How to put candles neo penotran forte. How to use Neo-Penotran suppositories. What to replace (analogues). Pharmacological action Neo-penotran

Suppositories vaginal in the form of a flat body with a rounded end, from white to slightly yellowish.

Excipients: Witepsol S55 1436.75 mg.

7 pcs. - plastic blisters (1) complete with fingertips - packs of cardboard.

pharmachologic effect

suppositories Neo-Penotran Forte-L contain miconazole, which has an antifungal effect, metronidazole, which has an antibacterial and antitrichomonal effect, as well as lidocaine, which gives a local anesthetic effect.

Miconazole, which is a synthetic derivative of imidazole, has antifungal activity and has a wide spectrum of action. Particularly effective against pathogenic fungi, including Candida albicans. In addition, miconazole is effective against gram-positive bacteria. The action of miconazole is the synthesis of ergosterol in the cytoplasmic membrane. Miconazole modifies the permeability of Candida species mycotic cells and inhibits glucose uptake in vitro.

Metronidazole, which is a derivative of 5-nitroimidazole, is an antiprotozoal and antibacterial agent effective against several infections caused by anaerobic bacteria and protozoa, such as Trichomonas vaginalis, Gardnerella vaginalis and anaerobic bacteria, incl. anaerobic streptococci.

Miconazole and metronidazole do not have a synergistic or antagonistic effect when taken simultaneously.

Lidocaine stabilizes the neuronal membrane by inhibiting the ionic fluxes necessary for the emergence and conduction of impulses, thereby providing a local anesthetic effect.

Pharmacokinetics

Miconazole nitrate: absorption of miconazole nitrate with intravenous vaginal application very little (approximately 1.4% of the dose). Miconazole nitrate can be determined in plasma within three days after intravaginal administration of Neo-Penotran Forte-L suppositories.

Metronidazole: the bioavailability of metronidazole with intravaginal administration is 20% compared with by oral administration. The equilibrium concentration of metronidazole in plasma is 1.1-5.0 μg / ml after daily intravaginal administration of Neo-Penotran Forte-L suppositories for 3 days. Metronidazole is metabolized in the liver by oxidation. The main metabolites of metronidazole are hydroxy derivatives and compounds acetic acid excreted by the kidneys. The biological activity of hydroxy metabolites is 30% of biological activity metronidazole. T 1 / 2 metronidazole is 6-11 hours. After oral or intravenous administration of metronidazole, 60-80% of the dose is excreted by the kidneys (about 20% - unchanged, and in the form of metabolites).

Lidocaine: action begins in 3-5 minutes. Lidocaine is absorbed when topically applied to damaged skin and mucous membrane and is rapidly metabolized in the liver. Metabolites and medicinal product unchanged (10% of the administered dose) is excreted through the kidneys. After daily intravaginal administration of Neo-Penotran Forte-L suppositories for 3 days, lidocaine is absorbed into minimum quantity, and its plasma levels are 0.04-1 µg/ml.

Indications

Vaginal candidiasis caused by Candida albicans;

Bacterial vaginitis caused by anaerobic bacteria and Gardnerella vaginalis, trichomonas vaginitis caused by Trichomonas vaginalis;

Mixed vaginal infections.

Dosing regimen

At recurrent disease or vaginitis resistant to other treatment it is recommended to extend the course of treatment up to 14 days.

Suppositories should be inserted in the supine position deep into the vagina using the supplied disposable fingertips.

Side effect

AT rare cases hypersensitivity reactions are observed ( skin rashes) and such side effects like stomach pains headache, vaginal itching, burning and irritation of the vagina.

The incidence of systemic side effects is very low, because with vaginal use of metronidazole contained in Neo-Penotran Forte-L vaginal suppositories, the plasma concentration of metronidazole is very low (2-12% compared with oral administration).

miconazole nitrate like all the others antifungals based on imidazole derivatives, which are introduced into the vagina, can cause vaginal irritation (burning, itching) (2-6%). Such symptoms can be eliminated by the local anesthetic action of lidocaine. In case of severe irritation, treatment should be discontinued.

For side effects due to systemic application metronidazole, include hypersensitivity reactions (rare), leukopenia, ataxia, psycho-emotional disturbances, peripheral neuropathy in overdose and long-term use, convulsions; diarrhea (rare), constipation, dizziness, headache, loss of appetite, nausea, vomiting, pain or cramps in abdominal cavity, change taste sensations(rare), dry mouth, metallic or bad taste, fatigue. These side effects occur in extremely rare cases, since blood levels of metronidazole with intravaginal use are very low.

