Neo-Penotran Forte: instructions for use. Neo-penotran forte candles

Registration number LSR-006559/09-170809

Tradename Neo-Penotran Forte

International nonproprietary name or generic name

Metronidazole+Miconazole

Dosage form
Vaginal suppositories

Compound
Each vaginal suppository contains:

• active ingredients: 750 mg metronidazole (micronized) and 200 mg miconazole nitrate (micronized)
• excipients: 1550 mg vitepsol S 55

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

Pharmacotherapeutic group
Antimicrobial combined agent (antimicrobial and antiprotozoal agent + antifungal agent).

CodeATX G01AF20

PHARMACOLOGICAL PROPERTIES
Pharmacodynamics
Neo-Penotran ® Forte suppositories contain metronidazole, which has an antibacterial and antitrichomoniacal 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 action (especially active against pathogenic fungi, including Candida albicans, the causative agent of thrush), and is effective against gram-positive bacteria.

Pharmacokinetics
The bioavailability of metronidazole when administered intravaginally is 20% compared to oral administration. After vaginal administration of the drug Neo-Penotran ® Forte, when equilibrium was reached, the concentration of metronidazole in plasma 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), and miconazole nitrate was not detected in plasma.

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 by the kidneys.

INDICATIONS FOR USE

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

CONTRAINDICATIONS
Known hypersensitivity to the active components of the drug or their derivatives, first trimester of pregnancy, porphyria, epilepsy, severe liver dysfunction, patients under the age of 18 due to insufficient data on use in this age category, virgins.

PREGNANCY AND LACTATION
Neo-Penotran ® Forte 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.

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

METHOD OF APPLICATION AND DOSES
Intravaginally. 1 vaginal suppository is inserted deep into the vagina for 7 days at night.

For recurrent vaginitis or vaginitis resistant to other types of treatment, Neo-Penotran ® Forte should be used for 14 days.

Suppositories should be inserted deep into the vagina using disposable finger tips, which are included in the package.

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

SIDE EFFECT
In rare cases, allergic reactions (skin rash) and side effects may occur, in particular abdominal pain, headache, vaginal irritation (burning, itching).

Local reactions: miconazole nitrate can cause vaginal irritation (burning, itching), as with intravaginal use of any other antifungal drugs based on imidazole derivatives (2-6%). If severe irritation occurs, treatment should be discontinued.

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

OVERDOSE
There are no data regarding overdose in humans with intravaginal use of metronidazole. However, when administered into the vagina, metronidazole may be absorbed in quantities sufficient to cause systemic effects. In case of accidental ingestion of a large number of suppositories, gastric lavage can be performed if necessary. Improvement in the condition after this can be achieved in persons who have taken up to 12 g of metronidazole orally. There is no special antidote. Symptomatic and supportive therapy is recommended. Symptoms of 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, darkening of urine. No symptoms of miconazole nitrate overdose have been identified.

INTERACTION
Alcohol: the interaction of metronidazole with alcohol can cause disulfiram-like reactions.
Oral anticoagulants: enhancing the anticoagulant effect.
Phenytoin: a decrease in the concentration of metronidazole in the blood while simultaneously increasing the concentration of phenytoin.
Phenobarbital: decrease in the concentration of mstronidazole 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: An increase in lithium toxicity may occur.
Astemizole and terfenadine: mstronidazole 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, pharmacology, repeated dose toxicity, genotoxicity, carcinogenic potential, and reproductive toxicity studies.

It is necessary to avoid drinking alcohol during treatment and for at least 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 base of the suppositories.

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

Do not swallow or otherwise administer!

Laboratory tests
The results may change when determining the level of liver enzymes, glucose (hexokinase method), theophylline and procainamide in the blood.

Impact on the ability to drive a car and equipment
Neo-Penotran ® Forte suppositories do not affect the ability to drive a car or operate machinery.

RELEASE FORM
Vaginal suppositories. 7 suppositories in a plastic blister made of PVC/PE. 1 blister along with a package of finger pads and instructions for use are placed in a cardboard box.

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

BEST BEFORE DATE
2 years. Do not use after the expiration date indicated on the package!

CONDITIONS OF VACATION FROM PHARMACIES
On prescription.

