Candles neo penotran contraindications. Interaction Neo-penotran with other drugs. Dosage and administration

Infectious diseases of the reproductive system can hardly be considered a rarity in modern gynecological practice. Such diseases require appropriate treatment, since otherwise the appearance of various complications. Quite popular today is the drug "Neo-Penotran" (candles). Reviews of doctors and patients indicate that this drug really does its job, quickly and effectively eliminating the infection and its main symptoms.

However, patients are often interested Additional Information about this drug. What is included in its composition? What properties does it have? How to use candles correctly? Is it possible for side effects to occur during therapy? The answers to these questions will be of interest to many readers.

Composition and form of release of the drug

According to surveys of patients and doctors, this drug is in rather high demand. And it is quite natural that for many additional information about the drug is quite important.

The drug is produced in the form vaginal suppositories No. 7. Suppositories are placed in contour packs of seven pieces. The main active substance of the drug is metronidazole, a substance with antimicrobial properties. In addition, the preparation also contains miconazole nitrate. Witepsol is used as the basis for the manufacture of suppositories in an amount of 1.9 g.

Depending on the amount of active substances, it is customary to distinguish the following types of drugs:

• Candles "Neo-Penotran" contain 500 mg of metronidazole and 100 mg of miconazole nitrate.
• Candles "Neo-Penotran Forte" have a large dose of active substances, namely, 750 mg of metronidazole and 200 mg of miconazole nitrate.
• There are also vaginal suppositories Neo-Penotran Forte-L”, which also contain metronidazole and miconazole nitrate in amounts of 750 and 200 mg, respectively. In addition, the composition of the drug includes lidocaine (100 mg).

What are the pharmacological properties of the drug?

Once in the human body, the active components quickly suppress vital processes pathogenic microflora. Metronidazole blocks the process of nucleic acid synthesis, which prevents further reproduction of microorganisms. Miconazole has a detrimental effect on fungal microorganisms, as it destroys their cell walls. By the way, the most sensitive to this substance are cryptococci, candida and aspergillus.

Main indications for use

In what cases are patients prescribed the drug "Neo-Penotran"? Vaginal suppositories are used to treat the following diseases:

Suppositories are used for local treatment. In most cases, this is sufficient for complete and Get well soon. But in more severe cases Your doctor may also prescribe oral medications.

How to apply correctly?

In no case should you use this drug on your own. After all, first you need a thorough diagnosis, which is possible only in medical institution. After making a diagnosis, the doctor will select you suitable shape a drug. For example, in more severe cases, Neo-Penotral Forte candles are used.

The vaginal suppository must be inserted deep into the vagina. For this purpose, special disposable fingertips are used, which are sold complete with the drug. The procedure is preferably carried out in evening time, just before bedtime - this will allow the suppository to completely dissolve and droop into the mucous tissues.

How long should you use Neo-Penotran candles? The instruction says that the course of treatment lasts no more than seven days. Only in the most severe cases (for example, in the presence of recurrent inflammation or resistant infections), the doctor can extend the course of treatment for another week and increase daily dose up to two suppositories.

Can the drug be used during pregnancy and lactation?

As already mentioned, this medicine do not use during the first 15 weeks of pregnancy, since during this period the laying of the main organs occurs. In the future, suppositories are allowed to be used, but only after a thorough diagnosis and under the supervision of the attending physician.

The active components of the drug quickly penetrate into breast milk therefore, lactation is a contraindication to therapy. If the use of suppositories is still necessary, then for the duration of treatment you need to stop. breast-feeding.

Can the medicine be used during menstruation?

Many patients are also interested in the question of whether Neo-Penotran candles can be used during menstruation. In fact, menstruation is not a contraindication to the use of the drug. Nevertheless, some gynecologists still recommend waiting for the end of the discharge.

On the other hand, if menstruation began during therapy, then you should not interrupt the course in any case. But you need to understand that you can’t use vaginal tampons - they need to be replaced with sanitary pads.

Are there contraindications?

Of course, many patients are interested in questions about whether the drug "Neo-Penotran" (candles) has contraindications. The reviews confirm that the medicine is usually well tolerated, but, unfortunately, not all categories of women can use it.

