Gynoheal
Generic Name
Metronidazole + Miconazole
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Description
Overview of the medicine
Gynoheal is a combination vaginal pessary containing metronidazole (an antibiotic) and miconazole nitrate (an antifungal). It is used to treat mixed vaginal infections caused by susceptible bacteria and fungi.
Uses & Indications
Dosage
Adults
Insert one vaginal pessary deep into the vagina, preferably at night before bedtime, for 7 to 14 consecutive days as directed by a physician.
Elderly
No specific dose adjustment is generally required. Use with caution and under medical supervision.
Renal_impairment
No dose adjustment typically needed for vaginal administration due to minimal systemic absorption, but consult a physician for severe impairment.
How to Take
The pessary should be inserted deep into the vagina using an applicator (if provided) or a clean finger, preferably at night before bedtime. Wash hands thoroughly before and after use.
Mechanism of Action
Metronidazole acts as an antibiotic by disrupting DNA synthesis in anaerobic bacteria and protozoa. Miconazole nitrate is an antifungal that inhibits ergosterol synthesis, an essential component of fungal cell membranes, leading to increased permeability and cell death.
Pharmacokinetics
Onset
Symptomatic relief usually begins within a few days of starting treatment.
Excretion
Mainly renal excretion for metronidazole and its metabolites. Miconazole and its metabolites are excreted primarily via faeces, with a small amount via urine.
Half life
Metronidazole: Approximately 8 hours (systemic). Miconazole: Approximately 24 hours (systemic, though low absorption from vaginal route).
Absorption
Both metronidazole and miconazole are absorbed systemically to a limited extent after vaginal administration. Systemic absorption of metronidazole is approximately 20-25%, and miconazole is less than 1%.
Metabolism
Primarily hepatic metabolism for both components.
Side Effects
Contraindications
- •Hypersensitivity to metronidazole, miconazole, or any component of the formulation.
- •First trimester of pregnancy (relative contraindication for metronidazole).
- •Known history of blood dyscrasias or active central nervous system disease.
Drug Interactions
Alcohol
Metronidazole may cause a disulfiram-like reaction (nausea, vomiting, flushing, tachycardia) with alcohol. Avoid alcohol consumption during treatment and for at least 24-48 hours after the last dose.
Warfarin
Metronidazole can potentiate the anticoagulant effect of warfarin, increasing the risk of bleeding. Monitor INR/PT closely.
Cimetidine
May increase metronidazole plasma levels.
Phenytoin, Phenobarbital
May decrease metronidazole plasma levels.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Overdose is unlikely with vaginal administration due to low systemic absorption. If accidental oral ingestion occurs or excessive absorption leads to systemic effects (e.g., severe nausea, vomiting, dizziness, ataxia), symptomatic and supportive treatment should be initiated. There is no specific antidote.
Pregnancy & Lactation
Pregnancy: Use is generally not recommended in the first trimester. In the second and third trimesters, use only if clearly needed and prescribed by a doctor, after careful risk/benefit assessment. Lactation: Both metronidazole and miconazole are excreted in breast milk. A decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture. Refer to the specific product packaging for exact details.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by regulatory bodies (e.g., DGDA in Bangladesh)
Patent Status
Off-patent (generic combination)
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Global Brand Names
International brand names for this medicine
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