Gyne-Lotrimin cream (Clotrimazole)

Clotrimazole Vaginal Cream is an antifungal medicine primarily used to treat vaginal yeast infections caused by Candida species. It works by inhibiting the growth of fungi, thereby alleviating symptoms such as itching, burning, and discharge associated with these infections.

In Australia, clotrimazole vaginal creams are marketed under several brand names, including:

• Canesten Clotrimazole Thrush 1 Day.
• APOHEALTH Thrush 6 Day Cream.
• Pharmacy Action FemCream.
• Pharmacy Choice Clotrimazole Thrush Treatment 6 Day Cream.
• PHARMACY HEALTH Clotrimazole 6 Day Thrush Treatment.
• APO-Clotrimazole 3 Day Thrush Cream.
• Blooms The Chemist Clotrimazole 3 Day Vaginal Cream.

These medicines are approved by the Therapeutic Goods Administration (TGA), Australia's regulatory authority for therapeutic goods. The TGA notes that clotrimazole is a safe and effective treatment for vulvovaginal candidiasis caused by Candida albicans, with low potential toxicity and low potential for abuse. However, they caution that inaccurate self-diagnosis can delay appropriate treatment. For the latest updates, refer to the TGA's official website.

What Is Clotrimazole Vaginal Cream?

Clotrimazole is an azole antifungal effective against various fungal infections, particularly vulvovaginal candidiasis. It is available in cream form for intravaginal use, typically administered at bedtime for a specified duration, depending on the concentration.

A yeast infection is a common type of vaginal infection. Your doctor may call it candidiasis. This condition is caused by an organism called Candida, a yeast type. Healthy women usually have this yeast on the skin, in the mouth, in the digestive tract, and in the vagina. At times, the yeast can increase. The infection is sometimes called yeast (Candida) "overgrowth." Some women may have a yeast infection on the skin outside the vagina (vulva) associated with the vaginal infection.

A yeast infection can occur at any age. It is most common during the childbearing years. Women who are pregnant or diabetic, taking antibiotics, birth control pills, or steroids, or who have a weakened immune system are more likely to get repeated yeast infections.

Various medical conditions can damage the body's normal defences against infection. One of the most serious of these conditions is infection with the human immunodeficiency virus (HIV, the virus that causes AIDS). The HIV causes the body to be more likely to get infections, including vaginal yeast infections. Therefore, women with HIV infection may have frequent vaginal yeast infections that do not clear up quickly with proper treatment. If you may have been exposed to HIV and are experiencing repeated vaginal yeast infections, you should see your doctor right away.

Symptoms of a Vaginal Yeast Infection

There are many symptoms of a vaginal yeast infection; they include:

• vaginal itching (ranging from mild to severe);
• a clumpy vaginal discharge that may look like cottage cheese;
• vaginal soreness, irritation, or burning;
• rash or redness on the skin outside the vagina (vulvar irritation).

Forms and Dosage of Clotrimazole

Clotrimazole vaginal creams in Australia are available in various formulations:

• 1% cream: Typically used in 6-day treatment regimens.
• 2% cream: Often used in 3-day treatment courses.
• 10% cream: Designed for single-dose treatments.

How to Use Clotrimazole for Vaginal Application:

• Wash your hands before use.
• Use the provided applicator to insert the cream as high as possible into the vagina, preferably at bedtime.
• Ensure to clean the area before application and wash hands afterward.
• Avoid using tampons, douches, or spermicides during treatment, and abstain from sexual intercourse to prevent irritation and ensure effectiveness.

It's essential to follow the specific instructions provided by a healthcare professional or those on the medicine label to ensure effective treatment and avoid complications. Use the cream only for vaginal application. Keep out of your nose, mouth, and eyes (may burn). Using it at bedtime will help achieve the best results. If symptoms persist or worsen after treatment, consult a healthcare provider.

What Do I Do if I Miss a Dose?