In particular, contraindications include various violations liver function, as well as functional disorders nervous system. The drug is not prescribed to virgins, girls under 15 years of age, as well as patients with hypersensitivity to any of the constituent components. this tool. In addition, the list of contraindications should include epilepsy, convulsive states, bleeding disorders, as well as the first trimester of pregnancy.

Possible side effects

In fact, the body tolerates Neo-Penotran (candles) quite well. Reviews of patients indicate that deterioration in well-being is extremely rare. However, the likelihood of developing adverse reactions still not worth discounting.

In some cases, vaginal suppositories cause irritation of the vaginal mucosa, which is accompanied by itching and burning. These sensations can occur both after the first injection and on the second or third day of therapy. Symptoms disappear on their own immediately after the end of therapy, although severe itching and soreness are indications for discontinuation of the drug.

appear much less frequently side effects from the side digestive system. Some patients complain of nausea, vomiting, loss of appetite, as well as constipation and diarrhea. Sometimes there is a metallic taste or increased dryness in the mouth.

What other complications can Neo-Penotran candles cause? The instruction indicates that occasionally patients have symptoms from the nervous system - headaches and dizziness. With too long use of the drug, convulsions, peripheral nephropathy and some psycho-emotional disorders may appear.

In people with hypersensitivity to the components of the drug, allergic reaction, which is accompanied by the appearance of a rash, urticaria, itching, swelling and burning.

Overdose and its signs

Today, many doctors prescribe Neo-Penotran Forte candles to patients. The price of the drug is quite affordable, and the effect of its use appears quickly. Nevertheless, you need to take this medicine with caution - be sure to follow all the doctor's prescriptions.

Cases of overdose are extremely rare, but it is possible. If it enters the blood too a large number Metronidazole may cause abdominal pain, nausea and vomiting. Also, some patients complain of an unpleasant metallic taste in the mouth. An overdose of the drug can cause dizziness, convulsions, ataxia, paresthesia. In some cases, there is staining of urine in dark color. Approximately the same symptoms occur when using too much large doses miconazole.

In the presence of such violations, you should consult a doctor. Usually, specific treatment not carried out - you just need to stop taking the drug for a while. If necessary, symptomatic therapy is needed.

Interaction with other drugs

Quite often in modern gynecology use in the treatment of candles "Neo-Penotran 7". The price of the drug is quite acceptable, and its effectiveness is confirmed by practice. But if you are prescribed this medicine, be sure to tell your doctor about other medicines you are taking.

Active substances this drug interact with anticoagulants, enhancing their effect. In addition, this medicine affects the level of theophylline and procainamide in the blood. "Neo-Penotral" can also suppress the activity of certain drugs taken for violations in work of cardio-vascular system therefore, patients sometimes experience arrhythmia. The active substances of suppositories interact with lithium preparations, enhancing their damaging effect.

On the other hand, cimetidine increases blood levels of metronidazole. In the same time simultaneous reception this drug with phenobarbital leads to a decrease in the amount of metronidazole.

special instructions

Of course, many patients are interested in questions about what the drug "Neo-Penotran" (candles) is - instructions, price, indications and contraindications. But there is some additional information that you should definitely read before starting treatment.

At the time of therapy, it is worth giving up sexual intercourse. After all, the risk of infection of a partner during an act is very high. In addition, Neo-Penotran Forte candles damage rubber and latex, which makes the use of such protective equipment and contraception ineffective.

This medicine is not used to treat girls who have not had sex. According to studies, the drug does not affect the reaction rate, the ability of a person to drive a car, etc.

The drug "Neo-Penotran" (candles): price and analogues

Naturally, many patients are primarily interested in the cost of a drug. So how much will the drug "Neo-Penotran" (candles) cost? The price, of course, can fluctuate. On average, 14 suppositories will cost 700-800 rubles. "Neo-Penotran Forte" costs a little more - 900-1000 rubles. Naturally, the cost depends on the manufacturer, the form of the medicine and the financial policy of the pharmacy.

What to do if Neo-Penotran candles do not suit you? Analogues cheaper, of course, exist. For example, such agents as Labilakt, Mykozhinaks, as well as Dalacin, Lekran, Ketoconazole are considered quite effective. In some cases, doctors prescribe "Metrogil", "Vagilak" and some other medicines.

