Can you use an expired inhaler safely. How long after expiration are inhalers still effective. What are the risks of using an expired inhaler. How should you properly store and dispose of expired inhalers.

Understanding Inhaler Expiration Dates

Inhaler expiration dates are not arbitrary deadlines set by pharmaceutical companies. They serve as crucial indicators of medication safety and efficacy. Typically, inhalers expire one year after issuance, but their effectiveness may extend beyond this date depending on storage conditions.

Why do inhalers have expiration dates? The primary reason is to ensure patient safety and medication effectiveness. From the moment of manufacture, the chemical compounds in inhalers begin to change. Over time, these compounds can break down, potentially affecting the medication’s potency and safety profile.

How Are Expiration Dates Determined?

Pharmaceutical companies employ rigorous stress testing to establish expiration dates. This process involves subjecting medications to various scenarios, including:

• Exposure to heat
• Humidity fluctuations
• Light exposure

During these tests, researchers study how long the compounds remain stable and whether the body can still properly absorb the medication after undergoing these conditions.

Safety and Efficacy of Expired Inhalers

Is it safe to use an expired inhaler? While many medicines remain effective after their expiration dates, it’s crucial to exercise caution. In general, albuterol sulfate inhalers (such as Proventil and Ventolin) may still be safe and effective for a short period after expiration if stored correctly.

However, the manufacturer cannot guarantee the medicine’s safety or efficacy beyond the expiration date. The rate of medication breakdown varies, and storage conditions play a significant role in preserving an inhaler’s effectiveness.

Potential Risks of Using Expired Inhalers

Using an expired inhaler may pose several risks:

1. Reduced effectiveness: The medication may not provide the intended relief for asthma symptoms.
2. Potential side effects: Degraded chemical compounds could lead to unexpected reactions.
3. Inadequate treatment: Relying on an expired inhaler could delay proper medical intervention.

Factors Affecting Inhaler Shelf Life

Several environmental factors can impact an inhaler’s shelf life and effectiveness:

• Temperature fluctuations
• Exposure to direct sunlight
• Humidity levels

Inhalers are often carried in purses or backpacks, subjecting them to varying environmental conditions. These factors can accelerate the degradation of the medication, potentially shortening its effective lifespan.

Proper Storage Techniques

To maximize an inhaler’s shelf life and maintain its effectiveness, consider the following storage tips:

1. Store in a cool, dry place
2. Maintain temperatures between 59째F to 86째F (15째C to 30째C)
3. Avoid exposure to extreme temperatures
4. Keep away from direct sunlight
5. Protect from high humidity

While these practices won’t extend the expiration date, they can help ensure the medication remains safer and more effective for a longer period.

When to Replace Your Inhaler

How do you know when it’s time to replace your inhaler? Here are some key indicators:

• The expiration date has passed
• The inhaler has been exposed to extreme conditions
• The medication doesn’t seem as effective as before
• There are visible changes in the inhaler’s appearance or function

If you’re unsure about your inhaler’s expiration date, consult your pharmacist. They can provide information about when your last prescription was filled, helping you determine if it’s time for a replacement.

Emergency Use of Expired Inhalers

Are there situations where using an expired inhaler is acceptable? In urgent situations where breathing is compromised, and no other options are available, an expired inhaler may be used as a temporary measure. However, this should only be done as a last resort until you can obtain a new inhaler or seek medical attention.

It’s crucial to emphasize that relying on expired medication for chronic condition management is not recommended. Always prioritize having an up-to-date, unexpired inhaler on hand for regular use and emergencies.

Proper Disposal of Expired Inhalers

How should you dispose of an expired inhaler? Proper disposal is essential to protect the environment and prevent misuse. Here are some guidelines:

1. Check local regulations: Some areas have specific disposal requirements for medical devices and medications.
2. Pharmacy take-back programs: Many pharmacies offer safe disposal services for expired medications.
3. Empty the canister: If allowed by local regulations, empty the canister completely before disposal.
4. Remove personal information: Always remove or obscure any personal information on the inhaler or packaging.

Never dispose of inhalers in regular trash or flush them down the toilet, as this can harm the environment.

Importance of Regular Inhaler Maintenance

Maintaining your inhaler goes beyond just checking the expiration date. Regular maintenance can ensure optimal performance and extend the life of your device. Consider these maintenance tips:

• Clean the inhaler regularly according to manufacturer instructions
• Check for blockages in the mouthpiece
• Keep track of the number of doses used
• Replace spacers or other attachments as needed

By incorporating these practices into your routine, you can maximize the effectiveness of your inhaler and potentially reduce the frequency of replacements.

Monitoring Inhaler Effectiveness

How can you tell if your inhaler is still working effectively? Pay attention to these signs:

1. Relief of symptoms: If your inhaler isn’t providing the expected relief, it may be losing effectiveness.
2. Unusual taste or smell: Changes in the medication’s taste or odor could indicate degradation.
3. Visual changes: Any discoloration or particles in the medication are cause for concern.
4. Inconsistent spray: If the inhaler’s spray pattern changes or becomes inconsistent, it may need replacement.

If you notice any of these issues, consult your healthcare provider or pharmacist for guidance.

Alternative Options for Asthma Management

While inhalers are a primary tool for managing asthma and other respiratory conditions, it’s essential to explore alternative and complementary options for comprehensive care. What other strategies can help manage respiratory health?

• Long-term control medications: These may include inhaled corticosteroids or leukotriene modifiers.
• Lifestyle modifications: Identifying and avoiding triggers, maintaining a healthy weight, and regular exercise can improve respiratory health.
• Breathing exercises: Techniques like pursed lip breathing or diaphragmatic breathing can help manage symptoms.
• Allergen immunotherapy: For asthma triggered by allergies, this treatment can reduce sensitivity to specific allergens.
• Complementary therapies: Some patients find relief through acupuncture, chiropractic care, or herbal remedies (always consult with a healthcare provider before trying alternative treatments).

Remember, these options should be discussed with your healthcare provider to ensure they’re appropriate for your specific condition and don’t interfere with your current treatment plan.

The Role of Regular Check-ups

Regular check-ups with your healthcare provider play a crucial role in managing respiratory conditions. These visits allow for:

1. Monitoring of condition progression
2. Adjustment of treatment plans as needed
3. Early detection of potential complications
4. Education on new treatment options or self-management techniques
5. Prescription renewals to ensure you always have an unexpired inhaler

By maintaining a consistent relationship with your healthcare provider, you can optimize your respiratory health management and reduce reliance on expired medications.

Technological Advancements in Inhaler Design

The field of inhaler technology is constantly evolving, with new designs aimed at improving medication delivery, user experience, and adherence. What innovations are shaping the future of inhalers?

• Smart inhalers: These devices can track usage, remind patients to take their medication, and even provide data to healthcare providers.
• Breath-actuated inhalers: These eliminate the need for hand-breath coordination, potentially improving medication delivery.
• Dry powder inhalers: Offering an alternative to aerosol inhalers, these may be more environmentally friendly and easier to use for some patients.
• Soft mist inhalers: These provide a slower-moving mist that may be easier to inhale for some users.
• Combination inhalers: Delivering multiple medications in a single device, these can simplify treatment regimens.

As these technologies continue to develop, they may offer solutions to some of the challenges associated with traditional inhalers, including expiration concerns and proper usage techniques.

