"Candide" (gel): composition, indications, instructions for use

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Manufacturers: Glenmark Pharmaceuticals Limited ((India)

Active ingredients

• Clotrimazole

Disease class

• Other and unspecified genitourinary tract infection in pregnancy
• Urogenital trichomoniasis
• Candidiasis of the vulva and vagina (N77.1*)
• Candidiasis of other urogenital localizations
• Vaginitis, vulvitis and vulvovaginitis in infectious and parasitic diseases classified elsewhere

Clinical and pharmacological group

• Not indicated. See instructions

Pharmacological action

• Broad spectrum antifungal

Pharmacological group

• Antifungal agents

Medicinal properties

The antimycotic effect of the main component of the gel is due to disruption of the production process of a special enzyme - ergosetrin, which is present in the membranes of fungal cells, affects the permeability of the cell membrane and triggers further cell lysis.

In low concentrations, clotrimazole has a fungistatic effect, in higher concentrations it has a fungicidal effect, also on both proliferating and other types of cells. At fungicidal concentrations, interaction with a number of enzymes (peroxidase and mitochondrial) is observed. As a result, the level of hydrogen peroxide increases significantly to maximum values, which is what leads to the destruction of flexible flora.

Clotrimazole has a detrimental effect on yeast and mold fungi, dermatophytes, Pityriasis versicolor, as well as pathogens of erythrasma. The antimicrobial effect is manifested against gram-positive and gram-negative microorganisms, including Trichomonas vaginalis.

In the case of intravaginal use of the gel, the level of absorption of clotrimazole does not exceed 10% of the applied dosage. High levels of clotrimazole in vaginal secretions and low levels in the blood are recorded within 48-72 hours. Metabolic transformations of clotrimazole occur in liver cells.

Gel for vaginal use Candid (Candid)

Instructions for medical use of the drug

Description of pharmacological action

The antimycotic effect of the active ingredient - clotrimazole (imidazole derivative) is associated with a disruption in the synthesis of ergosterol, which is part of the cell membrane of fungi, which changes the permeability of the membrane and causes subsequent cell lysis. In small concentrations it has a fungistatic effect, in large concentrations it has a fungicidal effect, and not only on proliferating cells. At fungicidal concentrations, it interacts with mitochondrial and peroxidase enzymes, resulting in an increase in the concentration of hydrogen peroxide to a toxic level, which also contributes to the destruction of fungal cells. Effective against dermatophytes, yeast-like and mold fungi, as well as the causative agent of pityriasis versicolor (Pityriasis versicolor) and the causative agent of erythrasma. It has an antimicrobial effect against gram-positive (staphylococci, streptococci) and gram-negative bacteria (Bacteroides, Gardnerella vaginalis), as well as against Trichomonas vaginalis.

Indications for use

- genital infections caused by yeast-like fungi of the genus Candida and/or Trichomonas vaginalis (vulvovaginal candidiasis, trichomoniasis); - genital superinfections caused by microorganisms sensitive to clotrimazole; — sanitation of the birth canal before childbirth.

Release form

gel for vaginal use 2%; aluminum tube 30 g with applicator, cardboard pack 1; gel for vaginal use 2%; aluminum tube 30 g, cardboard pack 1; Composition Gel for vaginal use 1 g clotrimazole 20 mg excipients: cetyl alcohol; propylene glycol; glycerol; benzyl alcohol; cetomacrogol emulsion wax; carbomer 940; sodium hydroxide; chlorocresol; purified water in aluminum tubes of 30 g, complete with applicator; 1 set in a cardboard pack.