The drug "Neo-Penotran" (candles): reviews of doctors and patients

Many women today face the problem of inflammatory and infectious diseases sexual sphere. And quite often it is Neo-Penotran that helps to get rid of a particular disease.

Neo-penotran forte is an antibacterial, antiprotozoal and antimycotic drug for local application used to treat so-called " female diseases» We are talking here, first of all, about vaginitis and vaginosis bacterial etiology currently occupying a leading position in overall structure gynecological diseases. Anatomical structure vagina provides a stable normal biocenosis, the constancy of which determines the degree of protection urinary tract from invasion pathogenic microorganisms and the subsequent deployment by the latter of large-scale "combat operations". Vaginal microflora A healthy woman is represented by more than 40 types of bacteria. Among the permanent "residents" of the vagina, it is necessary to highlight Lactobacillus spp. (species L.acidophilus, L.fermentans, L. Plantarum, L. Paracasei). The stability of the microbiological status of the vagina is determined by a number of external and internal factors. The underlying reason for the development of a series of dysbiotic processes in the vagina is disadaptation. It is the quantitative shifts in bacterial species diversity that ultimately lead to the development infectious process. If one pathogenic or facultative-pathogenic type of microorganism "killed another species from the world", then this big share probability in the near future comes back to haunt infectious and inflammatory symptoms. Treatment of bacterial vaginal infections, first of all, should decide main task, namely: the elimination of pathogenic microflora and the restoration of the normal bacterial status of the vagina. Complex therapeutic measures in this regard, should include the use of antibacterial, antiprotozoal and antifungal drugs. The most effective drug local action, which equally exhibits both antibacterial and antiprotozoal effects, is metronidazole, which in addition has favorable influence on immunity, stimulating the production of interferon.

This substance is active against Trichomonas vaginalis and Gardnerella vaginalis, as well as a number of anaerobes, incl. anaerobic Streptococcus. One of the best antifungal agents is miconazole, which has a wide range actions covering, among other things, pathogenic fungi genus Candida albicans. The drug neo-penotran forte contains both of these substances as active ingredients, which gives it significant advantages over other drugs of this type. pharmacological group. Neo-penotran forte is effective in diseases such as bacterial vaginosis, vaginal candidiasis, trichomonas vaginitis, mixed vaginal infections. It is believed that drug therapy for initial stage is optimal in terms of prevention of vulvo-vaginal mycoses. As the results showed clinical trials, the frequency of successful treatment outcomes in the case of using neo-penotran forte in comparison with others medicines approaches 100%. You can use the drug, incl. and pregnant women (however, only starting from the II and III semesters). Dosage form neo-penotran forte - vaginal suppositories - endow the drug with better tolerability in comparison with oral drugs. Even taking neo-penotran forte alone is already considered a combination therapy, which has undeniable advantages over monotherapy, especially when difficult infections caused by several pathogens. In addition to this, combination therapy minimizes the risk of adverse reactions (due to the use of lower dosages) and often eliminates the individual intolerance of patients. Neo-penotran forte can also be used as a means preventive sanitation before the operation. It can be used for a week both before and after surgical intervention. According to clinical trials, the use of neo-penotran forte can halve the risk of postoperative complications.

Pharmacology

Preparation with antibacterial, antiprotozoal and antifungal action for local use in gynecology.

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

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

Miconazole nitrate has a wide spectrum of activity. It is especially active against pathogenic fungi, including Candida albicans, and is also active against 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.

Release form

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

Excipients: Witepsol S55 - 1.55 g.

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

Dosage

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

With recurrent vaginitis or vaginitis resistant to other types of treatment, 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 elderly patients over 65 years of age, dosage adjustment is not required.

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: 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.

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.

Side effects

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

Local reactions: miconazole nitrate, like all others antifungals based on imidazole derivatives, which are introduced 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 taste sensations, constipation, dry mouth, metallic taste, fatigue.

Indications

• vaginal candidiasis;
• bacterial vaginosis;
• trichomonas vaginitis;
• vaginitis caused by mixed infections.