MANUFACTURER
Jenafarm GmbH & Co. KG, Otto-Schott-Strasse 15, D-07745, Jena, Germany
manufactured by Embil Pharmaceutical Co. Ltd., Bomoiti Birahane 40, Sisli, Istanbul, Türkiye 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.

Additional information can be obtained at:
107113, Moscow, 3rd Rybinskaya st., 18, building 2

Name:

Neo-Penotran

Pharmacological
action:

The drug contains antibiotic in combination with an antifungal agent.
The components of the drug, metronidazole and miconazole, when administered intravaginally, have a fungicidal, antimicrobial and antiprotozoal effect.
Metronidazole is a derivative of 5-nitroimidazole, has an antimicrobial effect, and is effective against protozoa.
When interacting with proteins of microorganisms, the 5-nitro group of metronidazole is restored and prevents the synthesis of nucleic acids. Inhibition of nucleic acid synthesis leads to the destruction of the DNA of microorganisms and their death.
Metronidazole is effective against a wide range of microorganisms and protozoa that cause vaginal infections, including Gardnerella vaginalis, Streptococcus spp. and Trichomonas vaginalis.

Miconazole – imidazole derivative, has a fungicidal effect.
The antifungal effect of miconazole is due to a disruption in the synthesis of fungal cell membrane components. Violation of the structure and integrity of the cell membrane leads to the death of the fungus.
The drug is effective against a wide range of pathogenic fungi, including Candida spp., Aspergillus spp., Dimorphons fungi, Criptoccocus neoformans, Pityrosporum spp., Torulopsis glabrata. When miconazole is used intravaginally, the strongest fungicidal effect is observed against Candida albicans. A slight bacteriostatic effect of the drug against gram-positive microorganisms has been described.
With intravaginal administration a small amount of metronidazole is absorbed into the systemic circulation.
After intravaginal administration of Neo-Penotran suppositories, miconazole is not detected in the blood plasma. Metronidazole, after absorption into the systemic circulation, is metabolized in the liver. It is excreted mainly in the urine.
The half-life is 6-11 hours.
The pharmacokinetics of the drug in healthy patients and patients suffering from vaginitis is no different.

Indications for
application:

Local treatment:
- vaginal candidiasis;
- trichomonas vulvovaginitis;
- bacterial vaginosis (also caused by nonspecific vaginitis, anaerobic vaginosis or gardnerella vaginitis);
- mixed vaginal infection.

Mode of application:

The drug is prescribed 1 vaginal suppository at night and 1 vaginal suppository in the morning for 7 days.
For recurrent vaginitis or vaginitis resistant to previous therapy, 1 vaginal suppository at night and 1 vaginal suppository in the morning are prescribed for 14 days.
Vaginal suppositories should be inserted deep into the vagina using the disposable finger tips contained in the package.
When prescribing the drug to elderly patients (over 65 years of age), no change in dosage regimen is required.

Side effects:

Local reactions: burning, itching, irritation of the vaginal mucosa (2-6%). Due to inflammation of the vaginal mucosa during vaginitis, irritation may increase after the introduction of the first suppository or by the third day of treatment. These complications disappear quickly after stopping treatment. In case of severe irritation, treatment should be discontinued.
From the digestive system: cramping abdominal pain (3%), metallic taste in the mouth (1.7%); in some cases - dry mouth, constipation, diarrhea, loss of appetite, nausea, vomiting.
From the central nervous system and peripheral nervous system: in some cases - headache, dizziness, ataxia, psycho-emotional disorders, peripheral neuropathy (with long-term use of the drug), convulsions.
Allergic reactions: in some cases - skin rash, urticaria.
From the hematopoietic system: in some cases - leukopenia.

Contraindications:

Severe liver dysfunction (including porphyria);
- diseases of the peripheral nervous system and central nervous system;
- hematopoiesis disorders;
- I trimester of pregnancy;
- patients under the age of 14 years;
- virginity;
- hypersensitivity to the components of the drug.

