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|Sultrin Vaginal

SULFONAMIDES (Vaginal)

Some commonly used brand names are:

In the U.S.—

• AVC ¹
• Sultrin ²
• Trysul ²

In Canada—

• AVC ¹
• Sultrin ²

Another commonly used name is sulfathiazole, sulfacetamide, and sulfabenzamide .

Category

• Anti-infective, vaginal

Description

Sulfonamides (sul-FON-a-mides) , or sulfa medicines, are used to treat bacterial infections. They work by killing bacteria or preventing their growth.

Vaginal sulfonamides are used to treat bacterial infections. These medicines may also be used for other problems as determined by your doctor.

Vaginal sulfonamides are available only with your doctor"s prescription, in the following dosage forms:

• Vaginal
• Sulfanilamide
  • Cream (U.S. and Canada)
  • Suppositories (U.S.)
• Triple Sulfa
  • Cream (U.S. and Canada)
  • Tablets (U.S.)

Before Using This Medicine

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For vaginal sulfonamides, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to any of the sulfa medicines, furosemide (e.g., Lasix) or thiazide diuretics (water pills), oral antidiabetics (diabetes medicine you take by mouth), or glaucoma medicine you take by mouth (for example, acetazolamide [e.g., Diamox], dichlorphenamide [e.g., Daranide], or methazolamide [e.g., Neptazane]). Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes, including to parabens, lanolin, or peanut oil.

Pregnancy—Studies have not been done in humans. However, vaginal sulfonamides are absorbed through the vagina into the bloodstream and appear in the bloodstream of the fetus. Studies in rats and mice given high doses by mouth have shown that certain sulfonamides cause birth defects.

Breast-feeding—Vaginal sulfonamides are absorbed through the vagina into the bloodstream and pass into the breast milk. Use is not recommended in nursing mothers. Vaginal sulfonamides may cause liver problems in nursing babies. These medicines may also cause anemia in nursing babies with glucose-6-phosphate dehydrogenase (G6PD) deficiency.

Children—Studies on this medicine have been done only in adult patients and there is no specific information comparing the use of vaginal sulfonamides in children with use in other age groups.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing the use of vaginal sulfonamides in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking or using any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other medical problems—The presence of other medical problems may affect the use of vaginal sulfonamides. Make sure you tell your doctor if you have any other medical problems, especially:

• Glucose-6-phosphate dehydrogenase (G6PD) deficiency—Anemia (a blood problem) can occur if sulfonamides are used

• Kidney disease

• Porphyria—Sulfonamides can cause porphyria attacks

Proper Use of This Medicine

Vaginal sulfonamides usually come with patient directions. Read them carefully before using this medicine.

This medicine is usually inserted into the vagina with an applicator. However, if you are pregnant, check with your doctor before using the applicator.

To help clear up your infection completely, it is very important that you keep using this medicine for the full time of treatment , even if your symptoms begin to clear up after a few days. If you stop using this medicine too soon, your symptoms may return. Do not miss any doses . Also, do not stop using this medicine if your menstrual period starts during the time of treatment .

Dosing—The dose of these medicines will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

• For sulfanilamide
• For vaginal cream dosage form:
  • For bacterial infections:
    • Adults and teenagers—One applicatorful (approximately 6 grams) inserted into the vagina one or two times a day for thirty days.
    • Children—Use and dose must be determined by your doctor.
• For vaginal suppositories dosage form:
  • For bacterial infections:
    • Adults and teenagers—One suppository inserted into the vagina one or two times a day for thirty days.
    • Children—Use and dose must be determined by your doctor.

• For triple sulfa
• For vaginal cream dosage form:
  • For bacterial infections:
    • Adults and teenagers—At first, one applicatorful (approximately 4 to 5 grams) inserted into the vagina two times a day for four to six days. Then, your doctor may lower your dose to one-half to one-quarter applicatorful two times a day. Use when you wake up and just before you go to bed.
    • Children—Use and dose must be determined by your doctor.
• For vaginal tablets dosage form:
  • For bacterial infections:
    • Adults and teenagers—One tablet inserted into the vagina two times a day for ten days.
    • Children—Use and dose must be determined by your doctor.

Missed dose—If you miss a dose of this medicine, insert it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Storage—To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store the vaginal tablet or vaginal suppository form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the vaginal cream and vaginal suppository forms of this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

If your symptoms do not improve within a few days, or if they become worse, check with your doctor.

Vaginal medicines usually will slowly work their way out of the vagina during treatment. To keep the medicine from soiling or staining your clothing, a sanitary napkin may be worn. Minipads, clean paper tissues, or paper diapers may also be used. However, the use of tampons is not recommended since they may soak up too much of the medicine. In addition, tampons may be more likely to slip out of the vagina if you use them during treatment with this medicine.

To help clear up your infection completely and to help make sure it does not return, good health habits are also required .

• Wear cotton panties (or panties or pantyhose with cotton crotches) instead of synthetic (for example, nylon or rayon) underclothes.
• Wear only freshly washed underclothes.

If you have any questions about this, check with your health care professional.

Many vaginal infections are spread by sexual intercourse. The male sexual partner may carry the fungus or other organism in his reproductive tract. Therefore, it may be desirable that your partner wear a condom (prophylactic) during intercourse to keep the infection from returning. Also, it may be necessary for your partner to be treated at the same time you are being treated to avoid passing the infection back and forth. In addition, do not stop using this medicine if you have intercourse during treatment .

Some patients who use vaginal medicines may prefer to use a douche for cleansing purposes before inserting the next dose of medicine. Some doctors recommend a vinegar and water or other douche. However, others do not recommend douching at all. If you do use a douche, do not overfill the vagina with douche solution . To do so may force the solution up into the uterus (womb) and may cause inflammation or infection. Also, do not douche if you are pregnant since this may harm the fetus . If you have any questions about this or which douche products are best for you, check with your health care professional.

Side Effects of This Medicine

Studies in rats have shown that long-term use of sulfonamides may cause cancer of the thyroid gland. In addition, studies in rats have shown that sulfonamides may increase the chance of goiters (noncancerous tumors of the thyroid gland).

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if either of the following side effects continues or is bothersome:

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 08/13/1998

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