Page 69 - P4403.14_V85_YOUROTC_Book OCTOBER_2023[Digital]29_09

68 HEALTHCARE HEALTHCARE 69

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have you heard TREATMENTS FOR

THRUSH IN WOMEN
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have you heard
TOPICAL COMBI RANGE
CLOTRIMAZOLE
o g a?

PESSARY & EXTERNAL INTERNAL & EXTERNAL SOFT GEL PESSARY &
CREAM CREAMS EXTERNAL CREAM

Pessary Internal cream in Soft gel pessary
The only product e ective at treating the cause of vaginal 500mg clotrimazole pre-filled applicator 500mg clotrimazole

dryness after the menopause without prescription 10% w/w clotrimazole

The only product e ective at treating the cause of vaginal + + + +
dryness after the menopause without prescription
When oestrogen levels decline after the menopause, around 1 in 2 women 1,2,3,4 will experience vaginal dryness, External cream + + External cream
soreness, burning, itching or discomfort during sex. Gina is clinically proven to restore vaginal health by 2% w/w clotrimazole External cream 2% w/w clotrimazole
When oestrogen levels decline after the menopause, around 1 in 2 women 1,2,3,4 will experience vaginal dryness, 2% w/w clotrimazole
replenishing moisture and balancing vaginal pH. Gina is a low-dose vaginal oestrogen tablet that works where
soreness, burning, itching or discomfort during sex. Gina is clinically proven to restore vaginal health by
it’s needed, treating the cause and relieving the symptoms of vaginal atrophy. Now available without prescription
replenishing moisture and balancing vaginal pH. Gina is a low-dose vaginal oestrogen tablet that works where • A pessary to treat the • A soft gel pessary
for women aged 50+ who have not had a period for at least 1 year.
it’s needed, treating the cause and relieving the symptoms of vaginal atrophy. Now available without prescription internal infection. • An internal cream to treat to treat the internal
for women aged 50+ who have not had a period for at least 1 year. the internal infection (may infection. designed to be
FIND PHARMACY RESOURCES AT HCP.MYGINA.CO.UK • A double strength**
FIND PHARMACY RESOURCES AT HCP.MYGINA.CO.UK be suitable for women comfortable to insert &
external cream to calm the
1. Kingsberg SA, Larkin L, Krychman M, Parish SJ, Bernick B, Mirkin S. WISDOM survey: attitudes and behaviors of physicians toward vulvar and vaginal atrophy (VVA) treatment in women including those with breast external symptoms of itch with vaginal dryness). dissolve easily.
1. Kingsberg SA, Larkin L, Krychman M, Parish SJ, Bernick B, Mirkin S. WISDOM survey: attitudes and behaviors of physicians toward vulvar and vaginal atrophy (VVA) treatment in women including those with breast
cancer history. Menopause 2019;26:124–131. 2. Nappi RE, Palacios S, Particco M, et al. The REVIVE (REal Women’s VIews of Treatment Options for Menopausal Vaginal ChangEs) survey in Europe: Country-specifi c
cancer history. Menopause 2019;26:124–131. 2. Nappi RE, Palacios S, Particco M, et al. The REVIVE (REal Women’s VIews of Treatment Options for Menopausal Vaginal ChangEs) survey in Europe: Country-specifi c
comparisons of postmenopausal women’s perceptions, experiences and needs. Maturitas 2016;91:81–90. 3. Nappi RE, de Melo NR, Martino M, et al. Vaginal Health: Insights, Views & Attitudes (VIVA-LATAM): results
comparisons of postmenopausal women’s perceptions, experiences and needs. Maturitas 2016;91:81–90. 3. Nappi RE, de Melo NR, Martino M, et al. Vaginal Health: Insights, Views & Attitudes (VIVA-LATAM): results & discomfort. • A double strength** • A double strength**
from a survey in Latin America. Climacteric 2018;21(4):397–403. 4. Palacios S, Nappi RE, Bruyniks N, et al. The European Vulvovaginal Epidemiological Survey (EVES): prevalence, symptoms and impact of vulvovaginal
from a survey in Latin America. Climacteric 2018;21(4):397–403. 4. Palacios S, Nappi RE, Bruyniks N, et al. The European Vulvovaginal Epidemiological Survey (EVES): prevalence, symptoms and impact of vulvovaginal
atrophy of menopause. Climacteric 2018;21(3):286–291.
atrophy of menopause. Climacteric 2018;21(3):286–291. external cream to calm the external cream to calm the
external symptoms of itch external symptoms of itch
Gina ® 10 micrograms vaginal tablets. Estradiol hemihydrate.
Gina ® 10 micrograms vaginal tablets. Estradiol hemihydrate.
Presentation: Vaginal tablet containing estradiol hemihydrate equivalent to estradiol 10 micrograms. Each tablet The effect of estradiol on plasma binding proteins is likely to be less with local vaginal administration compared & discomfort. & discomfort.