Carefully The drug should be prescribed to patients with severe liver dysfunction (including porphyria), diseases of the peripheral and central nervous system, and hematopoietic disorders.
In the case of vaginitis caused by Trichomonas vaginalis, it is advisable to simultaneously treat the sexual partner with metronidazole for oral administration.
When prescribing Neo-Penotran, patients should be warned that during the period of use of the drug and for 24-48 hours after the end of the course of treatment alcohol should be avoided due to the possibility of disulfiram-like reactions. When using Neo-Penotran and a contraceptive diaphragm or condom simultaneously, the suppository base may interact with the rubber.
The drug is not recommended for use by virgins.
Suppositories should only be used intravaginally and should not be swallowed or used in any other way.
Use in pediatrics
The drug is not recommended for use in children.

Interaction
other medicinal
by other means:

With the simultaneous use of metronidazole with ethanol, disulfiram-like reactions occur.
With the simultaneous use of metronidazole with disulfiram, central nervous system disorders (mental reactions) may occur.
With simultaneous use, metronidazole enhances the effect of indirect anticoagulants.
When used simultaneously with lithium preparations, an increase in lithium toxicity may be observed.
With simultaneous use of metronidazole with phenytoin the level of phenytoin in the blood increases, and the level of metronidazole in the blood decreases.
Phenobarbital, when used simultaneously, reduces the level of metronidazole in the blood.
When used concomitantly with cimetidine, the level of metronidazole in the blood may increase and, therefore, the risk of neurological side effects may increase.
Metronidazole and miconazole inhibit the metabolism of astemizole and terfenadine, resulting in the concentration of astemizole and terfenadine in the blood plasma increases.
It is possible to change the concentration of theophylline and procainamide in the blood plasma when used simultaneously with Neo-Penotran.

Pregnancy:

The use of Neo-Penotran is contraindicated in the first trimester of pregnancy.
In the second and third trimester of pregnancy, the use of Neo-Penotran is possible only in cases where the expected benefit of therapy for the mother outweighs the potential risk for the fetus.
If it is necessary to prescribe Neo-Penotran during lactation, breastfeeding should be stopped, because Metronidazole is excreted in breast milk.
Breastfeeding can be resumed 24-48 hours after the end of treatment.

Overdose:

Symptoms: with an overdose of metronidazole, nausea, vomiting, abdominal pain, diarrhea, itching, metallic taste in the mouth, ataxia, dizziness, paresthesia, convulsions, leukopenia, dark coloration of urine are possible; An overdose of miconazole nitrate may cause nausea, vomiting, stomatitis, pharyngitis, anorexia, headache, and diarrhea.
Treatment: in case of accidental ingestion of a large amount of the drug, gastric lavage and symptomatic therapy are performed.

Release form:

Suppositories Neo-penotran(500 mg+100 mg) vaginal in the form of a flat body with a rounded end, white or almost white, 7 or 14 pcs. complete with finger guards.
Suppositories Neo-Penotran Forte(750 mg+200 mg) vaginal in the form of a flat body with a rounded end, white or almost white 7 pcs. complete with finger guards.
Suppositories Neo-Penotran Forte L(100 mg+750 mg+200 mg) vaginal in the form of a flat body with a rounded end, from white to slightly yellowish color, 7 pcs. complete with finger guards.

Storage conditions:

The drug should be stored out of the reach of children at a temperature not exceeding 25°C.
Shelf life - 3 years.

1 vaginal suppository Neo-Penotran contains:
- active ingredients: metronidazole - 500 mg, miconazole nitrate - 100 mg;
- Excipients: vitepsol S55 (1.9 g/1 supp.).

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

Advantages of the drug

Good effect

Neo-penotran is a combination product containing two active components: miconazole, the effect of which is aimed at eliminating, and metronidazole, which has a detrimental effect on some representatives of the bacterial flora. Acting 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
Suppositories cope well with a large number of diseases that have the same or almost the same clinical manifestations. The list of indications includes the following pathologies:

— disturbances of the vaginal microflora (bacterial vaginosis);

- vaginitis, including mixed origin;

- Trichomonas infection.

This greatly distinguishes the remedy from “narrowly specialized” drugs, many of which only treat thrush.

Ease of use

As you know, you should use gloves when inserting vaginal suppositories, but the vast majority of women do not do this. A small but pleasant feature of the medicine is that it comes complete with rubber finger guards. Thus, manufacturers protect patients from possible complications associated with neglect of treatment hygiene rules.

