflammatory effect of Betiol rectal suppositories is due to the properties of their components - the extract of the plant Atropa belladonna (belladonna) and ichthyol. Belladonna alkaloids act on the nerve receptors in the muscle tissues of the rectum, significantly reducing their sensitivity, that is, reducing pain. And ichthyol has antibacterial and locally irritating properties. First, it irritates the mucous membrane of the rectum, and then also reduces its susceptibility to pain; in addition, the blood supply to the tissues is activated, which helps reduce inflammatory processes.
The pharmacokinetics of most suppositories are not presented in the instructions for the drugs. And when using suppositories for gonorrhea with Metronidazole, it should be taken into account that a fifth of the suppository drug is absorbed into the vaginal mucosa and enters the bloodstream, and about 20% of the antibiotic binds to plasma proteins. The drug is completely excreted from the body by the kidneys in about 20 hours.
What are gonorrhea suppositories?
It is worth paying attention to the fact that "candles for gonorrhea", which may be recommended as a local treatment, are not actually such. In all cases, the indications for the use of drugs of this form of release imply their use in complex antibacterial therapy as auxiliary means - to relieve symptoms, as well as to treat urogenital and anorectal infections and complications (urethritis, epididymitis, orchitis, cervicitis, vulvovaginitis, proctitis) that occur with gonorrhea.
The most popular names of suppositories for gonorrhea were: Hexicon (Chlorhexidine-Pharmex), Betadine (other trade names - Iodoxide, Vokadin, Ruvidon), Metronidazole (Metrovit, Metrovagin, Metron, Klion, Trichopol, Trichosept, Bacimex, Flagyl), Betiol. These drugs for intravaginal (or rectal) use are also implied when patients are interested in suppositories for gonorrhea in women.
In case of gonorrheal proctitis (when the infection gets from the vagina to the rectum), rectal suppositories for gonorrhea and trichomoniasis may be needed if – as often happens – a disease of mixed infectious etiology is diagnosed, and in addition to gonococci, trichomonads are detected. According to experts, such cases are considered difficult in terms of treatment.
This is due to the fact that trichomoniasis is caused not by bacteria, but by flagellated protozoan microorganisms of the protist group - Trichomonas vaginalis, and Neisseria gonococci are able to penetrate into the cells of trichomonads, where they "hide" from the action of antibiotics, which do not affect the body of protozoa. Today, the generally recognized drug of choice for trichomoniasis is Metronidazole, taken orally and used in the form of suppositories based on it (the names are listed above).
Method of application and dosage of suppositories for gonorrhea
Method of application of suppositories for gonorrhea Hexicon, Betadine and Metronidazole intravaginally, rectal suppositories Betiol are inserted into the rectum.
Standard doses are one or two suppositories per day, the duration of use is a week, but the doctor can extend the course of treatment. Metronidazole is inserted into the vagina once a day, the course of treatment is no more than 10 days.
Overdose is noted only in the instructions for Betiol suppositories, and it is expressed in dilation of the pupils and the development of psychomotor disorder with convulsions and impaired consciousness.
Contraindications for use
The above suppositories used in the complex treatment of gonorrhea have the following contraindications for use:
- Hexicon - hypersensitivity to chlorhexidine;
- Betadine - hypersensitivity to iodine, thyroid disease, liver and kidney failure;
- Metronidazole - severe liver failure, leukopenia, organic CNS dysfunction;
- Betiol - glaucoma, prostatic hyperplasia.
It should be noted that the use of suppositories for gonorrhea during pregnancy is different:
Vaginal suppositories Hexicon and rectal suppositories Betiol are not contraindicated for pregnant women, but the doctor's prescription of Betiol suppositories should take into account the balance of benefits for the mother and the risk to the unborn child. Betadine suppositories with iodine are strictly prohibited for pregnant women.
Metronidazole suppositories (and all synonyms) are contraindicated in the first trimester, but in the period from 13 to 24 weeks their use is permitted - with caution.
Side effects of suppositories for gonorrhea
Despite the minimal systemic absorption of the active substances included in the suppositories, they have side effects. Thus, irritation of the mucous membrane and itching in the area of administration are caused by the drugs Hexicon and Betadine.
The use of suppositories with Metronidazole may be accompanied by itching and burning, mucous vaginal discharge, increased frequency of urination, headache, nausea and vomiting, dry mouth with a metallic taste, cramping pain in the abdomen, intestinal dysfunction, decreased levels of leukocytes in the blood. And possible side effects of Betiol suppositories are expressed in dry mouth and thirst, diarrhea or constipation, urinary retention, as well as increased heart rate.
Interactions with other drugs
Hexicon suppositories are not used with preparations containing iodine, and Betadine suppositories, accordingly, cannot be combined with halogen antiseptics (i.e. containing chlorine), oxidizers and alkaline salts.
Metronidazole potentiates the effects of drugs that reduce blood clotting, as well as the immunosuppressant Cyclosporine. First-generation antihistamines can slow down the biotransformation of Metronidazole in the body and increase its serum concentration, which may result in increased side effects.
In cases of combined use, Betiol suppositories can enhance the effect of antiarrhythmic drugs, anticholinergic drugs for lowering blood pressure, barbiturate sleeping pills, and antidepressants.
Storage conditions: at a temperature of +15-25°C; Betiol suppositories – at +8-15°C.
The shelf life of Hexicon suppositories is 3 years, the rest – 2 years.
Currently, the recommended CDC USA and World Health Organization-approved treatment regimens for gonorrhea include the use of antibacterial drugs such as Ceftriaxone (125 mg IM once), Cefixime or Ofloxacin (4 g orally once), or Spectinomycin (2 g IM) followed by oral Doxycycline (1 g twice daily for a week). Suppositories for gonorrhea are not mentioned in this regimen, but this does not mean that topical agents cannot be prescribed by treating physicians, whose recommendations should be strictly followed.
Attention!
To simplify the perception of information, this instruction for use of the drug "Gonorrhea suppositories" 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.