Livarol

Livarol is a gynecological medicine with an antiseptic and antimycotic effect.

The principle of the influence of drugs develops by inhibiting the biosynthesis of ergosterol, as well as changes in the lipid structure of the fungal wall, due to which they undergo lysis. The drug demonstrates an effect against pathogens that are resistant to antimycotic antibiotics (levorin with nystatin) and clotrimazole. The emergence of secondary resistance with the use of ketoconazole was not observed. [1]

Indications Livarol

It is used for the treatment of vulvovaginal candidiasis (in the active phase or with relapses of the chronic).

It is prescribed to prevent the development of fungal vaginal infections in the case of a weakened body resistance, as well as during the use of drugs that disrupt the healthy vaginal flora.

Release form

The release of the therapeutic agent is realized in the form of vaginal suppositories - 5 pieces inside the cell pack; in a box - 1 or 2 such packs.

Pharmacodynamics

Ketoconazole is an artificial derivative of imidazole dioxolane. It has a strong fungistatic and fungicidal effect on dermatophytes (trichophytons, flocculent epidermophytos and Microsporum spp.), Yeast fungi (Torulopsis spp., Candida, Mallassezia spp., Cryptococci and Rhodotorula spp.), As well as higher and dimorphic fungi.

It has a weaker effect on Aspergillus, Sporothrix schenkii, certain dermatological fungi, white mold and other phycomycetes, excluding entomophthora fungi. [2]

Ketoconazole is active against gram-positive cocci (streptococci with staphylococci). [3]

Pharmacokinetics

After intravaginal administration, the drug is poorly absorbed, less than 1% of the substance enters the circulatory system. The plasma index Cmax with the introduction of 0.4 g of ketoconazole varies in the range of 0-10.7 ng / ml; this level is considered a trace level that does not have a systemic impact.

Dosing and administration

The suppository is inserted deep into the vagina from a supine position (with the legs bent at the knees and pulled up to the chest) or squatting. Cutting the suppository is prohibited, because this can provoke a disorder in the distribution of the active ingredient of the drug.

During the day (in the evening, before bedtime), the 1st candle is introduced; the whole cycle of application lasts 3-5 days. If necessary, the course can be repeated until clinical recovery occurs, which will be confirmed by test results.

In the case of a chronic stage of candidiasis, 1 suppository should be administered in a period of 10 days.

• Application for children

Due to the lack of experience in using Livarol in pediatrics, it is not used in this group of patients.

Use Livarol during pregnancy

Despite the fact that the total absorption of drugs after intravaginal use is extremely low or absent altogether, there have been no appropriately controlled clinical tests of the safety of Livarol administration during pregnancy. The medication is not used in the 1st trimester.

In the 2-3rd trimester, as well as with hepatitis B, the drug is used only in situations where the likely benefit is more expected than the risks of negative consequences for the child.

Contraindications

It is contraindicated to prescribe with severe intolerance to the elements of the drug.

Side effects Livarol

Side symptoms occur occasionally, quickly disappearing after stopping the use of drugs. Among them:

• lesions of the mucous membranes and epidermis: burning, urticaria, hyperemia, rashes, itching, irritation of the vaginal mucosa, as well as manifestations in the area of administration of the suppository;
• immune disorders: signs of intolerance, including Quincke's edema and anaphylactoid or anaphylactic symptoms;
• problems with digestive function: abdominal pain or nausea;
• disorders in the work of the National Assembly: dizziness.
• If any negative signs appear, you need to stop using the medication and consult a doctor.

Overdose

Poisoning and the development of toxic symptoms when using Livarol did not occur. With local intoxication, itching, hyperemia, irritation of the vaginal mucosa and burning sensation may occur. With such violations, douching procedures are carried out with plain water.

Interactions with other drugs

The use of the drug together with isoniazid and rifampicin causes a decrease in the plasma level of ketoconazole.

The combination of a substance with methylprednisolone, cyclosporine or indirect anticoagulants leads to an increase in the plasma values of the latter.

What consequences these interactions may have in practice when using ketoconazole in the form of vaginal suppositories is not known.

Storage conditions

Livarol is required to be kept in a place closed from the penetration of children. Temperature level - no more than 25 ° С.

Shelf life

Livarol can be used within 24 months from the date of manufacture of the medicinal product.

Analogs

Analogues of drugs are Kandibene, Ginalgin, Limenda with Ginezol 7, Lomexin and Ginofort with Gino-pevaril, Klion and Gravagin with Gino-travogen and Kanizon. In addition, Metromicon with Candide-v6, Pulsitex with Neo-penotran, Metromizol and Ekalin with Miko-penotran.