Contraindications for use

I trimester of pregnancy;

Porfiria;

Epilepsy;

Severe liver dysfunction;

Hypersensitivity to the components of the drug.

Use during pregnancy and lactation

Metronidazole and lidocaine belong to category B, miconazole - to category C. After the first trimester of pregnancy, Neo-Penotran Forte-L can be used under medical supervision in cases where the expected benefit exceeds potential risk for the fetus.

Breastfeeding should be stopped, because. metronidazole penetrates into breast milk. Feeding can be resumed 24-48 hours after the end of treatment. It is not known whether lidocaine passes into breast milk. A lactating woman should take lidocaine with caution.

Application for violations of liver function

Contraindicated in severe liver failure.

In patients with reduced liver function, the half-life of lidocaine may increase by a factor of two or more.

Application for violations of kidney function

Use in children

special instructions

Alcohol should be avoided during treatment and at least, within 24-48 hours after the end of the course due to possible disulfiram-like reactions. Large doses and prolonged systematic use of the drug can cause peripheral neuropathy and convulsions. Caution should be exercised when using suppositories simultaneously with contraceptive diaphragms and condoms due to possible interaction rubber with the basis of suppositories.

In patients diagnosed with trichomonas vaginitis, it is necessary simultaneous treatment sexual partner.

At kidney failure the dose of metronidazole should be reduced.

At serious violations liver function, the clearance of metronidazole may be impaired.

Metronidazole may cause symptoms of encephalopathy due to elevated levels in plasma and should therefore be used with caution in patients with hepatic encephalopathy.

In patients suffering from hepatic encephalopathy, the daily dose of metronidazole should be reduced to 1/3.

In patients with reduced liver function, the half-life of lidocaine may increase two or more times.

Decreased renal function does not affect the pharmacokinetics of lidocaine, but may cause accumulation of metabolites.

Influence on the ability to drive vehicles and control mechanisms

Suppositories Neo-Penotran Forte-L do not affect the ability to drive a car and work with mechanisms.

Preclinical safety data

Preclinical studies of safety, pharmacology, repeated dose toxicity, genotoxicity, carcinogenic potential, reproductive toxicity have not identified a potential risk to humans.

Overdose

Symptoms: nausea, vomiting, abdominal pain, diarrhea, itching, metallic taste in the mouth, ataxia, paresthesia, convulsions, leukopenia, dark urine. Symptoms of an overdose of miconazole nitrate are nausea, vomiting, dryness in the larynx and mouth, anorexia, headache, diarrhea.

Treatment: in case of accidental ingestion of a large dose of the drug, if necessary, gastric lavage can be done. There is no specific antidote; applied symptomatic treatment. Treatment should be administered to persons who have taken a dose of 12 g of metronidazole.

drug interaction

As a result of the absorption of metronidazole, the following interactions may occur:

Alcohol: disulfiram-like reactions.

Oral anticoagulants: enhancement of the anticoagulant effect.

Phenytoin: an increase in phenytoin levels and a decrease in the level of metronidazole in the blood.

Phenobarbital: decrease in the level of metronidazole in the blood.

Disulfiram: changes from the side of the central nervous system are possible (for example, mental reactions).

Cimetidine: it is possible to increase the level of metronidazole in the blood and, therefore, increase the risk of neurological side effects. Lithium: Lithium toxicity may increase.

Astemizole and terfenadine: Metronidazole and miconazole inhibit the metabolism of these compounds and increase their plasma concentration.

There is an effect on blood levels of liver enzymes, glucose (when determined by the hexokinase method), theophylline and procainamide.

Terms and conditions of storage

Store the drug at a temperature not exceeding 25°C. Do not store in refrigerator. Store in original packaging.

Keep out of the reach of children.