The Future of Respiratory Medicine

Looking ahead, what developments can we expect in the field of respiratory medicine? Some promising areas of research include:

1. Personalized medicine: Tailoring treatments based on individual genetic profiles and biomarkers.
2. Biologics: Advanced therapies targeting specific molecular pathways involved in respiratory diseases.
3. Gene therapy: Potential treatments addressing the root genetic causes of some respiratory conditions.
4. Artificial intelligence: Using AI to predict exacerbations and optimize treatment plans.
5. Nanotechnology: Developing more efficient drug delivery systems for respiratory medications.

These advancements hold the potential to revolutionize respiratory care, potentially reducing reliance on traditional inhalers and offering more targeted, effective treatments.

Environmental Considerations in Inhaler Use and Disposal

As awareness of environmental issues grows, it’s important to consider the ecological impact of inhaler use and disposal. How can patients and healthcare providers balance medical needs with environmental responsibility?

• Propellant-free inhalers: Some newer designs eliminate the need for environmentally harmful propellants.
• Recycling programs: Certain manufacturers offer recycling options for empty inhaler canisters.
• Dose counters: These can help prevent wastage by accurately tracking remaining doses.
• Proper disposal: Following guidelines for safe disposal can minimize environmental impact.
• Sustainable packaging: Some companies are exploring more eco-friendly packaging options for inhalers.

By considering these factors, patients can make more informed choices about their inhaler use and disposal practices, contributing to both personal health and environmental sustainability.

The Role of Policy in Inhaler Management

Policy decisions can significantly impact inhaler accessibility, affordability, and environmental impact. What policy considerations are relevant to inhaler use and management?

1. Prescription regulations: Policies affecting how often inhalers can be refilled or renewed.
2. Insurance coverage: Decisions about which types of inhalers are covered by insurance plans.
3. Environmental regulations: Policies governing the production and disposal of inhalers and their components.
4. Research funding: Allocation of resources for developing new, more sustainable inhaler technologies.
5. Public health initiatives: Programs aimed at improving respiratory health and reducing reliance on rescue inhalers.

Staying informed about these policy issues can help patients advocate for better access to respiratory care and more sustainable inhaler options.

Education and Support for Inhaler Users

Proper education and support are crucial for effective inhaler use and management. What resources are available to help patients maximize the benefits of their inhalers?

• Patient education programs: Many healthcare providers offer classes or one-on-one sessions on proper inhaler technique.
• Online resources: Reputable websites and apps provide information on inhaler use, maintenance, and troubleshooting.
• Support groups: Connecting with other inhaler users can provide valuable insights and emotional support.
• Pharmacist consultations: Many pharmacies offer counseling services to ensure patients understand their medications.
• Respiratory therapists: These specialists can provide in-depth guidance on inhaler use and respiratory health management.

By taking advantage of these resources, patients can improve their inhaler technique, adherence, and overall management of their respiratory condition.

The Importance of Inhaler Technique

Proper inhaler technique is essential for effective medication delivery. What are some common mistakes in inhaler use, and how can they be addressed?

1. Not shaking the inhaler before use
2. Incorrect positioning of the inhaler
3. Poor coordination between inhalation and activation
4. Inhaling too quickly or forcefully
5. Not holding breath after inhalation

Regular review of inhaler technique with a healthcare provider can help identify and correct these issues, ensuring optimal medication delivery and potentially reducing the need for rescue inhaler use.

Can You Use an Expired Inhaler?

Inhalers generally expire one year after they are issued, but they may be good for months after that, depending on how they are stored. However, if there’s any doubt, get a new inhaler.

Did you unearth a long-lost asthma inhaler between your couch cushions? Did an inhaler roll out from under your car seat after an undetermined amount of time? Did you find an inhaler that expired two months ago in your child’s backpack? If so, you may be wondering if it’s safe to use an expired inhaler. And if it’s not safe, how do you dispose of expired inhalers?

In short, it’s probably safe for you or your child to use the expired albuterol sulfate (Proventil, Ventolin) inhaler. But that answer includes some important warnings. While many medicines are still effective after their expiration dates, not all are. For that reason, it’s important to understand how expiration dates are determined and what can happen to those medicines once the expiration date has passed.

A medicine’s expiration date guarantees the medicine’s proper functioning if it’s stored correctly. An inhaler will still be safe and effective if used before the expiration date and if stored in proper conditions. Expiration dates for inhalers are often printed on the box or foil packaging. A secondary expiration date is frequently imprinted on the inhaler canister. If you can’t find the expiration date, call your pharmacist and ask when your last prescription was filled. If it has been more than a year, this inhaler is expired.

Some consumers suspect that expiration dates are a ploy by drug manufacturers to make people buy more drugs. That is not the case. Drug manufacturers are required to establish a timeframe during which their medicines are the most effective for consumer safety reasons. Thousands of pounds of medications go unused each year and must be destroyed. If dates were arbitrarily set, drug makers could save insurance companies, pharmacies, customers, and even themselves many millions of dollars each year by extending those dates.

Expiration dates are a good-faith effort by pharmaceutical companies to provide an effective product. From the moment a medicine is manufactured, the chemical compounds in it begin to change. Over time, these compounds can break down and be destroyed. Ideally, companies would have the time to let medications sit for several years while they test efficacy and safety. However, that would greatly increase the amount of time it takes for drugs to reach the market.

Companies stress test their medicines to determine expiration dates. To do that, they subject the medicine to typical scenarios in a sped-up timeframe. These tests include heat, humidity, and light. As medicines undergo these tests, they’re studied to see how long the compounds remain stable. The companies also check to see if the body can still correctly absorb the medicines after undergoing these scenarios.

How long does it take for albuterol sulfate inhalers to expire?

Most inhalers expire one year after they’re issued. After that date passes, the manufacturer cannot guarantee that the medicine will be safe or effective. Medicines breakdown at different rates, and much depends on how they’re stored.

If you’re in an urgent situation and need asthma medication in order to breathe, only use an expired inhaler as a supplement until you’re able to find an unexpired inhaler or you’re able to seek medical treatment.

Most inhalers are also safe to use up to one year after the expiration date. However, a lot depends on how the inhalers were stored during that year. Inhalers are often carried with people in purses or backpacks. That can mean they’re exposed to greater temperature or humidity changes. To be safe, you should dispose of an expired inhaler and request a new one from your doctor or pharmacy. After all, when it comes to breathing, you shouldn’t take risks with old medicine.

An inhaler’s expiration date takes into account typical use and storage. Manufacturers estimate the wide range of possible environmental changes these medicines may experience in their lifetime. These factors include exposure to heat, light, and humidity. The more an inhaler is exposed to these factors, the more quickly the medicine may degrade.

The following tips can help extend an inhaler’s shelf life and keep the medicine effective as long as possible. While these tips will not extend the expiration date, they may help ensure the medicine is safer longer, in the event you need to use it once it’s expired.

Store in a cool, dry place

Typical temperature storage should be between 59 to 86°F (15 to 30°C). If you leave your medicine in your car and the temperatures fall below 59°F (15°C) or above 86°F (30°C), talk with your pharmacist. One time may not be a concern, but the longer the inhaler is exposed to these extreme temperatures, the sooner it may begin degrading.

Protect the canister

The canister is under pressure, so if it is punctured, it may burst. If you’re storing an inhaler in your purse or backpack, keep it in a smaller padded bag to protect it.

