NONOXYNOL-9

NONOXYNOL-9
(noe-nox'ee-nole)
Conceptrol, Delfen, Emko, Gynol II, Koromex
Classifications: spermicide contraceptive;
Therapeutic: spermicide contraceptive
Pregnancy Category: C

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 30–60 min before intercourse. Repeat before each intercourse.

Administration

Topical

Apply foams, gels, jelly, cream: Fully load intravaginal applicator and insert about 2/3 of its length [7.5–10 cm (3–4 in.)] into vagina.
Use with diaphragm: Place 1–3 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.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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