Shelf life - 2 years. Do not use after the expiration date

Last update of the description by the manufacturer 31.07.2014

Filterable List

Active substance:

Compound

Description of the dosage form

Vaginal suppositories in the form of a flat body with a rounded end, from white to slightly yellowish.

pharmachologic effect

Pharmacodynamics

Neo-Penotran ® Forte L suppositories contain miconazole, which has an antifungal effect, metronidazole, which has an antibacterial and antitrichomonal effect, and lidocaine, which has a local anesthetic effect.

miconazole, which is a synthetic derivative of imidazole, has antifungal activity and has a wide spectrum of action. Particularly effective against pathogenic fungi, including candida albicans. In addition, miconazole is effective against gram-positive bacteria. The action of miconazole is the synthesis of ergosterol in the cytoplasmic membrane. Miconazole changes the permeability of the mycotic cell candida species and inhibits glucose uptake in vitro.

metronidazole, which is a derivative of 5-nitroimidazole, is an antiprotozoal and antibacterial agent effective against several infections caused by anaerobic bacteria and protozoa, such as Trichomonas vaginalis, Gardnerella vaginalis and anaerobic bacteria, incl. anaerobic streptococci. Miconazole and metronidazole do not have a synergistic or antagonistic effect when taken simultaneously.

Lidocaine stabilizes the neuronal membrane by inhibiting the ionic fluxes necessary for the emergence and conduction of impulses, thereby providing a local anesthetic effect.

Pharmacokinetics

Miconazole nitrate: absorption of miconazole nitrate when administered intravaginally is very small (approximately 1.4% of the dose). Miconazole nitrate can be determined in plasma within 3 days after intravaginal administration of Neo-Penotran ® Forte L suppositories.

Metronidazole: the bioavailability of metronidazole with intravaginal administration is 20% compared with oral administration. C ss of metronidazole in plasma is 1.1-5 μg / ml after daily intravaginal administration of Neo-Penotran ® Forte L suppositories for 3 days. Metronidazole is metabolized in the liver by oxidation. The main metabolites of metronidazole - hydroxy derivatives and acetic acid compounds - are excreted by the kidneys. The biological activity of hydroxymetabolites is 30% of the biological activity of metronidazole. T 1/2 of metronidazole is 6-11 hours. After oral or intravenous administration of metronidazole, 60-80% of the dose is excreted by the kidneys (about 20% - unchanged, and in the form of metabolites).

Lidocaine: action begins in 3-5 minutes. Lidocaine is absorbed when applied superficially to damaged skin and mucous membranes and is rapidly metabolized in the liver. Metabolites and the drug in unchanged form (10% of the administered dose) are excreted through the kidneys. After daily intravaginal administration of Neo-Penotran ® Forte L suppositories for 3 days, lidocaine is absorbed in a minimal amount, and its plasma levels are 0.04-1 μg / ml.

Indications for Neo-Penotran ® Forte L

vaginal candidiasis caused by candida albicans;

bacterial vaginitis caused by anaerobic bacteria and Gardnerella vaginalis;

trichomonas vaginitis caused by Trichomonas vaginalis;

mixed vaginal infections.

Contraindications

hypersensitivity to the components of the drug;

I trimester of pregnancy;

porphyria;

epilepsy;

severe liver dysfunction.

Use during pregnancy and lactation

After the first trimester of pregnancy, Neo-Penotran ® Forte L can be used under medical supervision in cases where the intended benefit outweighs the potential risk to the fetus.

Breastfeeding should be stopped, because. metronidazole passes into breast milk. Feeding can be resumed 24-48 hours after the end of treatment. It is not known whether lidocaine passes into breast milk. Breastfeeding women should use lidocaine with caution.

Side effects

In rare cases, hypersensitivity reactions (skin rashes) and side effects such as abdominal pain, headache, vaginal itching, burning and irritation of the vagina are observed.

The incidence of systemic side effects is very low, because with vaginal use of metronidazole contained in Neo-Penotran ® Forte L vaginal suppositories, the plasma concentration of metronidazole is very low (2-12% compared with oral administration). Miconazole nitrate, like all other antifungal agents based on imidazole derivatives that are injected into the vagina, can cause vaginal irritation (burning, itching - 2-6%). Such symptoms can be eliminated by the local anesthetic action of lidocaine. In case of severe irritation, treatment should be discontinued.

Side effects caused by the systemic use of metronidazole include hypersensitivity reactions (rarely), leukopenia, ataxia, psychoemotional disorders, peripheral neuropathy with overdose and prolonged use, convulsions; diarrhea (rare), constipation, dizziness, headache, loss of appetite, nausea, vomiting, abdominal pain or cramps, change in taste (rare), dry mouth, metallic or unpleasant taste, increased fatigue. These side effects occur in extremely rare cases, since blood levels of metronidazole with intravaginal use are very low.