Store it securely

Always replace the protective cap after you use your inhaler. If the cap is off, the canister could be damaged.

Most inhalers expire one year after they’re issued, and many may still be effective up to one year after that expiration date. A lot depends on how well the inhalers are stored. Inhalers can be expensive, so it’s important to protect and store them correctly to get the longest life from them. When in doubt, dispose of your inhaler and purchase a new one. This way, you won’t risk not having the treatment when you need it.

Inhalers don’t have a universal disposal recommendation. Drug take-back programs may not accept inhalers because the canisters are often pressurized and will explode if incinerated. Before you toss your inhaler, read the manufacturer’s instructions. They may provide information on properly disposing of the device. If the instructions aren’t clear, contact your pharmacist or local waste disposal office for more information. You may be asked to recycle the inhaler, return it to a pharmacy, or simply throw it away.

A:

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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10 Oral Thrush Home Remedies

When you’re staring at white spots on your tongue and cheeks and dealing with cotton mouth, you want it to go away—now.

These symptoms likely indicate oral thrush (also called oral candidiasis), and while it’s typically nothing to be concerned about, it can be uncomfortable.

What you’re seeing is an overgrowth of candida yeast.

Candida albicans—the same fungus that causes vaginal yeast infections—naturally grows in the mouth.

But when something throws off the natural balance of the oral microbiome and you get an overgrowth of candida fungus, you develop oral thrush. 

The most common oral thrush treatment is prescription antifungal medication.

However, natural remedies may help some people fight a thrush infection.

To help you determine your best course of action, in this article, I’ll explain the science behind 10 home remedies for oral thrush as well as the symptoms of oral thrush and when you should see a doctor for medical advice.

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Home Remedies for Oral Thrush 

Things you likely have at home or can easily buy may help treat a case of oral thrush or at least help you feel more comfortable until you can see a doctor.

Keep in mind that while they are “natural”, at-home therapies for yeast infections can still cause side effects.

So it’s best to talk to a healthcare provider before trying any of these home remedies, especially if you have any underlying health conditions that may be contributing to your candida infection.

Probiotics

Probiotics are the “good” bacteria that provide a health benefit when you consume them.

In the case of oral thrush, this good bacteria may help restore the balance of flora in your mouth so that candida albicans doesn’t overgrow.

Some studies show that taking probiotic supplements appears to protect against oral thrush, particularly for people who wear dentures.

Supplements containing lactobacillus may have the most benefit.

Apple cider vinegar

Apple cider vinegar, which is essentially fermented apple juice, has natural antifungal properties.

And cell studies show that the vinegar may fight the growth of candida.

However, it’s unclear if drinking apple cider vinegar can prevent or treat oral thrush. 

If you choose to try this home remedy, be sure to dilute the apple cider vinegar, as it is acidic and can damage tooth enamel.

Advocates of this method recommend using 1 teaspoon to 1 tablespoon apple cider vinegar in 1 cup water and using it like mouthwash daily.

Saltwater

Salt (a.k.a. sodium chloride) is an antifungal, hence, some believe an at-home saltwater rinse can be soothing for oral thrush symptoms and other oral problems.

While there is no harm in trying this, there’s also no research on this remedy.  

If you decide to try it, use 1/2 teaspoon salt in 1 cup warm water, and be sure not to swallow after rinsing—spit the saltwater out.

Oral hygiene 

Although it’s unknown if good oral hygiene can prevent or heal oral thrush, it’s never a bad idea to take care of your teeth and gums.

Follow these steps:

• Keep up with dental appointments for regular cleanings and checkups.
• Brush and floss daily. 
• Choose a soft-bristled toothbrush that won’t irritate your mouth further.
• Change your toothbrush about every three months and use a soft toothbrush.
• Drink enough water daily to prevent a dry mouth.

Baking soda

Baking soda is a common home remedy for oral thrush, but this pantry staple isn’t well studied to prove its effectiveness.

In one trial, people who had oral reconstructive surgery and used a baking soda saline rinse prevented oral thrush.

So while swishing baking soda and water probably won’t harm you, it may not do anything to help treat oral thrush.

Gentian violet

Also known as crystal violet or methyl violet 10b, Gentian violet is a type of antiseptic dye used in the 19th century to fight bacteria, fungi, and parasites.

It’s been shown in studies to be effective against candida albicans. 

You can find Gentian violet, an over-the-counter remedy, at most drug stores.

Look for a 1% solution.

To use it, apply a bit to a cotton swab or cotton ball, then gently dab it on the white spots in your mouth.

Keep in mind Gentian violet is a dye, so it can easily stain your mouth or clothes. Also be careful not to swallow the solution.

Essential oils

Some essential oils may be a potential remedy for oral thrush.

The ones that seems to have at least some benefit include:

• Clove oil: Due to its natural analgesic (pain-relieving) and antifungal properties, clove oil is commonly used as a home remedy for oral health and dental problems. Plus cell studies suggest it may prevent or treat oral thrush. You can make a clove mouth salve by adding a few drops of pure clove oil to an edible carrier oil, such as coconut oil. Apply it as needed to the white patches in your mouth, but keep in mind the oil may cause tingling or burning.

• Lemongrass oil: This natural antimicrobial fights bacteria and fungi, and, according to cell studies, inhibits the growth of candida and therefore may help treat oral thrush. Dilute a few drops of the oil in a cup of water and use it as a mouth rinse as needed.
• Rosemary oil: Another essential oil with antifungal properties, rosemary oil also appears to fight candida albicans. If you wish to try this, add a few drops to a cup of water, swish some in your mouth, then spit it out.
• Tea tree oil: Also known as melaleuca oil, tea tree oil is antiseptic that may fight candida and therefore possibly treat oral thrush. One small study of people living with AIDS found that using mouthwash with tea tree oil helped treat oral thrush. Researchers credit a compound called terpinen-4-ol. As with other essential oils for oral thrush, use tea tree oil to make a mouthwash: Dilute a couple drops in water, rinse your mouth with some of this solution, and then spit out. 

Coconut oil

Coconut oil contains caprylic and lauric acid, both of which have been shown to inhibit the growth of candida.

One study also suggests that coconut oil may be just as powerful as the medication fluconazole in resolving oral thrush symptoms.

A practice called oil pulling may be helpful in fighting oral fungus.

Simply place a tablespoon of raw, virgin coconut oil in your mouth, swish it around as it melts, and spit it out.

If you can, aim to swish for about 20 minutes to get the most benefit.

However, 5-10 minutes may also help.

Yogurt

Because yogurt contains probiotics—”healthy” bacteria that can prevent fungi overgrowth—it may be a helpful at-home remedy for oral thrush.

In one small study, elderly adults consumed probiotic yogurt or regular cheese.

Those who ate the yogurt had a 32 percent reduction in oral thrush incidence. 

If you try yogurt for oral thrush, choose plain yogurt that’s low in sugar or has no added sugar.

Too much sugar in your diet may contribute to fungal overgrowth and make your symptoms worse. 

Lemon juice

Lemon juice is considered a natural antifungal.

However, only one small study has examined its effects on candida: People living with HIV who also had oral thrush took gentian violet, lemon juice, or lemon grass for 11 days.

The lemon juice appeared to help treat the infection. 

While more research is necessary, if you wish to try this, squeeze half a lemon into a glass of water, and drink it.