The effect of estradiol on plasma binding proteins is likely to be less with local vaginal administration compared
Presentation: Vaginal tablet containing estradiol hemihydrate equivalent to estradiol 10 micrograms. Each tablet
is contained in a disposable, single-use applicator. to systemic administration. There is some evidence to demonstrate an increased risk of probable dementia in
is contained in a disposable, single-use applicator.
to systemic administration. There is some evidence to demonstrate an increased risk of probable dementia in
Indication: Treatment of vaginal atrophy due to oestrogen defi ciency in postmenopausal women aged 50 years women who start using continuous combined or oestrogen only HRT after the age of 65. The risks above apply
and above, who have not had a period for at least 1 year. to a lesser extent for oestrogen products for vaginal application however they should be considered in case of long
women who start using continuous combined or oestrogen only HRT after the age of 65. The risks above apply
Indication: Treatment of vaginal atrophy due to oestrogen defi ciency in postmenopausal women aged 50 years
Posology and Administration: Administered intravaginally by use of an applicator. Initial dose of one vaginal term or repeated use of this product. to a lesser extent for oestrogen products for vaginal application however they should be considered in case of long
and above, who have not had a period for at least 1 year.
tablet daily for two weeks followed by maintenance dose of one vaginal tablet twice a week. Interactions: It is unlikely that any clinically relevant drug interactions will occur with Gina ® . Complete relief from thrush and its 6 main symptoms
term or repeated use of this product.
Posology and Administration: Administered intravaginally by use of an applicator. Initial dose of one vaginal other locally applied vaginal treatments should be considered.
Contra-indications: Hypersensitivity to ingredients; known, past or suspected endometrial cancer; undiagnosed However, interactions with Interactions: It is unlikely that any clinically relevant drug interactions will occur with Gina ® .
tablet daily for two weeks followed by maintenance dose of one vaginal tablet twice a week. nancy and lactation: Not indicated.
genital bleeding; untreated endometrial hyperplasia; women with an intact uterus who have been treated with Preg However, interactions with other locally applied vaginal treatments should be considered.
unopposed systemic oestrogens; vulval dermatoses; current vaginal infection, vulval rash, severe vaginal Undesirable effects: Very low rates reported (similar to placebo) of breast pain, peripheral oedema and of itching, burning, discharge, redness, swelling and soreness*
Contra-indications: Hypersensitivity to ingredients; known, past or suspected endometrial cancer; undiagnosed
Pregnancy and lactation: Not indicated.
itching; known, past or suspected oestrogen-dependent malignant tumours; previous or current venous postmenopausal bleedings; they are most likely present only at the beginning of treatment. Other adverse events
genital bleeding; untreated endometrial hyperplasia; women with an intact uterus who have been treated with
thromboembolism; active or recent arterial thromboembolic disease; known thrombophilic disorders; acute liver reported are: Common (≥1/100 to <1/10): headache, abdominal pain, vaginal haemorrhage, vaginal discharge
unopposed systemic oestrogens; vulval dermatoses; current vaginal infection, vulval rash, severe vaginal
Undesirable effects: Very low rates reported (similar to placebo) of breast pain, peripheral oedema and
disease or history of liver disease as long as liver function tests have failed to return to normal; porphyria. or discomfort. Uncommon postmenopausal bleedings; they are most likely present only at the beginning of treatment. Other adverse events
itching; known, past or suspected oestrogen-dependent malignant tumours; previous or current venous
Precautions: HRT should only be initiated for symptoms that adversely affect quality of life. Careful appraisal (≥ 1/1,000 to <1/100): vulvovaginal mycotic infection, nausea, rash, weight increased, hot fl ush and hypertension. *Jack D Sobel. Genital Candidiasis. Medicine. Vol 42, Issue 7, July 2013, p364-368. **compared to Canesten 1% cream
thromboembolism; active or recent arterial thromboembolic disease; known thrombophilic disorders; acute liver association with systemic oestrogen/progestagen treatment: gallbladder disease,