Pharmacodynamics

The antimycotic effect of clotrimazole is associated with a disruption in the synthesis of ergosterol, which is part of the cell membrane of fungi, which changes the permeability of the membrane and causes subsequent cell lysis. In small concentrations it has a fungistatic effect, in large concentrations it has a fungicidal effect, and not only on proliferating cells. At fungicidal concentrations, it interacts with mitochondrial and peroxidase enzymes, resulting in an increase in the concentration of hydrogen peroxide to a toxic level, which also contributes to the destruction of fungal cells. Effective against dermatophytes, yeast-like and mold fungi, as well as the causative agent of pityriasis versicolor (Pityriasis versicolor) and the causative agent of erythrasma. It has an antimicrobial effect against gram-positive (staphylococci, streptococci) and gram-negative bacteria (Bacteroides, Gardnerella vaginalis), as well as against Trichomonas vaginalis.

Pharmacokinetics

With intravaginal administration of clotrimazole, absorption is 3–10% of the administered dose. High concentrations in vaginal secretions and low concentrations in the blood persist for 48–72 hours. In the liver, it is quickly metabolized to inactive metabolites.

Use during pregnancy

Clinical and experimental studies have not established that the use of the drug during pregnancy or breastfeeding has a negative effect on the health of the woman or fetus (child). However, the question of the advisability of prescribing the drug should be decided individually after consulting a doctor.

Contraindications for use

- hypersensitivity to clotrimazole or excipients; - menstrual period; - pregnancy (first trimester). With caution: - breastfeeding period.

Side effects

Itching, burning, hyperemia and swelling of the vaginal mucosa, headache, gastralgia, frequent urination, intercurrent cystitis, burning sensation in the penis of the sexual partner, pain during sexual intercourse.

Directions for use and doses

Locally. It is administered intravaginally, in the “lying on your back” position with slightly bent legs. 1 full applicator with gel (about 5 g of the drug), 1 time per day, in the evening. The course of treatment is 6 days. A repeated course of treatment is possible after consultation with a doctor.

Overdose

The use of the drug in high doses does not cause any reactions or life-threatening conditions.

Interactions with other drugs

When administered vaginally, clotrimazole reduces the activity of amphotericin B and other polyene antibiotics. When used simultaneously with natamycin and nystatin, the activity of clotrimazole may be reduced.

Special instructions for use

To prevent urogenital reinfection, simultaneous treatment of sexual partners is necessary. For trichomoniasis, for more successful treatment, other drugs that have a systemic effect (for example, metronidazole - orally) should be used together with Candida. During pregnancy, treatment with vaginal gel should be carried out without an applicator. In patients with liver failure, the functional state of the liver should be periodically monitored. If signs of hypersensitivity or irritation appear, treatment is stopped. Avoid contact of the drug with the mucous membrane of the eyes. Do not use the drug during menstruation. If there is no effect within 4 weeks, the diagnosis should be confirmed.

Storage conditions

In a place protected from light, at a temperature not exceeding 25 °C.

Best before date

36 months

ATX classification:

G Genitourinary system and sex hormones

G01 Antiseptics and antimicrobials for the treatment of gynecological diseases

G01A Antiseptics and antimicrobials for the treatment of gynecological diseases (excluding combinations with corticosteroids)

G01AF Imidazole derivatives

G01AF02 Clotrimazole

Precautionary measures

To prevent urogenital reinfection, both sexual partners should be treated. To carry out successful therapy for trichomoniasis, it is recommended to use other drugs that exhibit systemic effects (for example, metronidazole).

The use of an antifungal agent without an applicator is recommended throughout pregnancy.

In persons suffering from kidney pathologies, it is necessary to regularly monitor the functioning of the renal system

At the first signs of the development of excessive sensitivity, treatment therapy must be completed. It is necessary to avoid getting the gel on the mucous membrane of the eyes.

If there are no visible results within 4 weeks. You should consult your doctor about the need for further treatment.

Instructions for use

Indications for the use of Candide gel must be strictly observed.

The medication is applied to different parts of the body depending on the location of the lesion (feet, skin around nails, folds of skin, head of the penis) or inserted into the vagina using an applicator.

For the oral cavity for candidal stomatitis, a gel is used as a local remedy, as well as a solution that is applied to the affected areas of the mucous membrane with a cotton swab several times a day.