You can also use a mixture of lemon juice and a cup of water as a mouth rinse.

It may not be helpful to apply lemon juice directly to your oral thrush lesions since the juice’s acidity can increase irritation.

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Symptoms of Oral Thrush 

Everyone has candida albicans in their mouth, and it doesn’t usually result in problems.

But when the fungus overgrows, it can lead to oral thrush and bothersome symptoms such as: 

• Creamy, cottage cheese-like white lesions on the tongue, inner cheeks, gums, tonsils, or roof of the mouth 
• Redness, soreness, or a burning sensation 
• Difficulty eating or swallowing
• Loss of taste
• Dry mouth or a cotton-like feeling in the mouth
• Redness in the corners of the mouth
• Mild bleeding if the lesions are scraped

When to See a Doctor for Oral Thrush 

Most cases of oral thrush go away within 1-2 weeks.

But in some cases, it’s best to see a healthcare provider for proper diagnosis and care.

Visit your doctor if:

• You have a medical condition (such as HIV or cancer) that causes a weak immune system.
• Your child shows symptoms of oral thrush.
• You are generally healthy but the sores won’t go away with at-home treatments.

How K Health Can Help 

Did you know that you can get yeast infection treatment online through K Health?

We have clinicians available 24/7 to get you the care or medication that you need.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions,
and medical associations. We avoid using tertiary references.

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  https://pubmed.ncbi.nlm.nih.gov/32578760/

• Anti-Candida Albicans Activity of Essential Oils Including Lemongrass (Cymbopogon Citratus) Oil and Its Component, Citral. (2003).
  https://pubmed.ncbi.nlm.nih.gov/14615795/

• Antifungal Activity of Apple Cider Vinegar on Candida Species Involved in Denture Stomatitis. (2015).
  https://pubmed.ncbi.nlm.nih.gov/25219289/

• Antifungal Activity of Chemotype Essential Oils from Rosemary Against Candida Albicans. (2013).
  https://www.scirp.org/journal/paperinformation.aspx?paperid=32053

• Antifungal Activity of Essential Oils Extract from Origanum Dloribundum Munby, Rosmarinus Officinalis L. and Thymus Ciliatus Desf. Against Candida Albicans Isolated from Bovine Clinical Mastitis. (2017).
  https://www.sciencedirect.com/science/article/abs/pii/S1156523317300173

• Antimicrobial Activity of Apple Cider Vinegar Against Escherichia Coli, Staphylococcus Aureus and Candida Albicans; Downregulating Cytokine and Microbial Protein Expression. (2018).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5788933/

• Assessment of Antifungal Activity of Herbal and Conventional Toothpastes Against Clinical Isolates of Candida Albicans. (2012).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3609312/

• Candida Albicans Impairments Induced by Peppermint and Clove Oils at Sub-Inhibitory Concentrations. (2017).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486128/

• Effect of Clove and Thyme Essential Oils on Candida Biofilm Formation and the Oil Distribution in Yeast Cells. (2019).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6572016/

• Effect of Probiotics on Oral Candidiasis: A Systematic Review and Meta-Analysis. (2019).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836010/

• Efficacy of Alcohol-Based and Alcohol-Free Melaleuca Oral Solution for the Treatment of Fluconazole-Refractory Oropharyngeal Candidiasis in Patients with AIDS. (2002).
  https://pubmed.ncbi.nlm.nih.gov/12407487/

• Gentian Violet: A 19th Century Drug Re-Emerges in the 21st Century. (2013).
  https://onlinelibrary.wiley.com/doi/10.1111/exd.12257

• How Can You Prevent Oral Thrush? (2012).
  https://www.ncbi.nlm.nih.gov/books/NBK367577/

• In Vitro Antimicrobial Properties of Coconut Oil on Candida Species in Ibadan, Nigeria. (2007).
  https://pubmed.ncbi.nlm.nih.gov/17651080/

• Inhibitory Effect of Lemongrass Oil and Its Major Constituents on Candida Biofilm and Germ Tube Formation. (2012).
  https://www.sciencedirect.com/science/article/pii/S0254629912000713

• Natural Teeth Whitening: Fact vs. Fiction. (n.d.).
  https://www.mouthhealthy.org/en/az-topics/w/natural-teeth-whitening

• Oil Pulling for Maintaining Oral Hygiene – A Review. (2017).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198813/

• Prevention of Oral Candidiasis After Free Flap Surgery: Role of 3% Sodium Bicarbonate Saline in Oral Care. (2017).
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• Probiotics Reduce the Prevalence of Oral Candida in the Elderly–a Randomized Controlled Trial. (2007).
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• Sodium Chloride Inhibits the Growth and Infective Capacity of the Amphibian Chytrid Fungus and Increases Host Survival Rates. (2012).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349647/

• Suppression of Inflammatory Reactions by Terpinen-4-Ol, a Main Constituent of Tea Tree Oil, in a Murine Model of Oral Candidiasis and Its Suppressive Activity to Cytokine Production of Macrophages in Vitro. (2013).
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• Treatment of Oral Thrush in HIV/AIDS Patients with Lemon Juice and Lemon Grass (Cymbopogon Citratus) and Gentian Violet. (2008).
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Remedies for thrush: tablets, suppositories, ointments

Where can I buy?

Encyclopedia

Diseases of the intimate zone

Vulvovaginal candidiasis (or “thrush”) is an infectious lesion accompanied by inflammation of the vaginal mucosa, which is caused by fungi of the genus Candida.

The author of the article

Molchanov Oleg Leonidovich

Gynecologist, reproductive specialist, doctor of medical sciences.

Thrush

When “thrush” characteristic symptoms are observed: microorganisms and are present in small amounts on mucous membranes and human skin ^1.2 . However, under certain unfavorable conditions, yeast-like fungi begin to actively multiply and lead to disease.

Risk factors for the development of thrush:

The presence of chronic diseases and immunodeficiency conditions (HIV infection, diabetes mellitus, etc.)

Chronic stress and emotional overstrain

Irregular and / or unbalanced diet 900 03

Pregnancy

Frequent use of antibiotics, glucocorticosteroids, active hormonal contraception

Alcohol and smoking abuse

How is thrush treated?

Antifungal agents are used to treat thrush. These funds are systemic (tablets taken by mouth), as well as local – are produced in the form of vaginal tablets, suppositories, solutions and creams. The choice of drugs is based on various parameters: the severity of inflammation, the sensitivity of Candida fungi to a particular drug, the state of the woman’s immune system and the presence of concomitant diseases, as well as the convenience and ease of use ² .

How to treat thrush? Watch in a short video by Professor, Doctor of Medical Sciences, Evgenia Valerievna Shikh

Classification of drugs for “thrush”

Antifungal agents differ in chemical structure, on the basis of which they are divided into several classes of drugs that differ in the mechanism of action and a number of effects:

• Azoles
• Combinations
• Other antifungals

Antifungal drugs of various groups used to treat thrush

Sertaconazole (original Zalain®)

Characteristics

The unique structure of the sertaconazole molecule includes imidazole and benzothiophene derivatives, which enhance each other’s actions, thereby having an antifungal effect with a vengeance ²⁵ .

What is the difference between sertaconazole for the treatment of thrush? Watch in a short video of the professor, doctor of medical sciences, Shikh Evgenia Valerievna.