Contraindications

• I trimester of pregnancy;
• porphyria;
• epilepsy;
• severe violations liver function;
• patients under the age of 18 due to insufficient data on the use in this age category, virgins;
• hypersensitivity to active ingredients drug or their derivatives.

Application features

Use during pregnancy and lactation

The drug can be used after the first trimester of pregnancy under medical supervision, provided that the expected benefit to the mother exceeds potential risk for 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.

Application for violations of liver function

Use in children

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.

Alcohol should be avoided during treatment and at least, within 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, it is necessary simultaneous treatment sexual partner.

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.

Last update of the description by the manufacturer 31.07.2014

Filterable List

Active substance:

Description of the dosage form

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

pharmachologic effect

Pharmacodynamics

Neo-Penotran ® suppositories contain 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 spectrum of activity (especially active against pathogenic fungi, including candida albicans- the causative agent of thrush), effective against gram-positive bacteria.

Pharmacokinetics

The bioavailability of metronidazole with intravaginal use is 20% compared with by oral administration. After vaginal administration of the drug Neo-Penotran ®, when an equilibrium state was reached, 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 determined.

Metronidazole is metabolized in the liver. The hydroxyl metabolite is active. T1/2 of metronidazole is 6-11 hours. Approximately 20% of the dose is excreted unchanged by the kidneys.

Indications for Neo-Penotran ®

vaginal candidiasis;

trichomonas vulvovaginitis;

bacterial vaginosis;

mixed vaginal infection.

Contraindications

hypersensitivity to the active components of the drug or their derivatives;

porphyria;

epilepsy;

severe liver dysfunction;

pregnancy (I trimester);

age up to 18 years (not enough data on the use in this age category);

in virgins.

Use during pregnancy and lactation

Neo-Penotran ® suppositories 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.

Side effects

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

Local reactions: miconazole nitrate, like all other antifungal imidazole derivatives that are injected into the vagina, can cause vaginal irritation (burning, itching) (in 2-6% of cases).

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 3rd 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: leukopenia, ataxia, mental changes (anxiety, mood lability), convulsions; rarely - hypersensitivity reactions, diarrhea, dizziness, headache, loss of appetite, nausea, vomiting, abdominal pain or cramps, changes in taste, constipation, dry mouth, metallic taste, increased fatigue.

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: may increase the concentration of metronidazole in the blood and increase the risk of neurological side effects.

Lithium: an increase in lithium toxicity may be observed.

Astemizole and terfenadine: Metronidazole and miconazole inhibit the metabolism of these substances and increase their plasma concentrations.

Dosage and administration

intravaginally, deep.

1 vaginal supp. at night and 1 vaginal supp. morning for 7 days.

For recurrent vaginitis or vaginitis resistant to other treatments, Neo-Penotran ® should be used for 14 days.

For elderly patients (over 65 years): the 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 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 have not been identified.

Treatment: in case of accidental ingestion of a large number of suppositories, 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.

special instructions

Preclinical data indicate no specific risk to humans based on standard safety studies, 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 possible disulfiram-like reactions.

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

The drug neo-penotran forte, intended for the local treatment of vaginitis and vaginosis, is somewhat different from all other drugs similar action. To better evaluate the possibility of using this tool, consider its main advantages and disadvantages. Let this help you decide whether you should use it for treatment or not.

The benefits of the drug

good effect

Neo-penotran is combined remedy containing two active ingredients: miconazole, the effect of which is aimed at eliminating, and metronidazole, which has a detrimental effect on some representatives of the bacterial flora. Together, these substances destroy a wide range of harmful organisms that cause thrush, microflora disorders and inflammation of the vaginal mucosa. The medicine fights the problem purposefully and effectively.
Numerous indications
Candles work well a large number diseases that have the same or nearly the same clinical manifestations. The list of indications includes the following pathologies:

- violations of the microflora of the vagina (bacterial vaginosis);

- vaginitis, including mixed origin;

- Trichomonas infection.

This greatly distinguishes the remedy from the drugs " narrow specialization”, many of which overcome only thrush.

