TERCONAZOLE

TERCONAZOLE (ter-con'a-zole) Terazol 7, Terazol 3 Classifications: azole antifungal; Therapeutic: antifungal Prototype: Fluconazole Pregnancy Category: C

Availability

0.4%, 0.8% vaginal cream; 80 mg vaginal suppositories

Action

Terconazole is thought to exert antifungal activity by disruption of normal fungal cell membrane permeability.

Therapeutic Effect

Exhibits fungicidal activity against Candida albicans.

Uses

Local treatment of vulvovaginal candidiasis.

Contraindications

Hypersensitivity to terconazole or azole antifungals; use of tampons; lactation.

Cautious Use

Pregnancy (category C). Safety and efficacy in children <18 y are not established.

Route & Dosage

Candidiasis Adult: Intravaginal One suppository (2.5 g) q.h.s. x 3 d; one applicator full of 0.4% cream q.h.s. x 7 d; one applicator full of 0.8% cream q.h.s. x 3 d

Administration

Intravaginal

• Insert applicator high into the vagina (except during pregnancy).
• Wash applicator before and after each use.
• Store away from direct heat and light.

Adverse Effects (≥1%)

CNS: Headache. Urogenital: Vaginal itching, burning, irritation. Body as a Whole: Rash, flu-like syndrome (fever, chills, headache, hypotension).

Interactions

Drug: May inactivate nonoxynol-9 spermicides.

Pharmacokinetics

Absorption: Slow minimal absorption from vagina. Onset: Within 3 d. Metabolism: In liver. Elimination: Half in urine, half in feces. Half-Life: 4–11 h.

Nursing Implications

Assessment & Drug Effects

• Do not use if patient has a history of allergic reaction to other antifungal agents, such as miconazole.
• Monitor for sensitization and irritation; these may indicate need to discontinue drug.

Patient & Family Education

• Use correct application technique.
• Do not use tampons concurrently with terconazole.
• Learn potential adverse reactions, including sensitization and allergic response.
• Be aware that terconazole may interact with diaphragms and latex condoms; avoid concurrent use within 72 h.
• Refrain from sexual intercourse while using terconazole.
• Wear only cotton underwear; change daily.

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