Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik

Uses

Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik Topical Cream has an antibacterial effect on Gram-positive bacteria, it may be used in mycoses secondarily infected with such bacteria. Skin and nail infections due to dermatophytes, yeasts and other fungi such as: Tinea capitis, corporis, manuum, pedis, barbae, cruris, unguium or onychomycosis. Pityriasis versicolor, candidiasis of skin and nails, stomatitis angularis, otitis externa.

Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik Oral treatment and prevention of fungal infections of the oropharynx and gastrointestinal tract, and of super infections due to Gram-positive bacteria.

Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik is also used to associated treatment for these conditions: Acne Vulgaris, Dermatophytosis, Dermatophytosis of nail, Diaper Dermatitis, Excessive sweating and body odor, Fungal skin infection, Gastrointestinal candidiasis, Infection Mixed, Infections, Fungal of the Skin Folds, Nail candida, Oropharyngeal Candidiasis, Pityriasis versicolor, Ringworm, Seborrheic Dermatitis, Skin candida, Tinea Capitis, Tinea Corporis, Tinea Cruris, Tinea Pedis, Vaginal Candidiasis, Cutaneous candidiasis

How Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik works

Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik is an azole antifungal used to treat a variety of conditions, including those caused by Candida overgrowth. Unique among the azoles, miconazole is thought to act through three main mechanisms. The primary mechanism of action is through inhibition of the CYP450 14α-lanosterol demethylase enzyme, which results in altered ergosterol production and impaired cell membrane composition and permeability, which in turn leads to cation, phosphate, and low molecular weight protein leakage.

In addition, miconazole inhibits fungal peroxidase and catalase while not affecting NADH oxidase activity, leading to increased production of reactive oxygen species (ROS). Increased intracellular ROS leads to downstream pleiotropic effects and eventual apoptosis.

Lastly, likely as a result of lanosterol demethylation inhibition, miconazole causes a rise in intracellular levels of farnesol. This molecule participates in quorum sensing in Candida, preventing the transition from yeast to mycelial forms and thereby the formation of biofilms, which are more resistant to antibiotics. In addition, farnesol is an inhibitor of drug efflux ABC transporters, namely Candida CaCdr1p and CaCdr2p, which may additionally contribute to increased effectiveness of azole drugs.

Dosage

Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik dosage

For oral administration: Dosage is based on 15 mg/kg/day.

• Adults: 1-2 tea-spoonfuls of gel four times daily
• Children aged 6 years and over: One tea-spoonful of gel four times daily
• Children aged 2-6 years: One tea-spoonful of gel twice daily
• Infants under 2 years: Half tea-spoonful of gel twice daily.

For localised lesions of the mouth:

A small amount of gel may be applied directly to the affected area with a clean finger. For topical treatment of the oropharynx, the gel should be kept in the mouth for as long as possible. Treatment should be continued for up to 2 days after the symptoms have cleared.

For oral candidasis, dental prostheses:

Should be removed at night and brushed with the gel.

The dosage is same for all the ages.

For skin infections: Apply some cream to the lesions twice daily and rub it well with finger until it has fully penetrated the skin. All lesions usually disappear after 2 to 5 weeks. Prolong treatment for some 10 days to prevent relapse.

For nail infections: Clip infected nail as shortly as possible. Apply some cream once daily to the infected nail and rub with your finger, cover nail with a non-perforated occlusive plastic bandage.

Also after loosening of the infected nail (from 2-3 weeks onwards) uniterrupted treatment should be continued until the growth of a new nail has set in and definite cure can be observed (usually after seven months or more).

Side Effects

Topical application of Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik Nitrate has almost no side effect.

For oral gel: Occasionally, nausea and vomiting have been reported, and with long term treatment, diarrhoea. In rare instances, allergic reactions have been reported. There are isolated reports of hepatitis, for which the causal relationship with Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik has not been established.

Toxicity

Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik overdose has not been reported. Patients experiencing an overdose are at an increased risk of severe adverse effects such as headache, skin irritation, diarrhea, nausea, vomiting, abdominal pain, and dysgeusia. Symptomatic and supportive measures are recommended.

Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik has an oral LD₅₀ of 500 mg/kg in rats.

Precaution

If the concomitant use of Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik and anticoagulants is envisaged, the anticoagulant effect should be carefully monitored and titrated. It is advisable to monitor Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik and phenytoin levels, if they are used concomitantly. Particularly in infants and young children, caution is required to ensure that the gel does not obstruct the throat. Hence, the gel should not be applied to the back of the throat and the full dose should be divided into smaller portions. Observe the patient for possible choking.

Interaction

Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik can inhibit the metabolism of drugs metabolised by the Cytochrome P450-3A and -2C9 families. This can result in an increase or prolongation of their effects, including side effects. Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik Oral Gel should not be used during treatment with the following drugs: terfenadine, astemizole,mizolastine, cisapride, triazolam, oral midazolam, dofetilide, quinidine, pimozide, CYP3A4 metabolised HMG-CoA reductase inhibitors such as simvastatin and lovastatin.

Food Interaction

Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik Cholesterol interaction

[Minor] Elevations in cholesterol and triglyceride levels may occur in patients receiving intravenous miconazole and are attributed to the drug vehicle, Cremophor EL (polyethoxylated castor oil).

These increases are reversible upon discontinuation of miconazole therapy.

Clinicians should be cognizant of these effects when interpreting lab results of hyperlipidemic patients during treatment with miconazole.

Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik Drug Interaction

Moderate: fluconazole, alprazolamUnknown: ibuprofen, lorazepam, amoxicillin / clavulanate, diphenhydramine, omega-3 polyunsaturated fatty acids, fluticasone nasal, metoprolol, polyethylene glycol 3350, acetaminophen, bifidobacterium infantis / lactobacillus acidophilus, acetaminophen, cyanocobalamin, ascorbic acid, cholecalciferol, ranitidine, ondansetron, sertraline, cetirizine

Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik Disease Interaction

Moderate: liver diseaseMinor: hyperlipidemia

Volume of Distribution

A 1200 mg miconazole vaginal suppository resulted in a calculated apparent volume of distribution of 95 546 L while a 100 mg vaginal cream yielded an apparent volume of distribution of 10 911L.

Elimination Route

Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik given to healthy volunteers as a single 50 mg oral tablet produced a mean C_max of 15.1 ± 16.2 mcg/mL, a mean AUC_0-24 of 55.2 ± 35.1 mcg*h/mL, and a median T_max of 7 hours (range 2.0-24.1). In these patients measurable plasma concentrations ranged from 0.5 to 0.83 mcg/mL.

Topical miconazole is absorbed poorly into the systemic circulation. In pediatric patients aged 1-21 months given multiple topical applications of miconazole ointment for seven days, the plasma miconazole concentration was less than 0.5 ng/mL in 88% of the patients, with the remaining patients having a concentration of 0.57 and 0.58 ng/mL, respectively. Similarly, patients. administered with a vaginal 1200 mg ovule had a mean C_max of 10.71 ng/mL, mean T_max of 18.4 hours, and mean AUC_0-96 of 477.3 ng*h/mL.

Half Life

Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik has a terminal half-life of 24 hours.

Elimination Route

Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik is excreted through both urine and feces; less than 1% of unchanged miconazole is recovered in urine.

Pregnancy & Breastfeeding use

In animals, Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik has shown no teratogenic effects but is foetotoxic at high oral doses. The significance of this to man is unknown. However, as with other imidazoles, Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik Oral Gel should be avoided in pregnant women if possible. The potential hazards should be balanced against the possible benefits. It is not known whether Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik is excreted in human milk. Caution should be exercised when prescribing Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik Oral Gel to nursing mothers.

Only small amounts of Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik cream are absorbed following local administration. However as with other imidazoles, Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik nitrate should be used with caution during pregnancy.

Contraindication

Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik is contraindicated in patients with known hypersensitivity to the active drug.

Acute Overdose

In general, Gyno-Daktarin-1 Capsule Voor Vaginaal Gebruik is not highly toxic. In the event of accidental overdosage, vomiting and diarrhoea may occur.

Storage Condition

Store away from direct heat. Keep out of reach of children.

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