Ease of use

As you know, gloves should be used when inserting vaginal suppositories, but the vast majority of women do not. A small but nice "chip" of the drug is that it is produced complete with rubber fingertips. Thus, manufacturers protect patients from possible complications associated with neglect of the rules of hygiene treatment.

A simple treatment regimen

It is not difficult to be treated with neo-penotran. Suppositories are placed vaginally at night for a week, that is, the course takes one package. If the patient is faced with stubborn current diseases, suppositories can be used for 2 weeks.

Disadvantages of neo-penotran forte candles

Resorptive action

Many suppositories used in gynecology do not contain substances that penetrate the bloodstream, but neo-penotran is not one of them. As already mentioned, the composition of the product contains metronidazole. This medicine has the ability to be absorbed into the blood, that is, it has a resorptive effect. About 20% of the administered dose of metronidazole inevitably penetrates into the body. On the one hand, a fifth is not so much, but on the other hand, it is enough to cause side effects. For this reason, some patients cannot be recommended penotran as the best medicine. For example, at the beginning of pregnancy and during breastfeeding, it is undesirable to use the remedy.

Frequent occurrence of local side effects

Compared to many other drugs (imidazole derivatives), the drug often gives local side effects. Up to 5% of patients note that with the start of treatment, they have increased itching and burning in the vagina. These sensations either appear after the first candle, or gradually increase by the third day of therapy. Fortunately, in most cases they do not bring severe discomfort and disappear with treatment.

In general, there is a regularity in the appearance and strength of the resulting local effects. Only the inflamed mucosa reacts to the drug; if, hypothetically, this medicine was used healthy woman It wouldn't cause her any inconvenience. Thus, the more inflammation is manifested in your illness, the more likely that you will be additionally disturbed by burning and itching.

Presence of common side effects

The tool also has common side effects which, however, are quite rare. These include skin rash, headache, loss of appetite, diarrhea or constipation, discomfort and pain in the abdomen, and a feeling of lethargy. Usually they are not so pronounced as to reduce the ability to work or otherwise significantly affect the quality of life.

Presence of contraindications

In addition to the first trimester of pregnancy and breastfeeding, neo-penotran forte has several contraindications that should never be forgotten. This is porphyria hereditary disease with impaired pigment metabolism), epilepsy, liver failure and under 18 years of age.

We are used to what more dangerous drug, the higher the bar age limit to receive it. Logically, penotran should be quite dangerous. But this is not so - it’s just that in the younger age categories it was not tested.

Interaction with other drugs

The active preparations of suppositories interact with other drugs, so it is undesirable to use them in parallel with some drugs. Joint use may lead to pathological reactions.

With simultaneous treatment with neo-penotran and anticoagulants (warfarin), there is an increase in the action of the latter and the appearance of a tendency to bleeding. If, in parallel with suppositories, a person uses disulfiram (a drug for the treatment of alcoholism), behavioral changes and even psychosis are possible. When the agent is used at the same time as cimetidine (a drug that reduces the secretion of gastric juice), cimetidine often gives side effects from the nervous system.

To use penotran or not? The decision must be made individually. Don't look at the numerical difference between the number of pluses and minuses; the main thing is which of them are most relevant in your case. Neo-penotran cannot be called an ineffective remedy, just certain precautions must be observed when using it. If you don't forget to take them into account, everything will be fine.

Instructions for use for Neo-Penotran

Registration number P N014405/01-160709

PHARMACOLOGICAL PROPERTIES

Pharmacodynamics

Neo-Penotran ® suppositories contain metronidazole, which has an antibacterial and antitrichomonal effect, and mycoiazole, 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 spectrum of activity (especially active against pathogenic fungi, including Candida albicans, the causative agent of thrush), effective against gram-positive bacteria.

Pharmacokinetics
The bioavailability of metronidazole with intravaginal use is 20% compared with oral administration. After vaginal administration of the drug Neo-Penotran, when an equilibrium state was reached, 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. The half-life of metronidazole is 6-11 hours. Approximately 20% of the dose is excreted unchanged at night.

INDICATIONS FOR USE

• vaginal candidiasis,


• bacterial vaginosis,


• trichomonas vaginitis,


• vaginitis caused by mixed infections.

PREGNANCY AND LACTATION
Neo-Penotran ® suppositories 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.

