NONOXYNOL-9 (noe-nox'ee-nole)
Conceptrol, Delfen, Emko, Gynol II, Koromex Classifications: spermicide contraceptive; Therapeutic: spermicide contraceptive Pregnancy Category: C
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Availability
1%, 2%, 2.2%, 3.5%, 4%, 5% gel; 8%, 12.5% foam; 2.27%, 100 mg, 150 mg suppositories
Action
Nonionic surfactant spermicidal incorporated into foams, gels, jelly, or suppositories. Immobilizes sperm by cell membrane
disruption.
Therapeutic Effect
Applied over the cervix, blocks entrance to uterus by sperm, traps and absorbs seminal fluid, then releases the immediately
available spermicide.
Uses
As barrier contraceptive alone or in conjunction with a vaginal diaphragm or with a condom.
Contraindications
Cystocele, prolapsed uterus, sensitivity or allergy to polyurethane or to nonoxynol-9; vaginitis; history of TSS; pregnancy
(category C); immediately after delivery or abortion; during menstruation.
Route & Dosage
Contraceptive Adult: Topical Apply or insert 3060 min before intercourse. Repeat before each intercourse.
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Administration
Topical
- Apply foams, gels, jelly, cream: Fully load intravaginal applicator and insert about 2/3 of its length [7.510
cm (34 in.)] into vagina.
- Use with diaphragm: Place 13 tsp spermicide formulation in dome prior to insertion. After diaphragm is in place, additional
spermicide is recommended. Leave spermicide and diaphragm in place 6 h after intercourse.
Adverse Effects (≥1%)
Urogenital: Candidiasis; vaginal irritation and dryness; increase in vaginal infections; menstrual and nonmenstrual
toxic shock syndrome (TSS).
Interactions
Drug: Intravaginal
azole antifungals may inactivate the spermicides.
Pharmacokinetics
Onset: Spermicidal action is prompt upon contact with sperm; minimal systemic absorption.
Nursing Implications
Patient & Family Education
- Stop using nonoxynol-9 if pregnancy is suspected.
- Report symptoms of vaginal infection to physician: Burning, inflammation, intense vaginal and vulvar itching, cheesy, curd-like
discharge, painful intercourse, dysuria. Nonoxynol-9 antifungal properties are weaker than its antibacterial potency, thus
vulvovaginal candidiasis frequently occurs.
- Use spermicide before the first and every subsequent act of intercourse.