Candles for inflammation in gynecology

By using suppositories for inflammation in gynecology, it is possible to treat many diseases of the female reproductive system that develop under the influence of opportunistic microorganisms and specific infectious agents.

Vaginal anti-inflammatory suppositories contain various active components, the mechanism of action of which is aimed either at the cause of the pathology or at reducing the intensity of the inflammatory process and its accompanying symptoms.

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Indications suppositories for inflammation in gynecological diseases

In gynecological practice, local treatment does not replace systemic therapy, but rather complements it, since for some diseases, effective anti-inflammatory suppositories make it possible to quickly and with minimal side effects suppress the development of a local source of infection.

Clinical indications for the use of suppositories include:

• non-specific vaginitis (or colpitis, in which inflammation of the vaginal mucosa is caused by opportunistic microorganisms, in particular, Staphylococcus spp., Streptococcus B, Citrobacter spp., Proteus, Klebsiella spp., Pseudomonas, Schigellae, etc.);
• chlamydial vaginitis ( urogenital chlamydia );
• candidal vulvovaginitis (thrush);
• bacterial vaginosis (inflammation of the vaginal mucosa, most often caused by Gardnerella vaginalis and anaerobic bacteria);
• cervicitis due to cervical erosion;
• endocervicitis (inflammation of the endocervical glands and epithelium of the cervix, caused by staphylococci, E. coli, chlamydia, trichomonas, etc.);
• inflammation of the ovaries (oophoritis or adnexitis);
• inflammation of the fallopian tubes ( salpingitis ), fallopian tubes and ovaries (salpingo-oophoritis);
• inflammation of the uterine mucosa ( endometritis ).

Doctors classify inflammations caused by specific pathogens as thrush or candidiasis (caused by the yeast-like fungus Candida albicans), chlamydia (Chlamydia trachomatis), trichomoniasis (Trichomonas vaginalis), gonorrhea (Neisseria gonorrhoeae), and mycoplasmosis (Mycoplasma spp., Ureaplasma spp.).

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Release form

Based on what pharmaceutical manufacturers offer to the market today and what drugs are most often recommended by doctors, the following main names of suppositories for inflammation in gynecology should be indicated:

• Hexinon is an antiseptic bactericidal suppository for inflammation of the vagina and cervix (acute and chronic forms) caused by non-specific pyogenic bacteria, chlamydia or trichomonas.
• For non-specific bacterial and candidal vulvovaginitis (thrush), as well as vaginal trichomoniasis, Terzhinan (in the form of vaginal tablets) is used.
• The drug Polygynax (in the form of vaginal gelatin capsules) is intended for the treatment of vaginitis caused by non-specific infections (streptococci and staphylococci), mixed and fungal.
• Pimafucin (Natamycin, Primafungin) are antifungal suppositories that are effective against candidal vaginitis.
• Antiseptic suppositories for vaginal inflammation containing iodine – Betadine (Iodoxide, Ruvidone) – are prescribed for diagnosed non-specific vaginitis, as well as urogenital trichomoniasis and candidal vulvovaginitis. See more – Suppositories for thrush
• Anti-inflammatory suppositories based on eucalyptus extract Eucalimin are indicated in cases of non-specific vulvovaginitis and cervicitis.

As a rule, suppositories for inflammation of the appendages and uterus are rectal suppositories containing non-steroidal anti-inflammatory drugs, such as Diclofenac or Voltaren suppositories (with diclofenac), Flamax (with ketoprofen), Movalis (with meloxicam), Cefekon N (with naproxen), suppositories with indomethacin, etc. (the pharmacological characteristics of some of them are described in detail in the article - Suppositories for cystitis ). They are prescribed as a painkiller, since inflammation of the ovaries, fallopian tubes or endometrium requires the use of systemic drugs for etiotropic treatment, in particular, antibiotics.

Also read the publications - Vaginal suppositories for infections and Treatment of colpitis with suppositories

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Pharmacodynamics

The pharmacological action of Hexicon suppositories for vaginal and cervical inflammation is antiseptic and bactericidal; the active component of this product is cationic polybiguanide chlorhexidine (in the form of bigluconate). At a physiological level of acidity in the vagina, dissociation and release of the positively charged chlorhexidine cation occurs, which binds to the negatively charged cells of the lipoprotein membrane of bacteria and causes its destruction. Hexicon suppositories act on most gram-positive and gram-negative bacteria and fungi, so these are effective suppositories for inflammation.

Terzhinan vaginal tablets contain four active ingredients at once: the azole compound (imidazole derivative) ternidazole, active against Trichomonas and Gardnerella; the aminoglycoside antibiotic neomycin (acting mainly on gram-negative microorganisms); the polyene antimycotic nystatin (which has a detrimental effect on C. albicans by damaging its cell membranes); the synthetic corticosteroid prednisolone (which reduces inflammation by blocking the activity of leukocytes and inhibiting the synthesis of inflammatory mediators).

