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    3. Klion-D 100, 10 vaginal tablets — Made in Hungary — Free Delivery

    Klion-D 100, 10 vaginal tablets — Made in Hungary — Free Delivery


    Brand: GEDEON RICHTER
    Product Code: Klion-D 100
    Availability: In Stock
    $33.76
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    Indications

    Topical treatment in women with vaginal infections caused by Trichomonas and / or fungi.

    Application

    In case of trichomoniasis for 10 days, 1 time per day (in the evening before bedtime) is injected deep into the vagina 1 vaginal tablet moistened with water Klion-d 100. Simultaneously for 10 days, prescribe metronidazole tablets 1 tablet (250 mg) 2 times a day (in the morning and in the evening) inside during or immediately after a meal. Swallow the tablets whole without chewing.
    It is advisable to simultaneously treat the sexual partner with metronidazole tablets for oral administration.
    If necessary, the course of treatment can be repeated.
    In case of vulvovaginal candidiasis, 1 vaginal tablet of Klion-D 100 moistened with water is injected deep into the vagina for 10 days 1 time per day (in the evening before bedtime).

    Contraindications

    Hypersensitivity to the active or to any excipients of the preparation. 1 trimester of pregnancy, period of breastfeeding. hypersensitivity to imidazole derivatives. not recommended for use in combination with disulfiram or alcohol (see Interactions).

    Side effects

    Irritation of the vaginal mucosa and discomfort at the application site and hypersensitivity reactions have been reported.
    Adverse reactions associated with metronidazole
    With simultaneous use with metronidazole inside, the following adverse reactions may occur:
    infections and invasions: fungal superinfection (eg candidiasis).
    From the blood and lymphatic system: agranulocytosis, neutropenia, thrombocytopenia, pancytopenia, leukopenia.
    From the immune system: angioedema, anaphylactic shock.
    On the part of nutrition and metabolism: decreased appetite.
    Mental disorders: hallucinations, confusion, depressed mood.
    From the side of the central nervous system: headache, convulsions, drowsiness, dizziness, encephalopathy (for example, confusion, fever, increased sensitivity to light, torticollis, hallucinations, paralysis, visual and movement disorders) and subacute cerebellar syndrome (for example, ataxia (impaired coordination) , dysarthria, gait disturbance, nystagmus, tremor, which may disappear after discontinuation of the preparation; aseptic meningitis, taste disturbances (metallic taste in the mouth).
    During intensive and / or prolonged therapy with metronidazole, peripheral sensory neuropathy (hypesthesia) may occur.
    On the part of the organ of vision: temporary visual impairment, such as diplopia and myopia, blurry image, decreased visual acuity, changes in color perception, optic neuropathy / neuritis.
    From the digestive system: pain in the epigastric region, nausea, vomiting, intestinal colic, diarrhea, inflammation of the oral mucosa, glossitis with dry mouth, stomatitis, anorexia, coated tongue; pancreatitis, which are reversible when the preparation is discontinued.
    On the part of the hepatobiliary system: increased activity of liver enzymes (AsAT, AlAT, alkaline phosphatase), cholestatic or mixed hepatitis, hepatocellular liver damage, jaundice. Cases of liver failure requiring liver transplantation in patients treated with metronidazole in combination with antibiotics.
    On the part of the skin and subcutaneous tissue: flushing with hyperemia, pruritus, rash, urticaria, isolated cases of pustular rash and polymorphic erythema.
    Laboratory indicators: darkening of urine (causes a metabolite of metronidazole, has no clinical significance).
    From the musculoskeletal system and connective tissue: myalgia, arthralgia.
    Systemic disorders and disorders at the injection site: irritation at the injection site, pyrexia.
    Adverse reactions associated with miconazole: hypersensitivity reactions, including angioedema; anaphylactic shock.