Action features

Sertaconazole, being a member of the azole class, has a special chemical structure that combines an imidazole ring and benzothiophene. The imidazole ring is “responsible” for the disruption of the normal functioning of the cell membrane of the fungus, due to which its growth stops and the ability to reproduce is blocked. Benzothiophene is directly integrated into the cell wall, after which the death of the fungal cell occurs. Thus, preparations based on sertaconazole have both fungistatic (stop the growth and reproduction of the fungus) and fungicidal (contribute to its death) effect ¹² . The third type of action against fungi of the genus Candida by sertaconazole is its ability to prevent the transition of a fungal cell from a saprophytic (inactive) form to a potentially invasive or active one (capable of incorporating into mucosal cells and causing inflammation) ¹³ .

Thus, sertaconazole has a unique triple mechanism of action against fungi of the genus Candida.

A number of studies have demonstrated a high sensitivity of fungi to sertaconazole compared to other azole antifungals ^13.14 . One explanation for this is that sertaconazole is a more modern drug from the azole group, which may be associated with fewer cases of resistance or addiction of fungi to this therapy. Sertaconazole has a broad spectrum of action against pathogenic fungi (Candida albicans, C. Tropicalis, C. Spp., Pityrosporum orbiculare), dermatophytes (Trichophyton and Microsporum) ¹⁴ .

The drug has an antibacterial effect against streptococci and staphylococci ²² , relieves itching ²⁴ and inflammation ²³ .

Dosage and administration regimen

Zalain ^® is presented on the basis of sertaconazole in 2 forms:

• Cream Zalain ^® for external use

For vaginal use of Zalain suppositories ^®

For the treatment of thrush: single administration of 1 Zalain suppository ^® into the vagina. A high concentration of sertaconosal, the active ingredient Zalain ^® suppositories, persists for 7 days. Such a long-term effect is ensured due to the property of lipophilicity – the ability of sertaconazole to dissolve in lipid (fat) cell structures. If symptoms persist, it is recommended to re-insert another 1 suppository into the vagina after 7 days ¹⁵ .

Cream Zalain ^® for external use

For the treatment of thrush: Zalain ^® cream is used for lesions of the external genital organs to reduce the severity of itching, burning and other discomfort in the area of ​​the labia majora and minor.

It is recommended to apply to the affected areas of the skin 2 times a day. The duration of treatment is 4 weeks.

Fluconazole

Characteristics

Triazole antifungal (azole class)

Features of action

Like many other antifungal agents, fluconazole acts on the cell wall of the fungal cell. Basically, it delays or blocks the action of certain enzymes (special protein substances) that are necessary for the normal functioning of the outer membrane of the fungal cell, and when it is destroyed, the death of the fungus itself occurs (fungicidal effect) ³ .

Preparations containing fluconazole are available in capsule form and are used to treat various types of fungal infections, since this substance penetrates into all body fluids in the body (including vaginal secretions).

Dosage and administration regimen

Fluconazole capsules are used in various dosages for the treatment of various types of fungal infections. For example, with common fungal infections (generalized candidiasis), the dose of the substance should be 400 mg per day, and for the treatment of vulvovaginal candidiasis, 150 mg of fluconazole is used once ⁴ . The duration of treatment with drugs with fluconazole depends on the type of fungal disease and is determined individually.

For thrush: Fluconazole 150 mg is taken as a single oral dose.
Fluconazole is not recommended for use during pregnancy and while breastfeeding. Preparations with fluconazole can be used to prevent recurring episodes of vulvovaginal candidiasis ² , however, the development of resistance of fungi to exposure to this substance should be taken into account ⁵ .

Ketoconazole

Feature

Antifungal agent of the imidazole series (azole class)

Features of action

Ketoconazole has activity against yeast fungi and dermatophytes6. The mechanism of its action is associated with inhibition of fungal cell division, as well as disruption of their vital activity by affecting cell permeability, which can cause the death of the fungus (fungistatic + fungicidal effect) ⁷ .

Dosage and administration regimen

Preparations based on ketoconazole are available in the form of tablets (for the treatment of fungal infections of internal organs and other localizations, as well as for common forms of mycoses), shampoos (for the treatment of fungal infections of the scalp), ointments (for external treatment of fungal infections of the skin, nails), vaginal suppositories (for the treatment of thrush in women).

The dosage of ketoconazole depends on the location of the lesion, the severity of the disease, the age, body weight of the person and comorbidities. Ketoconazole is not used during pregnancy and lactation. Tablets for adults are recommended in a daily dose of at least 200 mg and not more than 400 mg. The ointment is applied to the affected areas with a thin layer once a day ⁴ .

Clotrimazole

Characteristics

Antifungal drug – a synthetic derivative of imidazole (a class of azoles).

Features of action

It affects the enzymatic activity of cell membranes, stopping the division of fungal cells (fungistatic effect). May exhibit a fungicidal effect in high concentrations ¹⁰ .

Dosage and administration regimen

Preparations with clotrimazole for external use are available in the form of ointments, creams and solutions, vaginal tablets. Ointment and cream with clotrimazole are applied to the affected areas 2-3 times a day, the duration of treatment is determined in a particular case, but is at least 1 week (average 2-3 weeks) ⁴ .

For the treatment of thrush: appoint 1 suppository 200 mg at night for 3 days or 1 suppository 100 mg for 6 days. The literature describes cases of insensitivity of fungi to therapy with clotrimazole ¹¹ .

Nystatin

Characteristics

Antifungal drug from the group of polyene antibiotics. Substances from this group are produced by special microorganisms of the genus Streptomyces.

Features of action

Nystatin disrupts the vital activity of fungal cells, stops their growth and reproduction (fungistatic effect).

Widely used to treat certain types of fungal infections, in particular vulvovaginal candidiasis (including during pregnancy) caused by fungi of the genus Candida, as well as fungal infections of the skin and internal organs ² .

Nystatin is poorly absorbed from the gastrointestinal tract, resulting in poorer efficacy in preventing fungal infection compared to, for example, the azole group of drugs ¹⁶ .

Dosage and administration regimen

Tablets with nystatin are prescribed for candidiasis of internal organs, 500,000 IU 4-8 times a day. Ointment with nystatin is prescribed in the form of applications to the areas of the skin affected by the fungus 2 times a day. Rectal suppositories are used in the same mode for the treatment of candidiasis of the lower intestines ⁴ .

For the treatment of thrush: Vaginal suppositories with nystatin are used 2 times a day for the treatment of vaginal candidiasis. The course of treatment with any kind of drugs with nystain should not be shorter than 7 days, even if the condition improved before ¹⁷ .

Natamycin

Characteristics

Another antifungal drug from the group of polyene antibiotics.

Features of action

It disrupts the transport processes of fungal cells, depriving them of all energy substrates. As a result, the fungus cell loses the ability to reproduce, and then its death occurs (fungicidal effect) ¹⁸ .

Used for the treatment and prevention of fungal infections of the skin and mucous membranes, including the treatment of vulvovaginal candidiasis. Mushrooms practically do not develop resistance (insensitivity) to its action ¹⁸ .

Dosage and administration regimen

Oral forms of preparations with natamycin are used at a dose of 100 mg with a frequency of administration 4 times a day. 2% ointment with natamycin is applied externally, applied to the skin 1-2 times a day ⁴ .