Simple treatment plan

Treatment with neo-penotran is not difficult at all. Suppositories are placed vaginally at night for a week, that is, one package is required per course. If the patient is faced with a persistent course of the disease, 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 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 recommend penotran as the best medicine. For example, it is not advisable to use the product at the beginning of pregnancy and during breastfeeding.

Frequent occurrence of local side effects

Compared to many other drugs (imidazole derivatives), the drug more often produces local side effects. Up to 5% of patients note that with the start of treatment they experienced 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 cause severe discomfort and disappear with treatment.

In general, there is a pattern in the appearance and strength of the local effects that have arisen. Only inflamed mucous membranes react to the drug; If, hypothetically, a healthy woman were to use this medicine, it would not cause her any discomfort. Thus, the more severe the inflammation in your illness, the more likely it is that you will be additionally bothered by burning and itching.

Presence of common side effects

The product also has common side effects, which, however, are quite rare. These include skin rash, headache, loss of appetite, diarrhea or constipation, discomfort and abdominal pain, 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, which should never be forgotten. These are porphyria (a hereditary disease with a disorder of pigment metabolism), epilepsy, liver failure and age under 18 years.

We are accustomed to the fact that the more dangerous the drug, the higher the age limit for taking it. Logically, penotran should be very dangerous. But this is not so - it was simply not tested in younger age categories.

Interaction with other drugs

The active preparations of suppositories interact with other drugs, so it is not advisable to use them in parallel with certain medications. Shared use may lead to pathological reactions.

With simultaneous treatment with neo-penotran and anticoagulants (warfarin), there is an increase in the effect 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 drug is used at the same time as cimetidine (a medicine that reduces the secretion of gastric juice), cimetidine is more likely to cause side effects from the nervous system.

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

Neo-Penotran forte is a drug with a pronounced antimicrobial effect with a wide range of applications. The combination of active components provides the basic properties of the substance. A detailed description of the characteristics of the medicine will help you understand the effectiveness of the medicine.

The action of Neo-Penotran forte is based on the active substances Metronidazole and Miconazole, which suppress the development of pathogenic microorganisms. The drug is practically not absorbed into the body and is easily administered from the body within 24 hours through the kidneys.

The composition of Neo-Penotran forte contains the following components:

• Metronidazole;
• miconazole nitrate;
• Lidocaine;
• vitepsol;

The presence of Lidocaine in the drug provides an analgesic effect that acts immediately after using the medicine.

The release form of Neo-Penotran forte is in the form of vaginal suppositories, packaged in cardboard boxes with a capacity of 7 and 14 pieces.

Prescriptions, contraindications, side effects

Neo-Penotran forte has the following indications for use:

• treatment and prevention of candidiasis of varying degrees;
• Trichomonas vaginosis, bacterial type;
• therapy for vaginal infections when used topically;

When using the medicine, a number of contraindications of the drug should be taken into account:

• allergy to the active composition of the drug;
• dysfunction of the liver, kidneys;
• severe disorders of the nervous system;
• epilepsy;
• pregnancy (first trimester);
• age category of girls up to 14 years.

Neo-Penatran forte is well tolerated by most women, but in rare cases side effects may occur in the form of:

• allergic manifestations (urticaria, itching);
• burning sensation in the genital area;
• phenomena of leukopenia;
• nausea and vomiting;
• metallic taste in the mouth.

The constant occurrence of unpleasant symptoms after using the medicine means stopping the use of suppositories and contacting your doctor for a recommendation!

It is worth noting that the introduction of vaginal suppositories implies the appearance of a certain white discharge. This phenomenon is within the normal range, since the remnants of the active substance may not completely dissolve in the vagina! If the nature of the disease changes for the worse, then you should stop using the medicine and consult a doctor!

Methods of using the medicine

The instructions for using Neo-Penatrene are quite simple and involve intravaginal administration of suppositories. The drug is administered into the vagina, preferably before bedtime, 1 piece per day for 7-14 days. The course of treatment is extended in case of severe pathology.

Included with the suppositories are special disposable tips for using Neo-Penatrene Forte. The total duration of treatment depends on the type and course of the pathology.

