Why do I Need this Clotrimazole Thrush Treatment Pessary Treatment?

The thrush pessary contains the active ingredient clotrimazole. Clotrimazole is an anti-fungal medicine that kills the fungi which is causing the infection. As the pessary is inserted into the vagina it gets straight to the infection and a single dose is usually all that is required. Symptoms should disappear within a few days, it is recommended that a clotrimazole cream is also used to relieve any external irritation at the same time as the clotrimazole thrush treatment pessary.

Before starting this treatment you are advised to read the Patient Information leaflet.

What is thrush?

Thrush is the term used for a common infection caused by a yeast like fungus called candida albicans. Thrush is also known as candidiasis. Vaginal thrush is a very common infection that affects women of all ages and most women will get thrush at least once during their lives. For more information about thrush click here.

What causes thrush?

Thrush is caused by a yeast that normally lives harmlessly in the body. Yeasts like warm and moist conditions and so can develop in areas like this, for example the mouth and vagina. The yeast is usually kept under control by harmless bacteria but sometimes conditions change, and yeast can grow. Thrush is particularly common because of hormonal changes, such as during pregnancy or in women under the age of 20.

Other reasons why the yeast may grow, causing thrush to develop, include:

• If you suffer from diabetes and your blood sugar levels are poorly controlled.
• If you are ill, run down or short of sleep.
• Taking the contraceptive pill.
• Taking certain antibiotics may cause infection as they kill the good bacteria in the vagina, allowing the yeast to multiply and cause infection.
• Having sex with someone who has a thrush infection.

How is thrush treated?

Thrush is cured easily by anti-fungal treatments that stop the growth of the yeast. If you have had thrush before and are confident that is what you have, then these treatments can be purchased from our website. Treatments available can be in the form of a cream or a pessary (a tablet that is inserted into the vagina, like the way you would insert a tampon). It is usually recommended to use both the cream and pessary as the cream can help soothe the irritation immediately.

When should I go to the doctor?

Once you have had thrush you will then recognise it if you get it again. However, if you have an itch and a discharge that you have not had before, you should visit your doctor or local G.U.M. clinic. You should also visit your doctor if you:

• Have not had thrush before.
• Are pregnant or think you might be.
• Have had more than 2 attacks of thrush in the last 6 months.
• Have any abnormal vaginal bleeding.
• Are under the age of 16 or over 60.
• Have abdominal (stomach) pain.
• Suffer from any blisters or sores in the genital area.
• Have a weakened immune system.
• Suffer from diabetes.
• Or there is no improvement after 7 days of treatment.

Thrush isn’t a sexually transmitted disease, but it may sometimes be passed on during sex so try to avoid sex during an infection. It may also be a good idea for your partner to be treated as well.

The symptoms of thrush may go away without treatment, but it can get very sore, complications are very rare.

If your thrush keeps returning your doctor might suggest a course of anti-fungal tablets.

For more information from the NHS click here.

Before you use this product

Do not use Clotrimazole if:
You are allergic (hypersensitive) to Clotrimazole, imidazoles, other vaginal anti−fungal products or any of the other ingredients of this medicinal product
You suffer from any of the following symptoms:
− Irregular vaginal bleeding
− Abnormal vaginal bleeding or a blood−stained discharge
− Vulval or vaginal ulcers, blisters or sores
− Lower abdominal pain
− Pain when passing urine (dysuria)
− Any adverse events such as redness, irritation or swelling associated with the treatment
− Fever or chills
− Feeling sick (nausea) or being sick (vomiting)
− Diarrhoea
− Foul−smelling vaginal discharge

Warnings and precautions
Talk to your doctor before using Clotrimazole:
If this is first time you have experienced symptoms of thrush
If you have had more than 2 infections of thrush in the last 6 months
If you have a previous history of sexually transmitted disease or have been exposed to a sexually transmitted disease
If you are or suspect you are pregnant (see below)
If you are aged under 16 or over 60 years of age

Other medicines and Clotrimazole
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without a prescription. This includes herbal medicines.