The course of treatment is 5 days or until the symptoms of fungal infection of the mucous membranes and skin are completely eliminated.

Analogs

Livarol

Nizhpharm, Russia

Price from 310 to 748 rub.

Livarol is an antifungal drug that is used to treat vaginal diseases caused by various types of fungi. The basis of Livarol is clotrimazole, the drug is available in the form of suppositories.

Pros:

• Ease of use
• Low price
• Can be used during pregnancy (2nd and 3rd trimester).

Minuses:

• Local allergic reactions may occur
• Not prescribed for children under 12 years of age.

Indications for prescribing the drug

Gel "Candide" is indicated for use in case of the development of the following diseases:

• candidal stomatitis – fungal pathology of the oral mucosa;
• urogenital trichomoniasis - a disease that is caused by a fungal infection caused by the bacterium Trichomonas;
• pityriasis versicolor or pityriasis versicolor - an infection of the skin on the chest and torso;
• foot fungus;
• fungal nail infection;
• vaginal candidiasis (so-called thrush);
• vaginitis, vulvitis (infection of female external organs);
• fungal balanitis (pathology of the skin of the head of the foreskin and penis);
• superficial mycosis of the skin.

The drug is also used for the purpose of sanitation of the birth canal.

Leave and release form

Dispensed from pharmacies with a doctor's prescription.

The pharmaceutical company plans to release white Candida B cream in a 15 g tube. Among users it is often called Candide B ointment. This name is considered to be a household name.

Candide B6 vaginal tablets are also available for sale. This is an antifungal agent, with a similar active ingredient - clotrimazole, used to treat vaginal candidiasis and other fungal diseases.

To treat onychomycosis of the feet, use a cream for external use.

Preparations for Candida fungus contain 1 mg. clotrimazole and additional excipients, depending on the form of release of the drug:

Directions for use and doses

Based on the instructions for use for Candide B cream, the medicine must be applied to clean skin two to three times daily for a month.
To avoid relapse, therapy should be continued even after the symptoms of the disease disappear for another three to four weeks, gradually reducing the dose and frequency of use.

In addition, it is not allowed to apply bandages or seal the source of the disease with an adhesive plaster, so as not to create a greenhouse effect.

It should be remembered that treating foot and nail fungus is a long and responsible process. To select the optimal duration of therapy and dosage, consult a dermatologist.

Treatment of genital diseases

For such pathologies, Candide gel can be used by both women to eliminate mycoses of the vagina, vulva, urethra, and men for balanitis, inflammation of the foreskin and head of the penis. For these pathologies, the product is applied to the surface of the head three times a day.

Does Candide gel help with thrush? Yes, and for infections of the vulva (external genitalia of women), a gel or powder is used, applied 2-3 times a day for 2 weeks.

For vaginal candidiasis, you can use not only the gel, but also any dosage forms of this medication that are injected into the female organ. The treatment regimen according to the annotation is 500 mg once. The gel is injected deep into the vagina in a lying position using a vaginal applicator, which is present in the package with the drug.

This pharmacological agent is best administered intravaginally after hygiene procedures before bedtime.

For urethral infections, gels and solutions are used, which should be injected into the urethra using an applicator. These medications must be taken daily for 5 days.

Methods of using Candida for nail fungus

Solution

The solution for external use is capable of penetrating deeply into the tissue, not only into the nail plate, but also under the nail plate - the place where thousands of fungal colonies accumulate. Apply it 2-3 times a day using a gauze roller or a cotton swab. For one application, 15 drops of Candide solution are enough. In liquid form, Candide can also be used to treat nail fungus in children, but the dose and frequency of treatment must be checked with a pediatrician. It depends on the severity of the lesion and the age of the child. The duration of treatment is until a healthy nail plate grows and another 2-3 weeks to prevent relapse.