In case of an overdose of Neo-Penatran forte, allergic manifestations, anorexia, stomatitis, dark urine, headaches, and stomach upset are possible. If the substance gets inside, signs of obvious intoxication appear. In this case, symptomatic treatment is recommended in the form of taking adsorbent drugs and gastric lavage.

The drug can be purchased at a pharmacy only with a special prescription written by a doctor. Shelf life: 2 years. After the expiration of time, use is strictly prohibited! Storage conditions at a temperature not exceeding 25 degrees in a dry, dark place out of reach of children.

Additional instructions and analogues

Concurrent use of the medication in combination with Ethanol is contraindicated. The use of oral anticoagulants, lithium-based drugs, disulfides and astemizole is increasing, so concomitant use is also prohibited.

Taking Phenytoin and Phenobarbital reduces the effectiveness of the active substance. Simultaneous combination with Cimetidine increases the effect of side effects. Neo-Penotran is not recommended for virginity and during menstruation. Long-term use of vaginal suppositories is possible only with the prescription of the attending physician!

The average cost of Neo-Penatran Forte ranges from 800-850 rubles, depending on the region of the country. The pricing policy of the drug among this category is in the average range and is justified by the high effectiveness of the drug.

The presence of contraindications or other restrictions on use allows you to select close analogues of Neo-Penatran Forte, described in the list below.

Before replacing a suitable drug, you should consult your doctor!

Reviews

Reviews of the drug Neo-Penotran Forte generally have a positive trend when studying general statistical data. Many women who have used the medicine talk about the high effectiveness of the medicine in treating thrush. The main advantage of the substance is the absence of severe contraindications and side effects. Below are basic recommendations about the effects of vaginal suppositories.

You can leave your reviews about the drug Neo-Penotran forte, they will be useful to other users of the site!

Obstetrician-gynecologist in Ufa

I would like to write a review about the drug Neo-Penotran, since I am a gynecologist and obstetrician and have been practicing medicine for quite a long time. The pregnancy period is the time to avoid the use of any medications that can negatively affect the development of the fetus. Therefore, only safe and effective medications are needed!

Neo-Penotran contains Metronidazole in combination with Miconazole, which have a negative effect on the cell membranes of the fungus and do not cause side effects or influence on the development of the embryo. Therefore, the medicine is an ideal option for the treatment of gynecological infections in the presence of certain restrictions on use. My patients who used the medication were satisfied with the effect they received! I believe that the best feedback about a medicine is the real results obtained after treatment!

Svetlana, Tyumen

The doctor prescribed Neo-Penatren forte to me during my 6th month of pregnancy, when the thrush got very worse and it was simply impossible to sit still due to the itching in the genitals. After the first use, I immediately felt a strong burning and itching, and then all the unpleasant symptoms gradually subsided. My impression of the drug is quite good, since the treatment time is only a week and at the same time it completely gets rid of thrush!

Gynecologist in St. Petersburg

I am a gynecologist and have more than 10 years of experience in the field of obstetrics and gynecology. During this period, I encountered a large number of different infections and practical cases with acute pathologies. I would like to note that one of the common diseases is fungal infections of the genital organs and vagina of a woman. To combat these microorganisms, a wide range of antifungal agents are used.

One of the effective drugs is Neo-Penotran in the form of vaginal suppositories. The medicine affects many strains of fungi and helps restore the natural microflora of the vagina. The advantages of the medication include the absence of heavy chemical compounds and a small number of contraindications. I often prescribe antifungal therapy and the results are always positive!

Nina, Volgograd

I constantly had problems with thrush, and as soon as my body weakens, the fungus immediately goes into an acute stage. Unpleasant sensations in the form of itching and discharge have already become familiar to me, and I took a large number of pills and no results! After the next appointment, the doctor prescribed Neo-Penatran and I started using the medicine. I want to say right away that everything does not go away on the second day and for recovery you need to complete the entire course of treatment.

I used candles for two weeks every day before bed. The itching gradually began to subside 5-6 days after the start of therapy. Now I’m in remission and everything is fine, but I want to note that nothing has bothered me for 4 months! And this is a good sign, since when using other medications, inflammation could occur within a week! A really effective drug. I recommend it for the treatment of thrush!

