Clotrimazole (Canesten combi pessary and cream)

How does it work?

Canesten combi pessary and cream consists of a Canesten 500mg pessary, which is inserted inside the vagina, and Canesten thrush cream, which is applied to the outside of the vagina (vulva and labia). Both contain the active ingredient clotrimazole, which is an antifungal medicine used to treat infections with fungi and yeasts.

Vaginal thrush is the common term for infections of the vagina with Candida species of fungi, in particular Candida albicans. This infection causes inflammation and discharge from the vagina.

Clotrimazole kills the Candida fungi causing the infection by interfering with their cell membranes. It works by stopping the fungi from producing a substance called ergosterol, which is an essential component of fungal cell membranes. The disruption in production of ergosterol causes holes to appear in the fungal cell membrane.

The cell membranes of fungi are vital for their survival. They keep unwanted substances from entering the cells and stop the contents of the cells from leaking out. As clotrimazole causes holes to appear in the cell membranes, essential constituents of the fungal cells can leak out. This kills the fungi and treats the infection.

Canesten 500mg pessary is inserted high into the vagina to allow the clotrimazole to act directly in the area of infection. The pessary is a single dose that should be inserted into the vagina at bedtime using the applicator provided.

Canesten thrush cream contains 2% clotrimazole. It is applied to the outside of the vagina (vulva and labia) to help provide immediate relief from the external symptoms of the infection, such as itching, inflammation and soreness.

What is it used for?

• Inflammation of the vagina (vaginitis) caused by infection with Candida albicans or other yeasts (also known as vaginal thrush).

Warning!

• If this is the first time you have experienced symptoms of vaginal thrush, if you have had more than two infections in the last six months, if you are or could be pregnant, or if you are under 16 or over 60 years of age, you should make sure you consult your doctor before using this medicine.
• You should also consult your doctor before using this medicine if you are allergic to any other vaginal antifungal products, or have any of the following symptoms: irregular or abnormal vaginal bleeding, blood-stained or foul-smelling vaginal discharge, vulval or vaginal ulcers, blisters or sores, lower abdominal pain, pain passing urine, fever, chills, nausea, vomiting or diarrhoea.
• Canesten pessary is not to be taken by mouth. It is for vaginal use only. Canesten thrush cream is for applying to the vagina only.
• Both Canesten pessaries and Canesten thrush cream may damage latex (rubber) condoms and diaphragms (caps) and so make them ineffective at preventing pregnancy and STIs. You should use an alternative method of contraception for at least five days after using this medicine, or preferably avoid having sex until after the infection has cleared up. Remember that having sex while you still have the infection is likely to transmit the infection to your partner, who could then transfer it back to you.
• If your sexual partner also has symptoms of thrush (in men these are soreness and redness of the penis, tightness of the foreskin or a white, odourless discharge from the penis), it is important that they are treated at the same time as you, for example with clotrimazole cream, to prevent you being re-infected. Ask your doctor or pharmacist for advice.
• You can keep using the cream until the symptoms of the infection have cleared up, however, you should consult your doctor if your symptoms have not got better within a week of using the Canesten pessary.

Not to be used in

• Known sensitivity or allergy to any ingredient.
• This medicine is not recommended for use in children.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• The safety of this medicine when used during pregnancy has not been specifically studied. However, it has been used by a large number of women during pregnancy without any apparant harmful effects. As with all medicines, you should consult your doctor before using this medicine during pregnancy. Avoid using the applicator to insert the pessary if you are pregnant. Use your fingers instead.
• Since very little of this medicine is absorbed into the bloodstream from the vagina it is unlikely that any of the medicine will pass into breast milk. However, as with all medicines, you should seek medical advice from your doctor or pharmacist before using this medicine if you are breastfeeding.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

• Vaginal irritation.
• Burning sensation.

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

This medicine is not known to affect other medicines.

Other medicines containing the same active ingredient

For treating vaginal thrush:

Canesten 10% VC	Canesten 100mg/200mg pessaries	Canesten 500mg pessary
Canesten cream combi internal and external creams	Canesten internal cream	Canesten thrush cream

For treating athlete's foot:

Canesten AF cream

Canesten AF powder

Canesten AF spray

For treating fungal skin infections:

Canesten 1% cream	Canesten dermatological powder	Canesten dermatological spray
Canesten solution	Care clotrimazole cream 1%