The solution for external use is capable of penetrating deeply into the tissue, not only into the nail plate, but also under the nail plate.

Cream

A white cream containing, in addition to clotrimazole, petroleum jelly, benzyl alcohol and paraffin, is also applied to the nails 2-3 times a day. Duration of treatment - for skin lesions on the feet and hands - from 4 weeks, for fungus on the nails - until the nail completely grows back in the place where deformation or discoloration of the nail plate was noticed.

Powder

The powder is applied twice: in the evening after washing and drying the skin (not only the surface of the nails, but also the spaces between the toes) and in the morning, before putting on shoes for 6-14 days. According to clinical studies, by the 6th day of use, weeping in the interdigital spaces of the feet stops, microcracks heal and itching disappears.

There is also a combined form of the drug - “Candide B”, which contains, in addition to clotrimazole, the topical steroid beclomethasone dipropionate. The latter quickly relieves inflammation that can accompany an acute fungal infection. However, Candide-B cannot be applied for more than 14 days precisely because of the presence of a steroid in the composition, because it can cause a number of side effects.

Candida price

Tube of 1% Candide cream containing 15 g. will cost 255-435 rubles. The solution costs a little more – 318-475 rubles. for 15 ml. (for one treatment, 10-15 drops are enough, which is about 1 ml). Cost 30 gr. Candide powder – 280-445 rubles. All drugs are produced by the Indian company GlenMARK Pharmaceuticals LTD.

Tube of 1% Candide cream containing 15 g. will cost 255-435 rubles.

Patient reviews of Candida B

Reviews of Candida B are descriptive and recommendatory in nature.
Users who have been diagnosed with the initial stage of a fungal disease note its high positive effect, excellent penetrating ability, but very high cost compared to analogues. Patients infected with a severe form of the fungus did not notice any positive dynamics after a long period of using the cream and were forced to approach treatment systematically.

If you have experience using this remedy to treat fungus, share it in the comments below the article.

Denis Lyulyukov, 39 years old, Syzran: “ The dermatologist prescribed the use of the cream instead of an alcohol antifungal solution, which did not have a positive effect. I used the ointment several times a day, the improvement dynamics were impressive. The redness subsided, and most importantly, the dryness disappeared, which worsened the condition of the already inflamed skin of the feet. I applied the cream intensively for about a month, then I started using it for prevention in the mornings before work.”

Sofia Svalova, 27 years old, Nalchik: “ This terrible disease overtook me too. Words cannot express the feeling of discomfort that every girl experiences when faced with this disease. The skin on my feet was peeling, itching, and even cracked on my toes. The dermatologist recommended this remedy.

The cream helped, but not immediately. I wanted a quick effect, but that’s not about it. You need to smear it several times a day for a month, and then prevent it for some period with other medications. It's expensive and costs a lot. Next time I would look for a cheaper drug that is just as effective.”

Contraindications

The drug "Candide" is not recommended for use in case of high sensitivity to the active element.

During pregnancy, it is allowed to use it in the treatment of infectious lesions only on open areas of the skin - hands or feet. The medicine is not recommended in the 1st trimester of pregnancy, since there is no data on the effect of the main substance on the developing fetus. In the 2nd-3rd trimesters, the use of the gel intravaginally is conditionally permitted on the recommendation of a specialist, however, it is not advisable to use an applicator with a plunger.

During lactation, this medication is also not prescribed, since its ability to pass into mother’s milk is unknown. If there is a need to use this antifungal drug to treat stomatitis or thrush during breastfeeding, you should first consult your doctor. The gel is also not used during menstrual flow.

When prescribing medication for the treatment of balanitis in men or vulvitis in women, it is recommended to abstain from sexual relations. There is evidence that clotrimazole-based gels have a direct effect on the structure of latex and may reduce the effectiveness of this type of contraceptives. When treating genital infections, a course of the drug is recommended for both partners in order to avoid re-infection.

Treatment of balanitis in men with this remedy is considered quite effective.