Elena, Krasnodar

I have chronic thrush, which constantly flares up, especially when my immune system is weakened. At the same time, most medications no longer work, since the fungus has adapted well to them! The doctor prescribed Neo-Penatren forte and warned that the medicine should work due to the content of two active ingredients.

I started using it from the beginning of the week and after the first administration I didn’t feel any special changes. But after 5 days the discharge went away, and so did the itching. I used the suppositories for another 10 days to consolidate the results and am very pleased with the effectiveness of the drug! There were no side effects or discomfort! Great drug!

Lyudmila, Pskov

I also treated thrush with Neo-Penatran and I want to say that I did not fully understand the effectiveness of the drug. After the doctor prescribed the medicine, I immediately started using it and on the first evening unpleasant side effects began. Constant itching and burning in the genital area, although there were no such manifestations before, just discharge!

I only used the drug for a week, and then I stopped because everything seemed to calm down! After bacteriological culture, thrush was discovered again! The doctor advised me to take another course, since additional use of vaginal suppositories is required as prophylaxis. My opinion about the drug is unequal, and now I’m deciding whether to continue taking the medication or switch to another one!

Neo-Penotran forte represents a number of drugs with broad effects in the treatment of gynecological pathologies of fungal origin. The drug has a sufficient number of close analogues and positive responses from the majority of women who have used the medication. The effectiveness of the product depends on the correctly prescribed course of treatment and compliance with all the instructions of the attending physician!

In gynecology, the use of Neo-Penotran Forte L is indicated - antibacterial suppositories that eliminate burning, itching, and discomfort. Suppositories effectively act on the cause of atypical discharge - bacteria, kill them and return normal vaginal reaction. It is useful to read the instructions for using Neo-Penotran Forte suppositories in order to use them correctly.

Vaginal suppositories Neo-Penotran

According to the pharmacological classification, these suppositories belong to drugs with antibiotic and antifungal effects and show activity against protozoans. They are intended for topical use in gynecology and are distinguished by a mixture of active components that act comprehensively on the cause of infection. Due to this, suppositories treat many gynecological diseases caused by bacteria.

Composition and release form

Vaginal suppositories are flat cylinders with a rounded end that are white or yellowish in color. Candles are produced in packs of seven complete with fingertips in cardboard packs. The composition is indicated in the table:

Pharmacodynamics and pharmacokinetics

The suppositories contain the antifungal substance miconazole, the antibiotic and anti-trichomoniacal component metronidazole, and the local anesthetic lidocaine. Miconazole shows antifungal activity against vaginal infections. The substance is effective against pathogenic fungi and gram-positive infections. The action of miconazole disrupts the synthesis of ergosterol in the cytoplasmic membrane. The substance changes the permeability of the cell membrane and slows down the process of glucose consumption.

Metronidazole in Penotran is a nitroimidazole derivative and is an antibiotic and antiprotozoal agent. The substance shows activity against anaerobic bacteria, protozoa, anaerobic streptococci. The combination of miconazole and metronidazole does not produce synergistic or antagonistic effects when taken simultaneously. The local anesthetic lidocaine inhibits the ion ducts that are needed for the initiation and conduction of impulses.

Absorption of miconazole nitrate when administered intravaginally is 1.5% of the dose, accumulation is detected in plasma for up to three days. The bioavailability of metronidazole is 20%, reaching equilibrium concentration after three days. The main metabolites of metronidazole are excreted by the kidneys after 12-22 hours. Lidocaine begins to act within five minutes, is absorbed through the mucous membranes, and is metabolized in the liver. Metabolites and 10% of unchanged substance are excreted by the kidneys.

Indications for use

According to the instructions, Neo-Penotran L suppositories have the following indications for use in the treatment of gynecological diseases:

• vaginal candidiasis (treatment of thrush) caused by Candida albicans;
• bacterial vaginitis, due to the action of anaerobic bacteria and Gardnerella vaginalis;
• trichomonas vaginitis, caused by the bacteria Trichomonas vaginalis;
• mixed vaginal genital infections.

