Suppositories from inflammation in gynecology

Applying a suppository against inflammation in gynecology, it is possible to treat many diseases of the female sexual sphere 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 directed either at the cause of the pathology, or at a decrease in the intensity of the inflammatory process and the accompanying symptoms.

[1], [2], [3]

Indications of the suppositories for inflammation in gynecological diseases

In gynecological practice, local treatment does not replace systemic therapy, but complement it, since in certain diseases it is the effective suppository from inflammation that makes it possible to quickly and with minimal side effects to suppress the development of a local foci of infection.

Clinical indications for the use of suppositories include:

• nonspecific vaginitis (or colpitis, in which the inflammation of the mucous membranes of the vagina is caused by opportunistic microorganisms, in particular Staphylococcus spp., Streptococcus B, Citrobacter spp., Proteus, Klebsiella spp., Pseudomonas, Schigellae, etc.);
• chlamydial vaginitis ( urogenital chlamydial infection );
• Candidiasis vulvovaginitis (thrush);
• bacterial vaginosis (inflammation of the vaginal mucosa, most often caused by Gardnerella vaginalis and anaerobic bacteria );
• cervicitis with cervical erosion;
• endocervicitis (inflammation of endocervical glands and cervical epithelium caused by staphylococci, Escherichia 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 ).

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

[4], [5]

Release form

Proceeding from the fact that the pharmaceutical companies are being offered to the pharmaceutical market and which drugs are most often recommended by doctors, it is necessary to indicate such basic names of suppositories from inflammation in gynecology:

• Hexinon - antiseptic bactericidal suppository against inflammation of the vagina and cervix (acute and chronic form), caused by nonspecific pyogenic bacteria, chlamydia or trichomonads.
• With nonspecific bacterial and candidiasis vulvovaginitis (thrush), as well as with vaginal trichomoniasis apply Terzhinan (in the form of vaginal tablets).
• The preparation Poliginax (in the form of vaginal gelatin capsules) is intended for the treatment of vaginitis caused by nonspecific infections (strepto- and staphylococci), mixed and fungal infections.
• Pimafucin (Natamycin, Primafungin) - antifungal suppositories effective for candidal vaginitis.
• Antiseptic suppositories against vaginal inflammation containing iodine - Betadine (Yodoxid, Ruvidon) - are prescribed for diagnosed nonspecific vaginitis, as well as urogenital trichomoniasis and vulvovaginal candidiasis. See more - Suppositories from thrush
• Anti-inflammatory suppository based on eucalyptus extract Eucalyptin is indicated in cases of nonspecific vulvovaginitis and cervicitis.

As a rule, the suppository against inflammation of the appendages and the uterus are rectal suppositories containing non-steroidal anti-inflammatory drugs, for example, suppositories Diclofenac or Voltaren (with diclofenac), Flamax (with ketoprofen), Movalis (with meloxicam), Cefexon H (with naproxenom), suppository with indamethacin, etc. (pharmacological characteristics of some of them are described in detail in the article - Suppositories from cystitis ). They are prescribed as an anesthetic, as 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 Suppository Against Infections and Colpitis Treatment with Candles

[6], [7], [8], [9]

Pharmacodynamics

The pharmacological action that the suppository exerts on the inflammation of the vagina and cervix of the uterus is Hexicon - antiseptic and bactericidal; The active component of this agent is cationic polybiguanide chlorhexidine (in the form of biguconate). At the 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. Suppositories Gexicon act on the majority of gram-positive and gram-negative bacteria and fungi, so this is an effective suppository against inflammation.

Vaginal tablets Terzhinan have at once four active substances: azole compound (imidazole derivative) ternidazole, active against trichomonads and gardnerella; aminoglycoside antibiotic neomycin (acting mainly on gram-negative microorganisms); polyene antimycotin nystatin (fatal to C. Albicans due to damage to its cell membranes); synthetic corticosteroid prednisolone (reducing inflammation by blocking the activity of leukocytes and inhibiting the synthesis of inflammatory mediators).

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

Pharmacodynamics of the preparation Polyzhinaks is based on the action of the polypeptide antibiotic polymyxin B (which destroys the envelopes of gram-negative bacteria), already mentioned above antibiotic neomycin and polyene antibiotic nystatin.

Containing polyenic antibiotic natamycin (pimaricin) suppositories Pimafucin act only on C. Albicans, disrupting the integrity of their cell membranes of fungi and inhibiting the synthesis of sterol compounds.

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

And such anti-inflammatory suppositories as Eucalyamin contain the 1.8-cineole (eucalyptol), a turpentine substance, obtained from the leaves of eucalyptus; suppository help to relieve inflammation with vaginitis, vulvovaginitis and cercivitis caused by staphylococci, streptococci and trichomonads.

[10], [11]

Pharmacokinetics

The pharmacokinetics of these drugs in the instructions are not presented. As with the majority of vaginal suppositories used in gynecology, it was simply not studied, because - according to the manufacturers - their active components are practically not absorbed and do not enter the blood.

[12], [13],

Dosing and administration

All suppository from inflammation in gynecology should be applied intravaginally - by inserting deeply into the vagina.

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

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

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

Pimafucin - one candle 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.

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

According to the instructions to the drugs, an overdose is possible only with the use of suppositories with iodine Betadine. Exceeding the recommended dosage may cause a metal taste in the mouth, increased salivation, throat swelling, shortness of breath, swelling, and bowel problems.

[18]

Use of the suppositories for inflammation in gynecological diseases during pregnancy

Not contraindicated for treatment during pregnancy and lactation Suppository Gexicon, Pimafucin and Eucalymin.

According to the instructions, the antiinflammatory suppositories of Polizinax in the therapy of pregnant women have not been adequately studied, so when they are prescribed the gynecologist must compare the risk to the fetus and the benefit to the mother.

Betadine suppository is not recommended for use in the II-III trimesters. And the vaginal tablets of Terzinan, on the contrary, can be used from the second trimester of pregnancy, and even in the first three months, if, as it is customary to write in instructions in medications, the potential benefit for a future mother is higher than the possible risk of a future child. However, Terjinan contains prednisolone, and it is common knowledge that corticosteroids are forbidden during pregnancy because of the high risk of congenital anomalies in the fetus.

Contraindications

Contraindications to the use of suppositories Geksicon, Terzhinan, Polizhinaks and Pimafucin, indicated in their instructions, is hypersensitivity to any incoming substances.

Suppositories of betadine are not used not only for individual hypersensitivity to iodine, but also for thyroid dysfunction (hyperthyroidism, thyroid tumors, etc.), as well as severe kidney failure.

Suppositories from inflammation of the vagina Eucalyline have no contraindications.

[14], [15]

Side effects of the suppositories for inflammation in gynecological diseases

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

Manufacturers of Eucalyzymin suppositories did not report any side effects of the drug.

Side effects of vaginal suppositories Betadine, in addition to the above reactions, can be expressed in the appearance of bullous rash, which indicates the drug toxicodermia. And in the presence of problems with the thyroid gland, the level of thyroid hormones (hyperthyroidism) is not ruled out.

[16], [17]

Interactions with other drugs

Special interaction of suppositories Polizhinaks, Terzhinan, Eucalinum and Pimafucin with any other drugs has not been revealed.

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

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Storage conditions

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

[21], [22], [23]

Shelf life

Shelf life of Gexikon, Terzhinan, Polizhinaks and Pimafutsin is 3 years; Betadin and Evkalimin - 2 years.

[24], [25], [26], [27],