Interaction

As a result of the absorption of metronidazole, the following interactions may occur.

Alcohol: disulfiram-like reactions.

Oral anticoagulants: enhancement of the anticoagulant effect.

Phenytoin: an increase in phenytoin levels and a decrease in the level of metronidazole in the blood.

Phenobarbital: decrease in the level of metronidazole in the blood.

Disulfiram: changes from the side of the central nervous system are possible (for example, mental reactions).

Cimetidine: it is possible to increase the level of metronidazole in the blood and, therefore, increase the risk of neurological side effects.

Lithium: possible increase in lithium toxicity.

Astemizole and terfenadine: Metronidazole and miconazole inhibit the metabolism of these compounds and increase their plasma concentration.

There is an effect on blood levels of liver enzymes, glucose (when determined by the hexokinase method), theophylline and procainamide.

Dosage and administration

Intravaginally. Suppositories should be administered in the supine position, deep into the vagina.

In case of recurrent disease or vaginitis resistant to other treatment, it is recommended to extend the course of treatment up to 14 days.

Overdose

Symptoms: with an overdose of metronidazole - nausea, vomiting, abdominal pain, diarrhea, itching, metallic taste in the mouth, ataxia, paresthesia, convulsions, leukopenia, dark urine; with an overdose of miconazole nitrate - nausea, vomiting, dryness in the larynx and mouth, anorexia, headache, diarrhea.

Treatment: is prescribed to persons who have taken a dose of 12 g of metronidazole. In case of accidental ingestion of a large dose of the drug, if necessary, gastric lavage can be done; symptomatic treatment is carried out. There is no specific antidote.

special instructions

It is necessary to avoid alcohol during treatment and at least for 24-48 hours after the end of the course due to possible disulfiram-like reactions. Large doses and prolonged systematic use of the drug can cause peripheral neuropathy and convulsions. Caution should be exercised when using suppositories simultaneously with contraceptive diaphragms and condoms due to the possible interaction of rubber with the suppository base.

In patients diagnosed with trichomonas vaginitis, simultaneous treatment of the sexual partner is necessary.

In renal insufficiency, the dose of metronidazole should be reduced. In severe hepatic impairment, the clearance of metronidazole may be impaired. Metronidazole may cause symptoms of encephalopathy due to elevated plasma levels and should therefore be used with caution in patients with hepatic encephalopathy (daily dose of metronidazole should be reduced to 1/3).

In patients with reduced liver function T 1/2 lidocaine may increase by 2 or more times. Decreased renal function does not affect the pharmacokinetics of lidocaine, but may cause accumulation of metabolites.

Composition and form of release

Vaginal suppositories - 1 supp. metronidazole (micronized) - 750 mg miconazole nitrate (micronized) - 200 mg excipients: witepsol S 55 - 1550 mg in a blister of 7 pcs.; in a cardboard pack 1 blister with a package of fingertips.

Description of the dosage form

Vaginal suppositories in the form of a flat body with a rounded end, white or almost white color.

Pharmacokinetics

The bioavailability of metronidazole with intravaginal use is 20% compared with by oral administration. After vaginal administration of the drug Neo-Penotran® Forte, upon reaching an equilibrium state, the plasma concentration of metronidazole was 1.6-7.2 μg / ml. Systemic absorption of miconazole nitrate with this route of administration is very low (approximately 1.4% of the dose), miconazole nitrate in plasma was not detected. Metronidazole is metabolized in the liver. The hydroxyl metabolite is active. T1 / 2 metronidazole - 6-11 hours. Approximately 20% of the dose is excreted unchanged by the kidneys.

Pharmacodynamics

The drug contains metronidazole, which has an antibacterial and antitrichomonal effect, and miconazole, which has an antifungal effect. Metronidazole is an antibacterial and antiprotozoal agent and is active against Gardnerella vaginalis and anaerobic bacteria including anaerobic streptococcus and Trichomonas vaginalis. Miconazole nitrate has a wide range action (especially active against pathogenic fungi, including Candida albicans - the causative agent of thrush), effective against gram-positive bacteria.

Indications for use

- vaginal candidiasis;

— bacterial vaginosis;

- Trichomonas vaginitis;

- vaginitis caused by mixed infections.