Medicines which may interact with Clotrimazole:
Other medicines used to treat fungal infections such as amphotericin and nystatin (polyene antibiotics)
Medicines used to reduce the body’s immunity when receiving organ transplant such as tacrolimus (immunosuppressants)

Pregnancy and Breast−feeding
Pregnancy
You must tell your doctor if you are pregnant or if you think that you are.
Clotrimazole can be used during pregnancy but only under the supervision of a doctor or midwife.
If your doctor tells you that you can use Clotrimazole during pregnancy, the vaginal tablet can be inserted without using the applicator.

Breast−feeding
Tell your doctor if you are breast−feeding or about to start breast−feeding. A risk to the suckling child cannot be excluded and your doctor will decide whether or not you should continue breast−feeding taking into account the benefit of breast−feeding for the child and the benefit of treatment for you.

Clotrimazole contains lactose
If you have been told by your doctor that you have intolerance to some sugars, contact your doctor before using this medicinal product.

Usage

Always use this medicinal product exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.
Treatment consists of one vaginal tablet, which should be inserted into the vagina at night.
Do not use this product if you are on your period. Start the treatment once your period has finished.
Although best avoided, you may continue to have sexual intercourse during treatment unless your doctor has advised you not to. However, this product may cause damage to latex contraceptives (e.g. condoms or diaphragms) and consequently may reduce the effectiveness of such contraceptives. You should use alternative contraception for at least 5 days after using this product.
Do not use tampons, douches (vaginal washes/cleansers) or other vaginal products whilst using this product.

Instructions how to insert Clotrimazole Vaginal Tablet
Wash your hands before and after inserting the vaginal tablet
Remove the applicator from the packaging
Remove the tablet from the aluminium package and place it firmly into the open end of the disposable applicator “B” (Diagram 1)
To fit the tablet into the applicator, squeeze the applicator lightly on both sides, whilst pushing the tablet far enough into the holder (about 1cm) to be held in place during insertion

Carefully insert the applicator into the vagina as deeply as is comfortable. This is easiest done when lying on your back with your legs slightly bent (Diagram 2)

Holding the applicator “B” in place, slowly and carefully push the inner plunger “A” as far as it will go so the tablet is placed in the vagina (Diagram 3)

Remove the disposable applicator from the vagina and dispose of it in a safe place, out of the reach of children. The applicator cannot be flushed down the toilet.

Duration of treatment
Each course of treatment consists of one Clotrimazole vaginal tablet, which remains effective for 3 days.
After 1−2 days, most of the external symptoms of the infection (e.g. discharge, itching etc) should have disappeared.
If the symptoms have not been relieved or if the infection returns within 7 days of using Clotrimazole vaginal tablet, treatment may be repeated.

If the infection recurs more than twice within 6 months, you should consult your doctor.

Ingredients
What Clotrimazole Vaginal Tablets contains: Each 500mg vaginal tablet contains 500mg Clotrimazole.
The other ingredients are: Adipic acid, microcrystalline cellulose, pre−gelatinised maize starch, sodium hydrogen carbonate, stearic acid, lactose, polysorbate 80, magnesium stearate, maize starch, colloidal silicon dioxide

Precautions
If anyone accidentally swallows the tablet
Clotrimazole vaginal tablets should only be used in the vagina. If you or anyone else has accidentally swallowed the vaginal tablet, you must contact your doctor or nearest emergency department immediately for advice.
If you have any further questions on the use of this medicinal product, ask your doctor or pharmacist.

Side effects when using
Like all medicines, this medicinal product can cause side effects, although not everybody gets them.
Seek medical advice immediately if you develop the following symptoms:
Allergic reactions: swelling of the face, throat or tongue, fever, difficulty in breathing, dizziness (this may also include fainting, low blood pressure, skin rashes with or without the formation of wheals)
Intolerable burning sensation or irritation

Side effects (frequency not known)

• Mild burning or irritation immediately after inserting the vaginal tablet
• Peeling of the genitals
• Severe itching (pruritus)
• Rashes (erythema)
• Swelling of parts of the body (oedema)
• Discomfort, burning sensation, irritation or pelvic pain
• Vaginal bleeding
• Stomach painReporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed here You can also report side effects directly via the Yellow Card Scheme at:

www.mhra.gov.uk/yellowcard

By reporting side-effects you can help provide more information on the safety of this product.

Other Information
If you need more advice consult your doctor or pharmacist.
Keep all medicines out of the sight and reach of children