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Suppositories  contain metronidazole, which has antibacterial and protivotrihomonadnyh mikoiazol action and having an antifungal effect.Metronidazole is an antibacterial agent and protivoprotozoynoe and is active against Gardnerella vaginalis and anaerobic bacteria, including anaerobic streptococci and Trichomonas vaginalis. Miconazole nitrate has a broad spectrum of action (especially trenbolone acetate results active against pathogenic fungi including Candida albicans – causative agent of thrush), is effective against Gram-positive bacteria.
Bioavailability in intravaginal application of metronidazole was 20%, compared to oral administration. After vaginal administration of the drug Neo-Penotran when the equilibrium concentration of metronidazole in plasma was 1,6-7,2 mg / ml. Systemic absorption of miconazole nitrate in this method of administration is very low (about 1.4% of the dose) of miconazole nitrate was not detected in the plasma.

Metronidazole is metabolized in the liver. The active metabolite is a hydroxyl. The half-life of metronidazole is 6-11 hours. About 20% of the dose is excreted unchanged in at night.

INDICATIONS

  • vaginal candidiasis,
  • Bacterial vaginosis
  • Trichomonas vaginitis,
  • vaginitis caused by mixed infections.

CONTRAINDICATIONS
Known hypersensitivity to the active components of the drug or its derivative, the first trimester of pregnancy, porphyria, epilepsy, severe liver function, patients under the age of 18 years due to insufficient data on the use in this age group, virgins.

Pregnancy and lactation
Suppositories  can be used after the first trimester of pregnancy under medical supervision, provided that the anticipated benefits to the mother outweighs the potential risk to the fetus.

At the time of treatment should stop breastfeeding because Metronidazole passes into breast milk. Breast-feeding can be resumed after 24-48 hours after treatment.

DOSAGE AND ADMINISTRATION
intravaginal use. According to one vaginal suppository and one at night vaginal suppository morning for 7 days. When recurrent vaginitis or vaginitis, resistant to other treatments,  should be used within 14 days.

Vaginal Suppositories should be administered deep into the vagina using a disposable fingertips contained in the package.

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

SIDE EFFECTS
In rare cases, there may be hypersensitivity reactions (skin rash) and side effects such as abdominal pain, headache, vaginal itching, burning and irritation of the vagina.

Local reactions: miconazole nitrate, as well as all other antifungal agents based on imidazole derivatives which are inserted into the vagina, may cause vaginal irritation trenbolone acetate results (burning, itching) (6.2%). Due to the vaginal mucosa inflammation in vaginitis, vaginal irritation (burning, itching) may be intensified after the introduction of the first suppository, or the third day of treatment. These complications are rapidly disappearing with continued treatment. With strong stimulation treatment should be discontinued. Systemic side effects are very rare, because the vaginal absorption of metronidazole in plasma level is very low. Side effects associated with systemic absorption of metronidazole include hypersensitivity reactions (rare); leukopenia; ataxia; mental changes (anxiety, mood lability), convulsions; rare: diarrhea, dizziness; headache; loss of appetite; nausea; vomiting; pain or cramps; change in taste (rare); constipation; dry mouth; metallic taste; fatigue.

OD
data concerning human overdose in intravaginal application of metronidazole absent. However, when administered metronidazole in the vagina can be absorbed in sufficient quantities to cause systemic effects. Accidental ingestion of large amounts of suppositories gastric lavage may be performed if necessary. Thereafter improvement can be achieved in patients, ingested 12 grams of metronidazole. No specific antidote exists. Recommended symptomatic and supportive therapy. Symptoms of metronidazole overdose include nausea, vomiting, abdominal pain, diarrhea, generalized itching, a metallic taste in the mouth, movement disorders (ataxia), dizziness, paraesthesia, convulsions, peripheral neuropathy (including after prolonged use at high doses), leukopenia, dark urine. Symptoms of overdose of miconazole nitrate were not identified.

Interaction with other drugs Alcohol: interaction of metronidazole with alcohol capable of producing disulfiramopodobnye reaction. Oral anticoagulants: increase in anticoagulant effect. Phenytoin: lowering blood metronidazole concentration while increasing the concentration of phenytoin. Phenobarbital: reduction of metronidazole concentration in blood. Disulfiram: possible side effects with CNS (psychotic reactions). Cimetidine: can increase the trenbolone acetate results concentration of metronidazole in blood and increase the risk of neurological side effects. lithium: there may be a rise of lithium toxicity. Astemizole and terfenadine:metronidazole and miconazole inhibit the metabolism of these compounds and increase their concentrations in plasma.

SPECIAL NOTES
Pre-clinical data show no specific risk to humans based on the results of standard safety research, pharmacology, toxicity of repeated doses, genotoxicity, carcinogenic potential, toxicity to the reproductive system.

You should avoid drinking alcohol during treatment and for at least 24-48 hours after the completion of the course because of possible reactions disulfiramopodobnyh. Caution should be exercised when using suppositories along with contraceptive diaphragms and condoms because of possible damage to the rubber suppository base.

Patients with a diagnosis of “Trichomonas vaginitis” should be simultaneous treatment of sexual partners.

Do not ingest or apply a different way!

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

Effects on ability to drive and use machinery
Suppositories Neo-Penotran not affect the ability to drive and use machines.

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