Contraindications for use

- I trimester of pregnancy;

- porphyria;

- epilepsy;

- severe liver dysfunction;

- patients under the age of 18 due to insufficient data on the use in this age category, virgins;

— hypersensitivity to active components drug or their derivatives.

Use in pregnancy and children

The drug can be used after the first trimester of pregnancy under medical supervision, provided that the intended benefit to the mother outweighs the potential risk to the fetus.

Stop during treatment breast-feeding because metronidazole passes into breast milk. Breastfeeding can be resumed 24-48 hours after the end of treatment.

Contraindication: patients under the age of 18 due to insufficient data on the use in this age group, virgins.

Side effects

Rarely, hypersensitivity reactions may occur ( skin rash) and side effects such as abdominal pain, headache, vaginal itching, burning, and irritation of the vagina.

Local reactions: miconazole nitrate, like all other antifungal agents based on imidazole derivatives that are injected into the vagina, can cause vaginal irritation (burning, itching) (2-6%). Due to inflammation of the vaginal mucosa with vaginitis, vaginal irritation (burning, itching) may increase after the introduction of the first suppository or by the third day of treatment. These complications quickly disappear as treatment continues. At strong irritation treatment should be discontinued.

Systemic side effects are very rare, since plasma levels of metronidazole are very low during vaginal absorption. Side effects associated with systemic absorption of metronidazole include: hypersensitivity reactions (rarely), leukopenia, ataxia, mental changes (anxiety, mood lability), convulsions; rarely - diarrhea, dizziness, headache, loss of appetite, nausea, vomiting, abdominal pain or cramps, change in taste, constipation, dry mouth, metallic taste, increased fatigue.

drug interaction

Alcohol: The interaction of metronidazole with alcohol can cause disulfiram-like reactions. Oral anticoagulants: increased anticoagulant action. Phenytoin: a decrease in the concentration of metronidazole in the blood while increasing the concentration of phenytoin. Phenobarbital: decrease in the concentration of metronidazole in the blood. Disulfiram: possible side effects from the central nervous system (psychotic reactions). Cimetidine: The concentration of metronidazole in the blood may increase and the risk of developing neurological side effects may increase. Lithium: There may be an increase in lithium toxicity. Astemizole and terfenadine: metronidazole and miconazole inhibit the metabolism of these substances and increase their plasma concentration.

Dosage

Intravaginally, 1 vaginal suppository is injected deep into the vagina for 7 days at night.

For recurrent vaginitis or vaginitis resistant to other types of treatment, within 14 days.

Suppositories should be inserted deep into the vagina using the disposable fingertips that come with the package.

Elderly patients (over 65 years old) - same recommendations as for younger patients.

Overdose

Data on overdose in humans with intravaginal use of metronidazole are not available. However, when administered intravaginally, metronidazole may be absorbed in sufficient amounts to cause systemic effects. Symptoms of an overdose of metronidazole: nausea, vomiting, abdominal pain, diarrhea, generalized itching, metallic taste in the mouth, movement disorders(ataxia), dizziness, paresthesia, convulsions, peripheral neuropathy(including after prolonged use in high doses), leukopenia, dark urine. Symptoms of an overdose of miconazole nitrate have not been identified. Treatment: symptomatic and supportive therapy. In case of accidental ingestion a large number suppositories if necessary - gastric lavage. Improvement in the condition after being achieved in individuals who have taken orally up to 12 g of metronidazole. There is no specific antidote.

First, about the differences between Neo-Penotran and Neo-Penotran Forte:

• Composition: Regular contains 500 mg of metronidazole and 100 mg of miconazole, Forte - 750 mg of metronidazole and 200 mg of miconazole;
• Normal put 2 times a day for 7 days, Forte once a day (at night), also 7 days. At the same time, the packaging of both is enough for a course of treatment, the price is comparable;
• Normal can be from 14 years old, Forte from 18.

"Neo-Penotran Forte" is an antifungal and antibacterial drug used to treat genital infections and inflammatory diseases pelvis, vulva and vagina.

The tool is available in the form vaginal suppositories for auxiliary (or main) therapy of chlamydia, bacterial vaginosis, thrush and other infectious diseases.

There is a variation with lidocaine, to reduce discomfort during treatment, it is called Neo-Penotran Forte L.

When is it applied?