For the treatment of thrush: Vaginal suppositories are used 1-2 times a day to treat vaginal candidiasis. The duration of treatment with natamycin preparations is determined individually, but it is always recommended to continue treatment for a few more days after symptoms have improved.

Povidone-iodine

Description

Local antiseptic preparation. Available in the form of vaginal suppositories.

Features of action

Active iodine, which is released from the active substance povidone-iodine, has a neutralizing effect on the cell wall of fungi, leading to cell death ¹⁹ .

Dosage and administration regimen

In case of candidiasis, 1 suppository is injected into the vagina 1 time per day for 7 days. It is also recommended as a prophylaxis before surgical or diagnostic interventions in the vagina.

For the treatment of thrush: 1 vaginal suppository 200 mg once a day for 7 days.
The drug is not used during pregnancy, breastfeeding and in women who have thyroid disease ⁴ .

Thus, a huge number of antifungal agents are currently used to treat vulvovaginal candidiasis (“thrush”). The choice of the drug depends primarily on the type of fungus that caused the disease (Candida albicans or Candida non-albicans), the presence or absence of a mixed infection (when, along with an increased number of fungi in smears from the vagina, other pathogenic flora is detected), as well as on the mechanism the action of the drug and its additional effects, the form of release of the drug, the duration of treatment. Special conditions of a woman (pregnancy, lactation, etc. ) must be taken into account.

Contents

Sertaconazole

Fluconazole

clotrimazole

Nystatin

Natamycin

Povidone-iodine

0% read

Zalain® Suppositories

Sertaconazole-based Zalain ^® preparations can be called a universal remedy for the treatment of thrush, because they:

• have a wide spectrum of action against fungal cells and a number of other vaginal pathogens
• active against both Candida albicans and non-albicans
• have a triple action on the cells of Candida fungi (fungistatic, fungicidal, prevents the transition of the inactive form of the fungus into pathogenic)
• preparations Zalain ^® are easy to use (the course of treatment with suppositories is only 1 day)
• remain active during menstruation
• the use of drugs in women during pregnancy and lactation is acceptable if the potential benefit to the mother outweighs the possible risk to the fetus or child

Only 1 suppository per course

Local effect of the drug

Absorption of sertaconazole into the bloodstream does not occur ¹³

May be used during pregnancy and lactation*

*as prescribed by a doctor if the benefits outweigh the risks

Where to buy Zalain® Suppositories

Instruction

Prevention of thrush

In recent years, there has been an increase in recurrent (repeating) forms of thrush and the development of fungal resistance to antifungal drugs. In this regard, great attention is paid to the prevention of the occurrence of vulvovaginal candidiasis ²⁰ .

Fungi that cause various diseases in humans (including vulvovaginal candidiasis), acquire aggressive properties and actively multiply in conditions associated with the use of antibiotics, violation of microflora and non-compliance with the rules of intimate hygiene. Therefore, it is important to follow the basic recommendations, following which you can successfully prevent thrush:

Avoid casual sex

Use a barrier method of protection during sexual intercourse (condoms)

Give up panty liners, synthetic underwear

Observe daily rules of intimate hygiene

Get a preventive examination by a gynecologist once a year

Give up bad habits

hygiene. When choosing these products, it is important to pay attention to the composition, which should not contain aggressive chemicals, alcohol, alkali, dyes.

For example, the cosmetic Zalagel ^® Intim contains tea tree oil, which has antibacterial, anti-inflammatory properties, helps to soothe itching and burning. And thanks to betaine, the gel prevents dryness of the intimate area, maintaining the physiological balance of the skin and external mucous membranes. Zalagel ^® Intim is recommended to be used once a day for regular intimate hygiene of the external genital organs or twice a day, morning and evening, in case of irritation or discomfort in the vulva ²¹ .

Frequently Asked Questions

Is there a difference in the effectiveness of different forms of drugs for the treatment of thrush?

Answer: Efficiency depends on the active substance and the sensitivity of pathogens to it.

Can tablets and suppositories be used at the same time to treat thrush?

Answer: The question of the treatment regimen is decided by a specialist, so be sure to seek specialized advice. When using vaginal suppositories Zalain ^® it is possible to use other means on the recommendation of a specialist. For complete information about Zalain ^® Suppositories, see the instructions for the drug.

Do I need to be re-examined after a course of treatment for thrush?

Answer: Cure in the case of thrush is established when the symptoms of the disease have completely stopped, and during repeated laboratory examination, a high amount (more than 10 ⁴ CFU) of fungi of the genus Candida. Therefore, to confirm the cure of the disease, a repeated clinical and laboratory examination is necessary (usually prescribed 10-14 days after treatment).