    special instructions

    Metronidazole should be used for no more than 10 days and no more than 2 or 3 times a year.
    During treatment and for at least 1 day after completion of treatment, it is forbidden to drink alcoholic beverages and it is recommended to refrain from sexual intercourse.
    In the absence of a satisfactory effect, it is recommended to carry out systemic antitrichomonidase or antifungal therapy.
    There is a possibility of persistence of gonococcal infection after elimination of Trichomonas infection.
    In patients undergoing hemodialysis, metronidazole and its metabolites are excreted within 8 hours of hemodialysis, so metronidazole must be taken immediately after hemodialysis.
    The dose should not be changed in patients with renal insufficiency undergoing peritoneal dialysis.
    The preparation must be used with caution in patients with hepatic encephalopathy. In persons with hepatic encephalopathy, the daily dose should be reduced by 1/3 and can be used once a day.
    In case of local hypersensitivity of the vaginal mucosa, treatment should be discontinued.
    Long-term use of the preparation requires monitoring of the blood count. If the patient develops leukopenia, it is important to carefully balance the expected benefit of continuing treatment with the possible risk. It is necessary to be aware of the risk of deterioration in the neurological status of patients with severe, chronic or acute neurological diseases in the treatment of metronidazole.
    Patients with permanent or progressive neuropathy should be given metronidazole very carefully.
    It is necessary to stop treatment if ataxia, dizziness, hallucinations appear, and if the patient's neurological status worsens.
    Metronidazole is able to fix treponema, which leads to a false positive result of the Nelson test.
    Use with caution in diabetic patients with impaired microcirculation.
    Use during pregnancy and lactation. In the first trimester of pregnancy, the preparation is contraindicated.
    Metronidazole crosses the placental barrier and rapidly enters the fetal circulation.
    Studies involving pregnant women have not been conducted.
    Based on a meta-analysis of studies with the introduction of metronidazole in the first trimester of pregnancy, it was concluded that there was no increase in the negative effect on the fetus. But despite this, metronidazole in the II-III trimester of pregnancy can be prescribed only after a thorough assessment of the expected benefits and negative consequences of the preparation.
    Lactation. When administered orally, metronidazole passes into breast milk at a concentration equal to its concentration in blood plasma. It can give breast milk a bitter taste. To avoid the negative impact of the preparation on the child, you should stop breastfeeding for the period of treatment and after stopping therapy - for another 1-2 days.
    Children. This dosage form is intended for use in adults.
    The ability to influence the reaction rate when driving vehicles or working with other mechanisms. Klion-D 100 vaginal tablets do not affect driving or working with mechanisms, but when taken orally with metronidazole, patients should be aware of the potential for dizziness, hallucinations, convulsions, which may affect driving or working with mechanisms.

    Interactions

    There are no data on the interaction of vaginal use of metronidazole and miconazole nitrate with other preparations.
    With the simultaneous use of a vaginal tablet containing metronidazole and miconazole nitrate with oral metronidazole, the following may occur:
    enhancing the effect of oral anticoagulant preparations. The risk of hemorrhagic complications increases due to a slowdown in their metabolism in the liver. It is necessary to monitor the levels of international normalized ratio (INR). It is recommended to adjust the dose of oral anticoagulant while taking metronidazole and within 8 days after its withdrawal;
    change in INR in patients receiving antibiotic therapy; recorded numerous cases of increased activity of oral anticoagulants. At the same time, the risk factors that determine the tendency to such a complication are the presence of infection or severe inflammation, the age of the patient and his general state of health. In these circumstances, it is difficult to determine to what extent the INR imbalance is affected by the infection itself or its treatment. However, some classes of antibiotics play an important role in this, in particular fluoroquinolones, macrolides, cyclins, trimoxazole and some cephalosporins:
    enzyme inducers (eg phenytoin, phenobarbital) can accelerate the excretion of metronidazole, which will lead to a decrease in its plasma level with a simultaneous increase in the clearance of phenytoin;
    enzyme inhibitors (eg cimetidine) may increase T½, reduce the clearance of metronidazole;
    the simultaneous use of alcoholic beverages causes adverse reactions similar to disulfiram (crampy abdominal pain, nausea, vomiting, headache, redness of the skin);
    lithium: it is necessary to control the concentration in the blood plasma of lithium, creatinine and electrolytes in patients taking lithium and metronidazole at the same time;
    simultaneous use with disulfiram is contraindicated (cases of acute transient disorders with delusions have been reported, as well as an additive effect that can cause an additive effect, psychotic conditions, confusion);
    the simultaneous administration of cyclosporine with metronidazole can lead to an increase in the level of cyclosporine in the blood plasma, which requires laboratory monitoring (determination of the level of cyclosporine in the blood plasma);
    metronidazole reduces the clearance of fluorouracil, and therefore increases its toxicity;
    busulfan: metronidazole can increase busulfan plasma levels, which can lead to a significant toxic effect of busulfan;
    Metronidazole may affect the results of studies of biochemical parameters of blood plasma, such as AST, ALT, LDH, glucose-hexokinase and TG levels.
    When used systemically, miconazole inhibits cytochrome P450 CYP 3A4 / 2C9 and inhibits the metabolism of preparations that are metabolized by these enzymes. Due to limited systemic availability, clinically significant interactions are rare. However, the preparation should be used with caution simultaneously with oral anticoagulants (for example, warfarin) and monitor the anticoagulant effect.
    With the combined use of miconazole with hypoglycemic agents - urea derivatives or phenytoin - it is possible to increase the effect of the latter.
    The simultaneous use of the preparation with other topical forms of preparations is not recommended.

    Overdose

    The preparation is intended exclusively for vaginal use. in case of accidental ingestion in a high dose, gastric lavage is indicated.
    If symptoms of an overdose appear (leukopenia, neuropathy, nausea, vomiting, ataxia and mild disorientation), only symptomatic therapy should be carried out (gastric lavage, activated charcoal, hemodialysis), since metronidazole does not have a specific antidote. Metronidazole and its metabolites are well eliminated by hemodialysis.

    Storage conditions

    At a temperature not exceeding 30 ° C in the original packaging to protect from light and moisture.

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