"Neo-Penotran Forte" is active against most gram-positive and anaerobic bacteria, and also quickly copes with fungi (thanks to miconazole, which is part of the drug). The drug is used to treat the following diseases:

• bacterial vaginosis;
• thrush (candidiasis) of the vagina and vulva;
• vaginitis caused by the pathogenic activity of Trichomonas;
• urogenital trichomoniasis;
• vulvitis;
• other vaginitis infectious origin;
• inflammatory pathologies pelvic organs.

Before prescribing the drug, you should undergo an examination to clarify the cause that caused the development of the pathogenic process.

How to apply?

Candles "Neo-Penotran Forte" should be inserted into the vagina a few centimeters. Before the introduction procedure, you must wash your hands or treat them with an antiseptic solution.

Despite the presence of fingertips in the kit, attention must be paid to nail hygiene - too long nail plates can scratch the vaginal mucosa, which can lead to the penetration of bacteria or germs and secondary infection.

Daily dosage for all categories of patients is 1 suppository. The duration of treatment is a week. For elderly patients there are no special recommendations for use.

Note! If necessary (for example, with a relapse of the disease), Neo-Penotran Forte can be used for two weeks.

Contraindications

Suppositories "Neo-Penotran Forte" cannot be prescribed to women if there is at least one indication from the list below:

• allergy or intolerance to the components of the drug;
• epilepsy;
• liver disease;
• pregnancy (1 trimester);
• porphyria;
• Availability hymen(virginity).

Important! For girls and girls under the age of 18, Neo-Penotran Forte is not prescribed due to the lack of clinical data on the use of the drug at this age.

Pregnancy and lactation

The drug is approved for use during pregnancy, starting from 12-14 weeks of gestation.

In the first trimester, the use of suppositories can provoke complications, as well as affect the formation internal organs fetus.

Treatment of pregnant patients is carried out strictly according to the indications and under the supervision of a gynecologist or other specialized specialist.

At the time of therapy, lactating women should stop lactation, since metronidazole passes into breast milk in significant concentrations.

You can resume feeding the child in 1-2 days - this is the period of excretion of the active substance from the body, consult your doctor about the timing of interrupting feeding.

During menstruation

The logic is as follows: if treatment can be planned in advance, then it is better to carry it out before or after menstruation. If the monthly began unexpectedly, then it is impossible to interrupt the treatment in any case. Put a candle at night, after that try not to get up, use pads.

The effectiveness of any suppositories decreases during menstruation, but this is not a reason to panic. In most cases, treatment is successful.

Overdose

Cases of overdose have not been registered.

Side effects

During therapy, there may be negative reactions most often local. These include itching and burning, as well as redness of the vagina of the vulva.

To avoid itching and burning, use Neo-Penotran Forte L, which contains lidocaine.

Much less often, "Neo-Penotran Forte" causes systemic reactions (less than 7% of all cases of diagnosing side effects), for example:

• stomach ache;
• constipation and diarrhea;
• other digestive disorders (nausea, vomiting, etc.);
• leukopenia;
• increased anxiety;
• psychoses;
• unpleasant bitterness in the mouth;
• convulsive syndrome;
• dry mucous membranes oral cavity;
• headache;
• loss of appetite.

Note! Systemic phenomena when using "Neo-Penotran Forte" practically do not occur due to the low concentration of active substances in the blood plasma when applied topically.

Composition and form of release

Suppositories "Neo-Penotran Forte" consist of only three components.

• Metronidazole (750 mg). It has an antibacterial effect, as well as antiprotozoal properties. Destroys anaerobic bacteria, including streptococci, gardnerella, Trichomonas, etc.
• Miconazole (as miconazole nitrate, 200 mg). Antifungal component, especially effective against fungi of the genus Candida, which cause the development of thrush. Fights most Gram-positive microorganisms.
• Witepsol. A mixture of saturated fatty acids for the production of suppositories (base).

The drug is available in the form vaginal suppositories white, placed in a blister of 7 pieces each. Included with the drug is an instruction manual and 7 fingertips.

Neo-Penotran Forte L differs only in the addition of lidocaine (100 mg per supp.), Due to this, discomfort when using the medicine.

Pharmacokinetics

Miconazole at local use in the blood plasma is not found. Metronidazole binds to plasma by 20%. The maximum concentration is reached within 2-4 hours.

The half-life of metronidazole is 6 to 11 hours. The substance is excreted with the kidneys (about 20% - unchanged). Metabolized in the liver.