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References

1. Prilepskaya V. N., Kira E. F., Apolikhina I. A. et al. ROAG. Clinical Guidelines for the diagnosis and treatment of diseases accompanied by pathological discharge from the female genital tract; 2019.
2. Federal clinical guidelines for the management of patients with urogenital candidiasis. / ROAG / Moscow – 2020
3. E.A. MEZHEVITINOVA, P.R. ABAKAROV, Sh.M. POGHOSYAN. USE OF FLUCONAZOLE IN WOMEN OF REPRODUCTIVE AGE WITH VULVOVAGINAL CANDIDIOSIS. FSBI “National Medical Research Center for Obstetrics, Gynecology and Perinatology named after academician V.I. Kulakov” of the Ministry of Health of the Russian Federation. Journal MEDICAL COUNCIL • No. 13, 2018, 10.21518/2079-701X-2018-13-96-102
4. Directory GRLS (State Register of Medicines)
5. Zheltikova T.M. MONITORING THE RESISTANCE OF CLINICAL YEAST STRAINS OF THE GENUS CANDIDA TO FLUCONAZOLE (BRIEF REVIEW). Medical advice. 2017;(2):70-74. https://doi.org/10.21518/2079-701X-2017-2-70-74
6. Frank C. Odds Spectrum of activity of oral antifungals, Proceedings of a Symposium at the 18th International Congress of Dermatology
7. Gupta AK, Lyons DC. The Rise and Fall of Oral Ketoconazole. J Cutan Med Surg. 2015 Jul-Aug;19(4):352-7. doi: 10.1177/1203475415574970. Epub 2015 Mar 5. PMID: 25775613.
8. Xu Y, Lu H, Zhu S, Li WQ, Jiang YY, Berman J, Yang F. Multifactorial Mechanisms of Tolerance to Ketoconazole in Candida albicans. Microbiol Spectr. 2021 Sep 3;9(1):e0032121. doi: 10.1128/Spectrum.00321-21. Epub 2021 Jun 23. PMID: 34160280; PMCID: PMC8552639
9. Crowley PD, Gallagher HC. Clotrimazole as a pharmaceutical: past, present and future. J Appl Microbiol. 2014 Sep;117(3):611-7. doi: 10.1111/jam.12554. Epub 2014 Jun 30. PMID: 24863842
10. Ausili A, Yakymenko I, Teruel JA, Gómez-Fernández JC. Clotrimazole Fluidizes Phospholipid Membranes and Localizes at the Hydrophobic Part near the Polar Part of the Membrane. biomolecules. 2021 Sep 2;11(9):1304. doi: 10.3390/biom11091304. PMID: 34572517; PMCID: PMC8464689
11. Sobel JD. Vulvovaginal candidosis. Lancet. 2007 Jun 9;369(9577):1961-71. doi: 10.1016/S0140-6736(07)60917-9. PMID: 17560449.
12. Carrillo-Muñoz AJ, Tur-Tur C, Cárdenes DC, Estivill D, Giusiano G. Sertaconazole nitrate shows fungicidal and fungistatic activities against Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum, causative agents of tinea pedis. Antimicrob. Agents Chemother. 2011;55(9):4420-4431
13. Croxtall JD, Plosker GL. Sertaconazole: A review of its use in the management of superficial mycoses in dermatology and gynaecology. Drugs 2009; 69(3): 339–59.
14. Plosker GL. Sertaconazole. A Review of Its Use in the Management of Superficial Mycoses in Dermatology and Gynaecology. Drugs.2009;69(3):339-359.
15. According to the official instructions for use of the drug Zalain (State Register of Medicines https://grls. rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=3bd5386b-0075-434d-a6ef-74ab056650ae)
16. Clarkson JE, Worthington HV, Eden OB. Interventions for preventing oral candidiasis for patients with cancer receiving treatment. Cochrane Database Syst Rev. 2007 Jan 24;2007(1):CD003807. doi: 10.1002/14651858.CD003807.pub3. PMID: 17253497; PMCID: PMC6746214
17. Young GL, Jewell D. Topical treatment for vaginal candidiasis (thrush) in pregnancy. Cochrane Database Syst Rev. 2001;(4):CD000225. doi: 10.1002/14651858.CD000225. PMID: 11687074
18. Malova I.O., Petrunin D.D. Natamycin is an antifungal agent of the class of polyene macrolides with unusual properties // Bulletin of Dermatology and Venereology. – 2015. – T. 91. – No. 3. – C. 161-184. doi: 10.25208/0042-4609-2015-91-3-161-184
19. Petersen EE, Weissenbacher ER, Hengst P, Spitzbart H, Weise W, Wolff F, Dreher E, Ernst U, Della Casa V, Pohlig G, Graf F, Kaiser RR. Local treatment of vaginal infections of varying etiology with dequalinium chloride or povidone iodine. A randomised, double-blind, active-controlled, multicentric clinical study. Arzneimittelforschung. 2002;52(9):706-15. doi: 10.1055/s-0031-1299955. PMID: 12404887.
20. Ogneshchenko NA Vulvovaginal candidiasis: what’s new? Published online 2012:70-72
21. Instruction leaflet Zalagel-Intim®
22. RLS, official product label of sertaconazole
23. Sur R., Babad J.M., Garay M., Liebel F.T., Southall M.D. Anti-Inflammatory Activity of Sertaconazole Nitrate Is Mediated via Activation of a p38-COX-2-PGE2 Pathway. J Invest Dermatol. 2008;128(2):336-344. doi: 10.1038/sj.jid.5700972.
24. Kaur S., Sur R., Liebel F.T., Southall M.D. Induction of Prostaglandin D2 through the p38 MAPK Pathway Is Responsible for the Antipruritic Activity of Sertaconazole Nitrate. J Invest Dermatol. 2010;130(10):2448-2456. doi: 10.1038/jid.2010.152.
25. Carrillo-Muñoz AJ, Tur-Tur C, Giusiano G, Marcos-Arias C, Eraso E, Jauregizar N, Quindós G. Sertaconazole: an antifungal agent for the topical treatment of superficial candidiasis. Expert Rev Anti Infect Ther. 2013 Apr;11(4):347-58. doi: 10.1586/eri.13.17. PMID: 23566144.

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Thrush: symptoms, treatment, suppositories

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Encyclopedia

Diseases of the intimate zone

Thrush, or vaginal candidiasis, is an infectious disease of the mucous membrane of the female genital organs, caused by excessive reproduction of yeast-like fungi of the genus Candida.

The author of the article

Molchanov Oleg Leonidovich

Gynecologist, reproductive specialist, doctor of medical sciences.

What is thrush?

Audio version of the page:

Yeast-like fungi are opportunistic pathogens (these are natural inhabitants that are present in the normal microflora of the vagina, intestines and oral cavity in small quantities). However, under the influence of certain internal and external factors, fungi begin to actively multiply, their number grows, and this leads to the development of the disease.

According to the World Health Organization, 1/5 of the world’s population has various fungal diseases. Women most often suffer from Candida infection of the vaginal mucosa, which is called vaginal candidiasis. Thrush is the most common disease among women aged 15-50, so most often women come to gynecologists with this problem. Moreover, the frequency of vaginal candidiasis is about half of all infectious pathologies that occur in the lower genitalia (genital organs) ¹ .

According to domestic and foreign literature, by the age of 25 more than 50% of all women have experienced the discomfort of vaginal candidiasis at least once ^{2. 3} .

The likelihood of the disease increases during pregnancy, so thrush occurs in at least 20% of expectant mothers. ³

How to treat thrush? Watch in a short video of Professor, Doctor of Medical Sciences, Shikh Evgenia Valerievna

What are the symptoms of thrush?

When the vagina is affected, the fungi also actively begin to multiply not only in the vagina, but also on the external genitalia, provoking the appearance of symptoms such as: 0003

vaginal discharge similar to cottage cheese

What are the types and what does the color of vaginal discharge mean

The symptoms of thrush may increase before menstruation and during pregnancy.

With a complicated form of vaginal candidiasis, vesicles (small vesicles with cloudy liquid) may appear. These vesicles can burst and form erosions (damage to the surface layer of the skin – the epithelium). Also, cracks may appear on the external genitalia. ⁹

Causes of thrush

The following groups of factors can provoke the appearance of vaginal candidiasis:

Taking medications

antibiotics, oral contraceptives, corticosteroids, chemotherapy

Endocrine

diabetes mellitus, hypothyroidism

Mechanical

tight underwear made of synthetic fabrics, long-term wearing of an intrauterine device, damage to vaginal tissues 900 03

Physiological

pregnancy

Psychological

stress

Other

metabolic disorders, dysbacteriosis, allergies, hypovitaminosis, chronic gynecological diseases ⁴

Forms of vulvovaginal candidiasis (thrush)

According to national clinical guidelines, it is customary to distinguish between 2 clinical forms of vaginal candidiasis ⁸ :

Acute

genitals, thick vaginal discharge, similar to cottage cheese, there is a burning sensation, redness of the perineum is observed, swelling is possible.

There may be up to 3 flare-ups per year.

Recurrent

This form of thrush is also called chronic. Approximately 50% of women with recurrent candidiasis experience repeated symptoms of the disease in the interval from several days to 3 months after successful treatment of the acute form ⁵ .

What complications can vaginal candidiasis (thrush) cause?

The lack of proper treatment of thrush in women often leads to the development of complications, and the following diseases may occur: 9Cervicitis vagina

narrowing of the vagina due to the formation of fibrous tissue

Cystitis

inflammatory processes in the bladder mucosa

Urethritis

inflammation of the urinary canal

Diagnosis of vaginal candidiasis

To make a diagnosis of “vaginal candidiasis”, the doctor comprehensively evaluates the woman’s complaints, clinical manifestations that are detected during examination on the chair, and the results of laboratory tests.

In the presence of a clinical picture characteristic of vaginal candidiasis, the doctor may prescribe the following types of laboratory tests:

Culture

A swab (vaginal contents) is placed in a special nutrient medium where microorganisms (if any) begin to multiply actively. This method helps to determine the type of pathogen and predict the effectiveness of antimicrobial drugs against this microorganism, which allows the doctor to choose an effective treatment regimen.