Instructions for use

Unless the doctor has recommended otherwise for treatment, the suppositories, one at a time, are inserted as deeply as possible into the vagina before bed for seven days. If the disease is recurrent or vaginitis is resistant to other treatment, then the course lasts up to 14 days. Intravaginal administration of suppositories is carried out from a lying position using disposable finger tips inserted inside each pack of medication.

special instructions

Studying the special instructions section of the instructions is useful, because there you can familiarize yourself with the rules for using candles:

• the medicine is not used by children and virgins;
• at the end of the course, it is not recommended to drink alcohol for 1-2 days to avoid the risk of disulfiram-like reactions;
• increased doses or prolonged use of the medication can cause peripheral neuropathy and seizures;
• when using suppositories together with condoms and latex diaphragms, damage to contraceptives is possible, so other methods of protection should be used during therapy;
• if the patient is diagnosed with trichomonas vaginitis, treatment of the sexual partner is required;
• in case of kidney failure or impaired renal function, the dose of suppositories is reduced;
• metronidazole can cause symptoms of encephalopathy, if it already exists, the dose is reduced to a third of the daily dose;
• with a decrease in liver function, the withdrawal period of lidocaine increases significantly;
• the drug does not affect the concentration and speed of mental reactions, therefore it can be used while driving.

During menstruation

According to doctors, it is better to start taking suppositories 1.5-2 weeks before the start of menstruation. During menstruation, treatment with suppositories may not have the desired effect. If necessary, suppositories can be used on days of minor discharge (4-5 days of menstruation). You cannot use several suppositories at once to speed up the course of therapy.

During pregnancy

Neo-Penotran suppositories can be used during pregnancy only if prescribed by a doctor, having previously assessed the expected benefit to the mother above the potential risk to the fetus. Breastfeeding is a contraindication for the use of suppositories because metronidazole passes into breast milk. Lactation should be resumed 1-2 days after the end of treatment with the medication.

Drug interactions

When Forte Neo-Penotran is absorbed and combined with other medications, drug interactions may occur:

• oral anticoagulants enhance the anticoagulation effect;
• the medication increases the level of Phenytoin, which in parallel reduces the level of metronidazole in the blood (Phenobarbital acts similarly);
• Disulfiram leads to changes in the central nervous system;
• Cimetidine increases the level of metronidazole in the blood, increasing the risk of neurological side effects;
• when combined with lithium preparations, the risk of toxicity increases;
• components of the drug inhibit the metabolism of Astemizole and Terfenadine;
• Theophylline and Procainamide affect the levels of liver enzymes and blood glucose.

Side effects and overdose

Known side effects of the drug include the following factors:

• skin rashes, abdominal pain, headache;
• vaginal itching, vaginal irritation;
• leukopenia, ataxia, peripheral neuropathy;
• hypersensitivity reactions, psycho-emotional state disorders;
• cramps, diarrhea, constipation, dizziness;
• change in taste, increased fatigue.

Symptoms of an overdose of Neo-Penotran L components are nausea, vomiting, diarrhea, and itching. The urine darkens, a metallic taste appears in the mouth, and dryness in the larynx. If you accidentally take an intravaginal drug orally from 12 g of metronidazole, you need to rinse your stomach; there is no special antidote; symptomatic therapy is prescribed.

Contraindications

If there are the following contraindications to the drug Neo-Penotran Forte (indicated in the instructions), it is not recommended to take suppositories in order to avoid negative consequences:

• first trimester of pregnancy, breastfeeding;
• porphyria;
• epilepsy;
• childhood;
• virginity;
• severe damage to the liver and kidneys;
• hypersensitivity to the components included in the drug.

Terms of sale and storage

You can buy Neo-Penotran Forte only with a prescription from a gynecologist. They are stored at temperatures up to 25 degrees, but not in the refrigerator, away from children and sunlight. The shelf life is two years.

What to replace

On the shelves of pharmacies you can find analogues of Neo-Penotran Forte, which are similar to these suppositories in terms of the active component composition (direct substitutes) or in the pharmaceutical effect that appears (indirect). The following drugs are popular:

• Gainex;
• Klion-D;
• Limenda;
• Metromizole;
• Metromicon-Neo;
• Gainomax;
• Ginalgin;
• Clevazol.

Price

You can buy candles through pharmacies or the Internet at prices that depend on the number of pieces in the package and the level of the trade margin. The approximate cost of medicines in Moscow and St. Petersburg will be:

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