of the risks and benefi ts should be undertaken at every pharmacy visit for resupply and HRT should only be Other side effects reported in reported are: Common (≥1/100 to <1/10): headache, abdominal pain, vaginal haemorrhage, vaginal discharge
or discomfort. Uncommon
disease or history of liver disease as long as liver function tests have failed to return to normal; porphyria.
continued as long as the benefi t outweighs the risk. A complete personal and family medical history should be skin and subcutaneous disorders (chloasma, erythema multiforme, erythema nodosum, vascular purpura, Canesten Thrush Combi Soft Gel Pessary & External Cream 500mg / 2% w/w vaginal capsule & cream; Canesten Thrush Combi Pessary & External Cream 500mg / 2% w/w pes-
(≥ 1/1,000 to <1/100): vulvovaginal mycotic infection, nausea, rash, weight increased, hot fl ush and hypertension.
obtained. The need for referral to a doctor should be guided by this and the contraindications and warnings for use. probable dementia). Post-marketing experience: The following adverse drug reactions, have been spontaneously sary & cream; Canesten Thrush Combi Internal & External Creams 10% w/w / 2% w/w vaginal cream & cream contain clotrimazole. Indications: For the treatment of candidal vul-
Precautions: HRT should only be initiated for symptoms that adversely affect quality of life. Careful appraisal
Women should be advised to report any unexpected vaginal bleeding or changes in their breasts to their doctor or reported for patients being treated with estradiol 25 micrograms vaginal tablets and are considered possibly
Other side effects reported in association with systemic oestrogen/progestagen treatment: gallbladder disease,
of the risks and benefi ts should be undertaken at every pharmacy visit for resupply and HRT should only be
nurse. Women should be referred to a doctor before treatment initiation if they: have endometriosis unless there related to treatment. The reporting rate of these spontaneous adverse reactions is very rare (<1/10,000 patient vovaginitis (thrush). MA Holder: Bayer plc, 400 South Oak Way, Reading, RG2 6AD (information about these products, including adverse reactions, precautions, contra-indications,
skin and subcutaneous disorders (chloasma, erythema multiforme, erythema nodosum, vascular purpura,
continued as long as the benefi t outweighs the risk. A complete personal and family medical history should be
has been a prescription for vaginal oestrogens and health status is unchanged since the last prescription and years): Neoplasms benign and malignant (including cysts and polyps): breast cancer, endometrial cancer. and method of use can be found at https://www.medicines.org.uk/emc/product/8225/smpc; https://www.medicines.org.uk/emc/product/5532/smpc; https://www.medicines.org.
probable dementia). Post-marketing experience: The following adverse drug reactions, have been spontaneously
obtained. The need for referral to a doctor should be guided by this and the contraindications and warnings for use.
she has no recent symptoms of endometriosis; endometrial hyperplasia unless there has been a prescription for Immune system disorders: generalised hypersensitivity reactions (e.g. anaphylactic reaction/shock). Metabolism
reported for patients being treated with estradiol 25 micrograms vaginal tablets and are considered possibly
vaginal oestrogens and health status is unchanged since the last prescription or she has had a hysterectomy; are and nutrition disorders: fl uid retention. Psychiatric disorders: insomnia. Nervous system disorders: migraine uk/emc/product/134/smpc). Legal Category: GSL. Date of Preparation: February 2023. ® = Registered trademark of Bayer AG.
Women should be advised to report any unexpected vaginal bleeding or changes in their breasts to their doctor or
receiving hormonal therapy unless there has been a prescription for a concurrent vaginal oestrogen and the health aggravated. Vascular disorders: deep venous thrombosis, Gastrointestinal disorders: diarrhoea. Skin and
related to treatment. The reporting rate of these spontaneous adverse reactions is very rare (<1/10,000 patient
nurse. Women should be referred to a doctor before treatment initiation if they: have endometriosis unless there
status is unchanged since the last prescription; are switching to Gina from another vaginal oestrogen if it was subcutaneous tissue disorders: urticaria, rash erythematous, rash pruritic, genital pruritus. Reproductive system
years): Neoplasms benign and malignant (including cysts and polyps): breast cancer, endometrial cancer.