METHOD OF APPLICATION AND DOSES
Intravaginally. By 1 vaginal suppository at night and 1 vaginal suppository in the morning for 7 days. For recurrent vaginitis or vaginitis resistant to other treatments, Neo-Penotran should be used for 14 days.

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

Elderly patients (over 65): the same recommendations as for younger patients.

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

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 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; vomit; pain or cramps in the abdomen; change in taste sensations (rare); constipation; dry mouth; metallic taste; increased fatigue.

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. 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. 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.

INTERACTIONS WITH OTHER DRUGS
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: may increase the concentration of metronidazole in the blood and increase the risk of neurological side effects.
Lithium: an increase in lithium toxicity may be observed.
Astemizole and terfenadine: Metronidazole and miconazole inhibit the metabolism of these substances and increase their plasma concentrations.

SPECIAL INSTRUCTIONS
Preclinical data indicate no specific risk to humans based on standard safety studies, 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 possible disulfiram-like reactions. Caution should be exercised when using suppositories simultaneously with contraceptive diaphragms and condoms due to possible damage to the rubber of the suppository base.

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

Do not swallow or otherwise apply!

Laboratory tests
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 a car and machinery
Suppositories Neo-Penotran do not affect the ability to drive a car and work with mechanisms.

RELEASE FORM
Suppositories are vaginal. 7 suppositories in a PVC/PE plastic blister. 1 or 2 blisters, together with a package of fingertips and instructions for use, are placed in a cardboard box

STORAGE CONDITIONS
At a temperature not higher than 25°C. Do not store in refrigerator. Keep out of the reach of children.

BEST BEFORE DATE
3 years. Do not use after the expiry date stated on the packaging!

TERMS AND CONDITIONS OF DISCOUNT FROM PHARMACIES
On prescription.

MANUFACTURER
Jenafarm GmbH & Co. KG, Otho-Schott-Straße 15, D-07745, Jena, Germany
manufactured by Embil Pharmaceutical Co. Ltd., Bomoiti Birahane 40, Sisli, Istanbul, Turkey 80223
Jenapharm GmbH & Co. KG, Otto-Schott-Strape 15, D-07745, Jena, Germany,
manufactured by Embil Pharmaceutical Co. Ltd., Bomonti Birahane Sok. no. 40 80223 Sisly, Istanbul, Turkey.

Make you suffer, but heal

Benefits: Strong and fast action

Cons: Price, outrageous

If you bought Neo-Penotran - get ready for torment. I have never tried such a vigorous remedy in my life - after the introduction, the candle causes just a wild, unbearable burning sensation, as if you yourself know where the acid was poured. And do not hope that after a couple of hours it will pass - I used a candle for the night, as a result - a night without sleep. In addition, for some reason, the remedy caused an increase in itching for me with each use. When, and so, everything inside itches utterly, it’s hard to endure - your hands itch and douche and wash it all. It's good that all these sufferings eventually pay off - Neo-Penotran saved me in 4 days from the strongest thrush, which hadn't taken anything before. That's how he is - fast, strong and ruthless. And it’s also wildly expensive, it’s a pity, even for such a price, the manufacturers considered it unnecessary to make the drug more gentle.

Benefits: none

Cons: Terrible side effects

My review is extremely negative. Appointed before the colposcopy for the sanitation of the vagina. On the 1st day of admission there was only a slight burning sensation, on the 2nd day the stomach ached a little. But on the 3rd it began! My stomach hurt and spasmed, but I continued the treatment, which I greatly regretted! Day 4 ended with nausea, vomiting and very severe pain in the stomach. Acute gastritis and pancreatitis. The tests performed showed that ALT jumped up to 45 and pancreatic amylase up to 150! And this is an exacerbation of pancreatitis and liver. I lived calmly before these candles, I didn’t stick to a special diet, but here you are please. Now 2 days have passed since the cancellation of this "miracle" drug, the stomach still hurts, I can’t eat, drink, or sleep normally. Is it a loan to poison people like that? The medicine is made in Turkey, I read it late, I avoid such medicines! Girls, women, be careful with the reception. The package cost 990 rubles, the money that I will now spend on restoring the gastrointestinal tract is incommensurable! For good, you need to contact the organization that deals with drug control with a complaint, but first, you need to at least start eating and drinking normally after the miracle candles!