It should be noted that the composition of the drug from the French manufacturer (Laboratoires Bouchara-Recordati) differs from that produced in the Russian Federation and Romania. Terzhinan, used in EU countries, contains metronidazole (instead of ternidazole), and there is no prednisolone in it at all.

The pharmacodynamics of the drug Polygynax is based on the action of the polypeptide antibiotic polymyxin B (which destroys the membranes of gram-negative bacteria), the antibiotic neomycin mentioned above, and the polyene antibiotic nystatin.

Pimafucin suppositories, which contain the polyene antibiotic natamycin (pimaricin), act only on C. albicans, disrupting the integrity of their fungal cell membranes and inhibiting the synthesis of sterol compounds.

The active substance of Betadine suppositories is povidone-iodine, which provides bactericidal and antifungal action due to its ability to coagulate proteins of pathogenic microorganisms.

And such anti-inflammatory suppositories as Eucalimin contain the terpene substance 1,8-cineole (eucalyptol), obtained from eucalyptus leaves; suppositories help relieve inflammation in vaginitis, vulvovaginitis and cervical cancers caused by staphylococci, streptococci and trichomonads.

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Pharmacokinetics

The pharmacokinetics of the named drugs are not presented in the instructions. As is the case with most vaginal suppositories used in gynecology, it has simply not been studied, since - according to the manufacturers - their active components are practically not absorbed and do not enter the blood.

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Dosing and administration

All suppositories for inflammation in gynecology should be used intravaginally - by insertion deep into the vagina.

Hexicon – one suppository 1-2 times a day for a week; the maximum permissible duration of use is three weeks.

Terzhinan – one vaginal tablet (pre-soaked in water) once a day for 10 days.

Polygynax – one vaginal capsule per day (at night), duration of use should not exceed 10-12 days.

Pimafucin – one suppository once a day (before bedtime); the standard course of treatment is from three days to a week.

Betadine – one suppository per day for 7-14 days.

Eucalimin can be used up to three times a day (one suppository).

According to the instructions for the drugs, an overdose is possible only when using Betadine iodine suppositories. Exceeding the recommended dosage can cause a metallic taste in the mouth, increased salivation, sore throat, shortness of breath, swelling, and intestinal problems.

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Use suppositories for inflammation in gynecological diseases during pregnancy

Hexicon, Pimafucin and Eucalimin suppositories are not contraindicated for treatment during pregnancy and lactation.

According to the instructions, the anti-inflammatory suppositories Polygynax have not been sufficiently studied in the treatment of pregnant women, therefore, when prescribing them, the gynecologist must compare the risk to the fetus and the benefit to the mother.

It is not recommended to use Betadine suppositories in the II-III trimesters. But Terzhinan vaginal tablets, on the contrary, can be used from the II trimester of pregnancy, and even in the first three months, if, as is customary to write in the instructions for medical preparations, the potential benefit for the expectant mother is higher than the possible risk to the future child. However, Terzhinan contains prednisolone, and during pregnancy, as is known, the use of corticosteroids is prohibited due to the high risk of developing congenital anomalies in the fetus.

Contraindications

Contraindications to the use of Hexicon, Terzhinan, Polygynax and Pimafucin suppositories, indicated in their instructions, are hypersensitivity to any of the incoming substances.

Betadine suppositories are not used not only in cases of individual hypersensitivity to iodine, but also in cases of thyroid dysfunction (hyperthyroidism, thyroid tumors, etc.), as well as severe renal failure.

Eucalimin suppositories for vaginal inflammation have no contraindications.

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Side effects suppositories for inflammation in gynecological diseases

Suppositories for inflammation in gynecology - Hexicon, Terzhinan, Polygynax and Pimafucin - can cause an allergic reaction in the form of itching, burning and redness of tissues in the genital area.

The manufacturers of Eucalimin suppositories have not reported any side effects of the drug.

Side effects of Betadine vaginal suppositories, in addition to the above reactions, may include the appearance of a bullous rash, which indicates drug toxicoderma. And if there are problems with the thyroid gland, an increase in the level of thyroid hormones (hyperthyroidism) is not excluded.

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Interactions with other drugs

No special interactions of Polygynax, Terzhinan, Eucalimin and Pimafucin suppositories with any other drugs have been identified.

Anti-inflammatory suppositories Hexicon are not used simultaneously with iodine preparations, and iodine-containing suppositories Betadine are incompatible with other antiseptic agents (including alkaline and chlorine-containing ones).

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Storage conditions

Suppositories for inflammation in gynecology should be stored in a place protected from moisture, at room temperature, but not above +25°C.

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Shelf life

The shelf life of Hexicon, Terzhinan, Polygynax and Pimafucin is 3 years; Betadine and Eucalimin – 2 years.

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