Antifungal pessaries (for vaginal thrush)

Medication Information Leaflet

What are antifungal pessaries for?

Antifungal pessaries are used to treat vaginal thrush (also known as vulvovaginal candidiasis). Vaginal thrush is caused by an overgrowth of a fungus known as Candida albicans. This infection causes symptoms such as itching, swelling, and thick, white odourless discharge. These medications will prevent the growth of the fungus and clear the infection. They may contain ingredients such as Sertaconazole, Clotrimazole or Isoconazole.

How should I use these medications?

  • Insert one pessary into your vagina as deeply as possible, in a lying position in the evening, just before bedtime.
  • Some products only require a one-night dose, whereas others require you to insert a pessary for 3 to 6 nights consecutively. Complete the entire course.
  • Do not stop using your medication without checking with your healthcare professional. Stopping too soon may cause the infection to come back.
  • Avoid vaginal intercourse during the period of treatment.
  • You may consider using a panty liner during the duration of treatment to absorb any discharge.
  • Do not use tampons, intravaginal douches, spermicides or other products to be used in the vagina when you are using these medications.
  • The treatment is not to be carried out during menstruation, as it may be less effective.

What should I do if I forget to use these medications?

If you miss a dose, use it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue normally. Do not use two doses or extra medication to make up for the missed dose.

What precautions should I take when using these medications?

  • Wash your hands before and after handling the pessary
  • Inform your healthcare professional if:
    • You are allergic to antifungal pessaries or any other ingredients used in these medications
    • You are pregnant, planning to become pregnant or breastfeeding
    • You are taking any other medications, including supplements, traditional medications and herbal remedies

What are some common side effects of these medications?

Mild stinging, itching and redness may occur at the affected area. 

  • These side effects are usually mild and go away after some time. However, if the symptoms are bothersome, do not go away or become worse, stop these medications and consult your healthcare professional.

What are some rare but serious side effects that I need to see a doctor immediately?

The symptoms of a drug allergy include one or more of the following:

  • Swollen face/eyes/lips/tongue
  • Difficulty in breathing
  • Itchy skin rashes over your whole body

Signs that you may require further medical attention include:

  • Abnormal vaginal bleeding
  • Vaginal discharge that is either green, yellow, or has a fishy smell
  • Symptoms differ from previous vaginal thrush infections
  • You had 4 or more cases of vaginal thrush within the last year
  • Symptoms reappear after 2 months
  • You previously had a sexually transmitted infection
  • You have a weakened immune system
  • You have diabetes
  • You continue to have symptoms 3 days after your last dose of the medication

If you experience any of these symptoms, you should stop these medications and see your doctor immediately.

What food or medication should I avoid when I use these medications?

Check with your healthcare professional if other topical medications may be applied together with these medications.

How should I store these medications?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children.

Discard this medication within a year after opening unless stated otherwise by the manufacturer

How do I throw these medications away safely?

Pack these medications into a black trash bag and seal it tightly before throwing into the rubbish chute or bin. 
 

Disclaimers

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

The information above is solely for informational purposes only and is not intended as a substitute for the advice provided by your physician, pharmacist or other healthcare professional. You should not use the information for diagnosing or treating a health problem or disease, or prescribing any medicine or other treatment. Always speak with your physician, pharmacist or other healthcare professional before taking any medicine or supplement, or adopting any treatment for a health problem. Under no circumstances will the National Medication Information workgroup be liable to any person for damages of any nature arising in any way from the use of such information.

Last updated on December 2023

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