Interaction with other substances

special instructions

• No alcohol allowed(any dose) during treatment, as well as 48 hours after its completion. In combination with alcohol, the drug can cause disulfiram-like reactions (nausea, vomiting, and others).
• It is recommended to avoid sexual intercourse when using Neo-Penotran Forte, as the rubber of the condom may be damaged (the components that make up the basis for the manufacture of suppositories).

Storage

The drug can be stored at room temperature or in the refrigerator (not lower than 2 degrees). Freezing suppositories is not allowed! Candles can be stored for 2 years within the expiration date.

Reviews

(Leave your feedback in the comments)

I was prescribed "Neo-Penotran Forte" even during pregnancy for the treatment of trichomoniasis. When used, there was a slight burning sensation, but this lasted about 2-3 days, and did not cause severe discomfort. Inserted candles for 7 days. It helped very well, so I don’t understand those who say that the remedy is expensive. There are drugs and cheaper, but with much large quantity side effects and less success. Save on health, I think it's not worth it.

She was treated with Neo-Penotran Forte a month ago. I have chronic thrush What have I not tried! A lot of money was thrown away, but little helped. As a result, I bought this drug through a friend (it is sold by prescription, you can’t just buy it) and finally got rid of the problem. If this happens again, I will immediately ask the doctor for a prescription for Neo-Penotran Forte.

* - The average value among several sellers at the time of monitoring, is not public offer

21 comments

Most the best drug from bacterial vaginitis, with thrush, it also helps a lot! I advise everyone! The first and third days there is a slight burning sensation, this is normal. On the third day, all the symptoms completely go away, but the main thing is to finish everything to the end! Once again super! I wish you all good health!

Please help me insert candles neo penotran and after 15 minutes they flow out, I would like to know if they help and after what time they begin to act?

• Hello,

  It is better to put any candles at night, after that it is advisable not to get up. If prescribed 2 times a day, then it's okay, active substance still gets where it needs to go. Don't forget to use daily.

Help, I came to the doctor with a complaint of discharge (a month ago I had thrush, I drank a flucostat), I also took a swab for pain when urinating (liquid, white), when I came to find out the analysis, the doctor said that elevated white blood cells, advised Neo-Penotran Forte, they also sent me to a urologist, there I passed urine, but they didn’t find anything in the urine, I’ve already inserted suppositories 4 times, but the pain during urination remained, what could it be?

pharmachologic effect

A drug with antibacterial, antiprotozoal and antifungal activity for local application in gynecology.

The drug contains metronidazole, which has an antibacterial and antiprotozoal effect, and miconazole, which has an antifungal effect.

Metronidazole active against Gardnerella vaginalis, Trichomonas vaginalis, anaerobic bacteria, including anaerobic streptococcus.

Miconazole nitrate has a wide spectrum of activity. Especially active against pathogenic fungi, including Candida albicans, also active for gram-positive bacteria.

Pharmacokinetics

Suction

The bioavailability of metronidazole with intravaginal use is 20% compared with oral administration. After vaginal administration, upon reaching the equilibrium state, the plasma concentration of metronidazole was 1.6-7.2 μg / ml. Systemic absorption of miconazole nitrate with this route of administration is very low (approximately 1.4% of the dose), miconazole nitrate in plasma was not detected.

Metabolism and excretion

Metronidazole is metabolized in the liver. The hydroxyl metabolite is active.

T1 / 2 metronidazole is 6-11 hours. Approximately 20% of the dose is excreted unchanged by the kidneys.

Indications

- vaginal candidiasis;

- bacterial vaginosis;

- Trichomonas vaginitis;

- vaginitis caused by mixed infections.

Dosing regimen

The drug is administered intravaginally, 1 suppository at night for 7 days.

At recurrent vaginitis or vaginitis resistant to other treatments, Neo-Penotran ® Forte should be used within 14 days.

Vaginal suppositories should be inserted deep into the vagina using the disposable fingertips contained in the package.

For

Side effect

AT rare cases hypersensitivity reactions (skin rash) and side effects such as abdominal pain, headache, vaginal itching, burning and irritation of the vagina may be observed.

Local reactions: miconazole nitrate, like all other antifungal agents based on imidazole derivatives that are injected into the vagina, can cause vaginal irritation (burning, itching) (2-6%). Due to inflammation of the vaginal mucosa with vaginitis, vaginal irritation (burning, itching) may increase after the introduction of the first suppository or by the third day of treatment. These complications quickly disappear as treatment continues. If irritation is severe, treatment should be discontinued.