Enzyme-linked immunosorbent assay (ELISA)

helps to detect the presence of specific substances specific to a particular pathogen, called antibodies.
So, with the help of ELISA, a search for antibodies to fungi of the genus Candida can be carried out.

Polymerase chain reaction (PCR)

highly sensitive test that allows direct identification of the pathogen by looking for DNA or RNA fragments of a specific pathogen.

You may also need:

• CBC
• test for sexually transmitted infections
• test for glucose and carbohydrate metabolism products

Differential diagnosis of thrush (from what other similar diseases should thrush be distinguished)?

Differential diagnosis, as a rule, is carried out by a specialist with other diseases caused by the following microorganisms

Treatment of thrush in women

After examining the patient on the chair and receiving the results of tests and studies, the gynecologist can make an accurate diagnosis, which means choosing the right treatment. Even seemingly the same disease in each patient will be treated differently. This is due to the fact that thrush can be triggered by different types of fungi, which are conditionally divided into types – Candida albicans and Candida non-albicans. The same drug may be active against some types of fungi, but not against others.

It is important that drugs for the treatment of thrush (antimycotics – antifungal agents) can have two mechanisms of action against thrush at once: firstly, block the growth and reproduction of fungi (fungistatic effect).

Secondly, cause fungi to die (fungicidal action).

Conventionally, all preparations for thrush can be divided into the following groups:

• Preparations of the azole group
• Preparations of the polyene group
• Combined preparations
• Other preparations

Azole group drugs for the treatment of thrush

Sertaconazole, clotrimazole, ketoconazole, miconazole, fluconazole, voriconazole, itraconazole.

Some drugs in this group (for example, clotrimazole) have only a fungistatic effect. However, with the external use of the drug in high concentrations, a fungicidal effect may be exerted. The mechanism of action of the drug in this case will be to disrupt the integrity of the fungal cell membrane. ¹¹

The use of oral (oral) azole preparations during pregnancy is not recommended unless the expected benefit outweighs the possible risks.

Preparations of the polyene group

Nystatin, natamycin, amphotericin B, levorin can not only provoke the death of fungi, but also block the processes of their growth and reproduction.

Combinations

Miconazole + mazipredone, isoconazole + diflucortolone.

Other preparations

Preparations with iodine, derivatives of salicylic acid.

Treatment of thrush with drugs with sertaconazole

One of the most modern antimycotic drugs is sertaconazole. Due to the fact that the agent is a derivative of imidazole and benzothiafene, it has a triple effect on fungi: it inhibits the growth and reproduction of fungi (fungistatic action), leads to their death (fungicidal), and also prevents the transition of fungi from a non-pathogenic form (blastospores) to pathogenic pathogenic (micellar) ¹⁸ . By reducing the number of fungi, there is a decrease in the severity of the inflammatory process. By blocking the synthesis of the main components of the cell, the drug damages the cell wall of the fungus and provokes its death, which solves the problem of “addiction” (resistance).

Due to benzothiafene, sertaconazole penetrates well into the skin and mucous membranes (it has a high lipophilicity compared to many other drugs), thereby enhancing the local antimycotic effect. The drug has good potency against many types of fungi (both Candida albicans and Candida non-albicans), gram-positive bacteria (streptococci and staphylococci), as well as protozoa.

How thrush is treated with sertaconazole. Watch in a short video of Professor, Doctor of Medical Sciences, Shikh Evgenia Valerievna

Sertaconazole can be presented in the following dosage forms: suppositories and cream. Including preparations based on sertaconazole are produced under the brand name Zalain ^® .

Consider the effect of each drug in more detail.

Zalain ^® Candles for the treatment of thrush

Zalain vaginal suppositories are used for local treatment of urogenital candidiasis (thrush) ¹² .

Application: 1 suppository is administered intravaginally 1 time, if necessary, re-use after 7 days.

One Zalain ^® suppository for the treatment of vulvovaginal candidiasis (thrush) is valid for 7 days, because sertaconazole (the active ingredient of Zalain ^® suppositories) has a high lipophilicity – the ability to dissolve in lipid (fat) cell structures. Due to this property, the drug remains in the vaginal mucosa for 7 days at a therapeutic concentration, having a triple mechanism of action on Candida fungi: it stops the growth and reproduction of fungi, promotes their death and prevents the transition of fungi into a pathogenic form ¹⁸ . It is convenient and easy for a woman to use 1 suppository for 7 days of treatment.

The use of the drug in pregnant women has not been specifically studied. However, with the introduction of vaginal suppositories with sertaconazole, it is not absorbed into the bloodstream ¹³ . From this we can conclude that the drug acts exclusively locally, and this indicates its high safety profile. Therefore, it is possible to use the remedy during pregnancy and lactation if the potential benefit to the woman outweighs the possible risk to the unborn child, which of course should be determined by the attending physician ¹⁴ .

Only 1 suppository per course

Local effect of the drug

Absorption of sertaconazole into the bloodstream does not occur ¹³

Can be used during pregnancy and lactation if the expected benefit outweighs the risks

900 03

Where to buy Zalain ^® Candles for thrush treatment

Instruction

Instruction

Zalain ^® Cream

Zalain ^® The cream is used in the treatment of thrush of the external genital organs, when the disease is accompanied by severe itching, burning. The drug with a wide spectrum of action has antifungal, antibacterial and anti-inflammatory effects, helps to reduce itching, discomfort in the intimate area of ​​a woman ¹⁹ .

Compared with the drug containing ketoconazole, when using sertaconazole, there are shorter terms of clinical and mycological recovery, better tolerance (reduction of the period of exacerbation of itching in the treatment of thrush), the possibility of using it in erosive processes on the mucous membranes of the genital organs ¹⁶ .

Application: 1-2 times a day by applying the drug in a thin layer on the affected area of ​​the skin, covering 1 cm of healthy skin. The duration of the course is 4 weeks ¹⁵ .

Has a triple effect: antibacterial, antipruritic, anti-inflammatory

Used 1-2 times a day

Where to buy Zalain ^® Cream

or

Find the nearest pharmacy

Prevention of thrush

To prevent the onset of the disease, it is recommended to take preventive measures, namely:0003

Do not use sanitary napkins

Avoid uncontrolled use of antibiotics

Be attentive to your health and consult a doctor if symptoms appear

In daily intimate hygiene, it is very important to use products specially designed for this. Gel for intimate hygiene should not contain alcohol, dyes and other aggressive components.

One of the multifunctional cosmetic products for external intimate hygiene is Zalagel ^® Intim — gel-soap for delicate cleansing and care. This product contains tea tree oil, which has the following effects: antiprotozoal (leads to the death of protozoan microorganisms), antiviral, antibacterial and antifungal ¹⁷ , helps to soothe itching and burning, has a deodorizing effect.

Zalagel ^® Intim

Zalagel ^® Intimacy with tea tree oil is specially designed for delicate cleansing of intimate places and can be used in daily intimate hygiene.

Gently cleanses the intimate area

Creates a destructive environment for fungi of the Candida genus

Protects the female genital organs from infections

Tea tree oil in the composition of the product has an antibacterial and antiviral effect

Reduces itching and irritation 900 03

Where to buy Zalagel ^® Intim

or

Find the nearest pharmacy

Instruction

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