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Terconazole

Pronunciation: ter-CONE-uh-zole
Class: Vaginal antifungal agent

Trade Names

Terazole 3
- Vaginal cream 0.8%
- Vaginal suppositories 80 mg

Terazole 7
- Vaginal cream 0.4%

Zazole
- Vaginal cream 0.8%

Taro-Terconazole (Canada)

Pharmacology

May alter permeability of fungus cell membrane, allowing leakage of essential intracellular components.

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Pharmacokinetics

Absorption

Terconazole C max is approximately 5.9 ng/mL or 0.006 mcg/mL and T max is about 6.6 h.

Distribution

Terconazole is 94.9% protein bound. The degree of binding is independent of the drug concentration.

Metabolism

Terconazole is extensively metabolized.

Elimination

Terconazole t ½ is 6.9 h (range, 4 to 11.3 h). Excretion of radioactivity is by both renal (32% to 56%) and fecal (47% to 52%) routes.

Special Populations

Gender

Following terconazole administration, absorption varies in hysterectomized subjects (5% to 8% absorption) vs nonhysterectomized subjects (12% to 16% absorption). Other than this, overall absorption is similar in all women.

Indications and Usage

Local treatment of vulvovaginal candidiasis.

Contraindications

Standard considerations.

Dosage and Administration

Adults

Intravaginal 1 suppository at bedtime for 3 days or 1 applicatorful of 0.4% cream at bedtime for 7 days or 1 applicatorful of 0.8% cream for 3 days.

Storage/Stability

Store at room temperature.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

CNS

Headache.

GI

Abdominal pain.

Genitourinary

Dysmenorrhea; genitalia pain; vulvovaginal burning; itching; irritation; burning.

Miscellaneous

Body pain; fever; chills.

Precautions

Pregnancy

Category C . Avoid during first trimester because of absorption possibility.

Lactation

Undetermined.

Children

Safety and efficacy not established.

Recurrent infections

May indicate underlying medical cause, including diabetes or HIV infection.

Patient Information

  • Instruct patient to complete full course of therapy. This medication must be used continuously even through menses.
  • Alert patient to potential side effects of vulvovaginal itching or burning, head or body aches. Advise patient to discontinue medication and notify health care provider if irritation occurs.
  • Instruct patient to insert applicator high into vagina.
  • Wash hands before and after application. Also, maintain external clean genitalia but avoid use of douches or other vaginal OTC products while using the medication.
  • Advise patient to wash applicator with mild soap and rinse thoroughly.
  • Caution patient to refrain from sexual intercourse during course of therapy in order to help to prevent reinfection.
  • Advise patient that sanitary napkin or minipad may be used to prevent stains on clothing.
  • Instruct patient to consult with health care provider if infection recurs. Diabetes, AIDS, and chronic antibiotic or steroid therapy place patient at increased risk for recurrent infection.
  • Explain that ingredients in product may interact with latex and weaken latex condoms and diaphragms. Advise patient to avoid use of these forms of birth control for 72 h after application of medication.

Copyright © 2009 Wolters Kluwer Health.

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