Systemic side effects occur very rarely, since the level of metronidazole in plasma is very low during vaginal absorption. Side effects associated with systemic absorption of metronidazole include: hypersensitivity reactions (rarely), leukopenia, ataxia, mental changes (anxiety, mood lability), convulsions; rarely - diarrhea, dizziness, headache, loss of appetite, nausea, vomiting, abdominal pain or cramps, change in taste, constipation, dry mouth, metallic taste, increased fatigue.

Contraindications for use

- I trimester of pregnancy;

- porphyria;

- epilepsy;

- severe liver dysfunction;

- patients under the age of 18 due to insufficient data on the use in this age category, virgins;

- hypersensitivity to the active components of the drug or their derivatives.

Use during pregnancy and lactation

The drug can be used after the first trimester of pregnancy under medical supervision, provided that the intended benefit to the mother outweighs the potential risk to the fetus.

At the time of treatment, breastfeeding should be stopped, since metronidazole passes into breast milk. Breastfeeding can be resumed 24-48 hours after the end of treatment.

Use in children

Contraindication: patients under the age of 18 due to insufficient data on the use in this age group, virgins.

Overdose

Data on overdose in humans with intravaginal use of metronidazole are not available. However, when administered intravaginally, metronidazole may be absorbed in sufficient amounts to cause systemic effects.

Symptoms metronidazole overdose: nausea, vomiting, abdominal pain, diarrhea, generalized itching, metallic taste in the mouth, movement disorders (ataxia), dizziness, paresthesia, convulsions, peripheral neuropathy (including after prolonged use in high doses), leukopenia, dark urine .

Symptoms of an overdose of miconazole nitrate not identified.

Treatment: in case of accidental ingestion of a large number of suppositories, if necessary, gastric lavage can be performed. Improvement after this can be achieved in individuals who have taken orally up to 12 g of metronidazole. There is no specific antidote. Symptomatic and supportive therapy is recommended.

drug interaction

The interaction of metronidazole with ethanol can cause disulfiram-like reactions.

With the simultaneous use of Neo-Penotran Forte with oral anticoagulants, an increase in anticoagulant action is noted.

With the simultaneous use of Neo-Penotran Forte with phenytoin, there is a decrease in the concentration of metronidazole in the blood while increasing the concentration of phenytoin.

With the simultaneous use of Neo-Penotran Forte with phenobarbital, a decrease in the concentration of metronidazole in the blood is noted.

With the simultaneous use of Neo-Penotran Forte with disulfiram, side effects from the central nervous system (psychotic reactions) are possible.

With the simultaneous use of Neo-Penotran Forte with cimetidine, the concentration of metronidazole in the blood may increase and the risk of developing neurological side effects may increase.

With the simultaneous use of Neo-Penotran Forte with lithium, an increase in lithium toxicity may be observed.

With the simultaneous use of Neo-Penotran Forte with astemizole and terfenadine, metronidazole and miconazole suppress the metabolism of these substances and increase their plasma concentrations.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Terms and conditions of storage

The drug should be stored out of the reach of children at a temperature not exceeding 25 ° C. Do not store in refrigerator. Shelf life - 2 years.

Application for violations of liver function

Contraindicated in severe violations liver function.

Use in elderly patients

For elderly patients over 65 years of age correction of the dosing regimen is not required.

special instructions

Preclinical data suggest no specific risk to humans based on results standard research safety, pharmacology, repeated dose toxicity, genotoxicity, carcinogenic potential, reproductive system toxicity.

It is necessary to avoid alcohol during treatment and at least for 24-48 hours after the end of the course due to the development of possible disulfiram-like reactions.

Caution should be exercised when using suppositories simultaneously with contraceptive diaphragms and condoms due to possible damage rubber base suppositories.

In patients with trichomonas vaginitis, simultaneous treatment of the sexual partner is necessary.

The patient should be informed that the suppositories should not be swallowed or used in any other way.

It is possible to change the results when determining the level of liver enzymes, glucose (hexokinase method), theophylline and procainamide in the blood.

Influence on the ability to drive vehicles and control mechanisms

The drug does not affect the ability to drive vehicles and control mechanisms.