One shot of two birds with one stone - it's about him

Advantages: Effect, speed of action, cures several diseases at once

Disadvantages: Expensive, suppositories leak, irritate mucous membranes

Penotran is a two-in-one remedy, both an antifungal and an antibiotic. Thanks to this, the drug saves me from several problems at once - I was cured of both vaginal candidiasis and bacterial vaginitis at the same time. Not to say that I was treated with comfort - the suppositories irritate the mucous membrane very much. It is especially difficult in the first days, when the disease is very strong and the sensitivity is high because of this - when the candle begins to melt, it stings strongly and a burning sensation is felt. But as the treatment progresses, and consequently, the disease weakens, this discomfort disappears - I had to endure it for three days, clenching my teeth, then everything was fine. But my symptoms greatly weakened after the first two suppositories, and I recovered quite quickly - it took 6 days in total for both diseases to disappear without a trace. And yes, I advise you to put candles exclusively at night - they flow out, and even in the morning it’s better not to go out to people without daily, you will stain your linen.

Doesn't work well with fungus

Benefits: Convenient

Disadvantages: High price, temporary effect. candidiasis is not cured

I do not think that these suppositories will work if you have vaginal candidiasis - as I did. Antifungal component There is miconazole in it, but either the dose is small, or this substance simply works poorly, but the remedy does not cope with the fungus. In the first days, I seemed to feel better - if I used a candle before going to bed, I didn’t really suffer at night. But in the morning - apparently, as soon as the action of the candle ended - the itching returned and became as strong as it had been before. It would be correct to call the effect of the drug temporary - while I used them for 8 days, I was interrupted by a short-term relief of symptoms, and nothing more. And when I canceled it, everything returned to its previous state at all - can this be called a treatment? And all the more insulting that the candles are very expensive - about 800 rubles a pack.

Too expensive for this quality

Benefits: Finally cured

Disadvantages: Expensive, works slowly, in the early days very severe discomfort causes

Based on the price, a drug of such a cost should act with lightning speed and be very effective. But in fact, we get a complete discrepancy between price and quality. To cure ordinary vaginosis, I had to use these suppositories for about two weeks - and after all, the disease was not complicated or somehow neglected. In the first three days, I did not feel any effect of the drug at all - it itched all the same, the discharge did not decrease. But I immediately felt discomfort - the very first candle made me yell and jump, because unknown reasons in a causal place, I began to bake to horror. If it weren’t for my greed and the very toad that suffocates, I would immediately throw this package away, but it was a pity for 795 rubles. That's why I used all 14 candles. I felt better only by the seventh thing - the discharge decreased and the itching began to lose ground. And then, little by little, the symptoms subsided - by the 12th, I can say I was cured. Discomfort passed over time - either the body got used to it, or it was just some kind of reaction, but after a couple of days of this severe burning sensation I no longer felt. But the result is still disappointing - I had to suffer, be treated for a long time and spend too much money for this.

Helps quickly and efficiently

Benefits: Very good effect help very quickly, easy to use

Cons: Price bites

Super tool for fast and effective treatment. At first I had cystitis - I treated it, I treated it, I did not finish it, apparently - the infection remained and led to cervicitis. The gynecologist prescribed these suppositories - use them for two weeks, but I didn’t need so much, I managed to recover completely in 8 days. Neo-Penotral relieved the symptoms of the disease already on the first day - she introduced a candle, and after an hour and a half she already felt how the itching was weakening. For the first time during the illness, I managed to sleep (I introduced a candle at night), and in the morning, when I went to the toilet, I felt that the burning sensation was not as strong as it had been before. Further, the amount of discharge began to decrease quite rapidly, the pain in the lower back began to recede - probably, somewhere by 3-4 days I was already more than half better. What surprises me the most is how quickly the effect developed - it's just candles, not oral tablets, and still - they work perfectly. By the end of the week, I only had a slight itch, but then it disappeared completely, and that's it - the disease was eliminated. If not very high price, I would put the drug on a podium, but even so it is very good.