If you forgot about your dose, use a missed dose as soon as you think about it. If it is close to your next dose, skip the missed dose and return to your schedule. Never use two doses at the same time or extra doses to avoid overdose.

Prescription

Clotrimazole Vaginal Cream is available over-the-counter (OTC) in many regions, meaning a prescription is not typically required for purchase.

Clotrimazole vaginal creams are classified as Schedule 3 (Pharmacist Only Medicines) in Australia. This means they can be purchased without a prescription. However, it is advisable to consult a healthcare provider if this is the first occurrence of symptoms or if symptoms persist.

Clinical Pharmacology

Clotrimazole is a broad-spectrum antifungal agent belonging to the imidazole class, primarily used to treat various fungal infections, including those caused by Candida species and dermatophytes.

Mechanism of Action

Clotrimazole exerts its antifungal effects primarily by inhibiting the biosynthesis of ergosterol, a crucial component of the fungal cell membrane. It blocks the enzyme lanosterol 14-alpha demethylase, which converts lanosterol to ergosterol. This inhibition disrupts the integrity and functionality of the fungal cell membrane, leading to cell death or growth inhibition. The action can be fungistatic (inhibiting growth) at lower concentrations and fungicidal (killing fungi) at higher concentrations.

Pharmacodynamics

Clotrimazole has a broad spectrum of activity against dermatophytes, yeasts, and moulds. It is effective against Trichophyton rubrum, Candida albicans, and Epidermophyton floccosum. The minimum inhibitory concentration (MIC) values for these fungi typically range from less than 0.062 to 8.0 µg/ml, depending on the organism and conditions tested.

Pharmacokinetics

Clotrimazole is administered via topical, oral (transmucosal), and intravaginal routes. Clotrimazole Vaginal Cream should be applied intravaginally. About 5% to 10% of clotrimazole is absorbed when administered vaginally. Therapeutic concentrations can persist in the vagina for up to three days post-application.

Important Safety Information

Patients should be aware of potential side effects such as vaginal burning, irritation, and abdominal cramps. If severe allergic reactions occur or symptoms do not improve after treatment, medical attention should be sought immediately.

This medicine may cause harm if swallowed. If clotrimazole vaginal cream is swallowed, call a doctor or poison control centre right away.

Condoms or diaphragms may not work to prevent pregnancy or stop the spread of diseases passed through sex while using clotrimazole vaginal cream and for some time after you stop it. Use another form of birth control during this period.

Contraindications to Clotrimazole

1. Allergy to clotrimazole. Individuals with a known hypersensitivity to clotrimazole or any components should not use this medicine.
2. Unverified vaginal infections. Do not self-treat if you have never had a vaginal yeast infection diagnosed by a healthcare provider.
3. Concurrent use with certain products. Avoid tampons, douches, spermicides, or other vaginal products during treatment, as these can interfere with effectiveness.
4. Eye contact. Avoid contact with the eyes due to severe irritation risk.

Side Effects

Users in Australia have reported side effects such as vaginal irritation, burning, or itching. These symptoms are generally mild and temporary. If symptoms persist or worsen, consult a healthcare professional. Serious allergic reactions are rare but require immediate medical attention.

Interactions of Clotrimazole Cream with Other Medicines

Clotrimazole cream has potential interactions with various medicines, but overall risk is low due to minimal systemic absorption. If you take medicines like tacrolimus or anticoagulants, consult a healthcare provider.

Overdose of Clotrimazole Cream

If you think there has been an overdose, call your poison control centre or get medical care right away.

Storage

Store at room temperature (ideally 20°C to 25°C), away from excess heat, moisture, and direct sunlight. Keep out of reach of children.

Similar Medications in Australia

Alternative antifungal treatments for vaginal thrush available in Australia include:

• Miconazole;
• Nystatin;
• Fluconazole.

Benefits of Using Clotrimazole Cream

More information can be found here, provided by the Australian Register of Therapeutic Goods (ARTG).