has been a prescription for vaginal oestrogens and health status is unchanged since the last prescription and
used for less than 3 months or it was used at the recommended dose and bothersome symptoms are experienced. and breast disorders: endometrial hyperplasia, vaginal irritation, vaginal pain, vaginismus, vaginal ulceration.
Immune system disorders: generalised hypersensitivity reactions (e.g. anaphylactic reaction/shock). Metabolism
she has no recent symptoms of endometriosis; endometrial hyperplasia unless there has been a prescription for
During treatment women should be referred to a doctor if symptoms do not start to improve by 3 months General disorders and administration site conditions: drug ineffective. Investigations: weight increased, blood
vaginal oestrogens and health status is unchanged since the last prescription or she has had a hysterectomy; are
of treatment. The intravaginal applicator may cause minor local trauma. Treatment should be discontinued oestrogen increased. and nutrition disorders: fl uid retention. Psychiatric disorders: insomnia. Nervous system disorders: migraine Case Buying Trade POR
aggravated. Vascular disorders: deep venous thrombosis, Gastrointestinal disorders: diarrhoea. Skin and
immediately and advice sought from a doctor if new onset of vaginal bleeding or spotting, new onset of vaginal The Summary of Product Characteristics (SmPC) should be consulted for a full list of side effects and further Save Product Size RRP Pip Code
receiving hormonal therapy unless there has been a prescription for a concurrent vaginal oestrogen and the health
itching, vaginal infection not adequately treated by a pharmacy treatment or symptoms of endometriosis occur. details of risk estimates. subcutaneous tissue disorders: urticaria, rash erythematous, rash pruritic, genital pruritus. Reproductive system Size Price/Single Offer % %
status is unchanged since the last prescription; are switching to Gina from another vaginal oestrogen if it was
Prompt advice should be sought from a doctor if: jaundice or deterioration in liver function, signifi cant increase PL Number: PL 04668/0273 Legal Category: P Cost (excl VAT): RRP is £24.99 24 vaginal tablets with
and breast disorders: endometrial hyperplasia, vaginal irritation, vaginal pain, vaginismus, vaginal ulceration.
used for less than 3 months or it was used at the recommended dose and bothersome symptoms are experienced.
in blood pressure, new onset of migraine-type headache, pregnancy. Women should speak to a doctor if the applicators CANESTEN
General disorders and administration site conditions: drug ineffective. Investigations: weight increased, blood
During treatment women should be referred to a doctor if symptoms do not start to improve by 3 months
following conditions are present, have previously occurred or have been aggravated during pregnancy or taking For full product information please refer to the SmPC which can be obtained from the Marketing
oestrogen increased.
of treatment. The intravaginal applicator may cause minor local trauma. Treatment should be discontinued
hormone treatment: leiomyoma; risk factors for thromboembolic disorders; risk factors for oestrogen-dependent Authorisation Holder: Novo Nordisk Limited, 3 City Place, Beehive Ring Road, Gatwick, West Sussex, RH6 0PA. 11% Off
tumours; hypertension; liver disorders; diabetes mellitus with or without vascular involvement; cholelithiasis; Tel: 01293 613555. The Summary of Product Characteristics (SmPC) should be consulted for a full list of side effects and further CANESOASIS CYSTITIS RELIEF 6'S UK 6 £3.77 £6.89 20% 34% 388-3261
immediately and advice sought from a doctor if new onset of vaginal bleeding or spotting, new onset of vaginal
migraine or severe headache; systemic lupus erythematosus; epilepsy; asthma and otosclerosis. details of risk estimates.
itching, vaginal infection not adequately treated by a pharmacy treatment or symptoms of endometriosis occur.
Continued suitability of treatment should be verifi ed at each supply with special consideration given to any 500mg CAPS 1+2% CREA 10g GSL GB 10g 3 £9.97 £19.79 10% 40% 368-6300
Prompt advice should be sought from a doctor if: jaundice or deterioration in liver function, signifi cant increase
PL Number: PL 04668/0273 Legal Category: P Cost (excl VAT): RRP is £24.99 24 vaginal tablets with
symptoms of endometrial hyperplasia or carcinoma. It is not recommended to add a progestagen. Evidence Adverse events should be reported. Reporting forms and
in blood pressure, new onset of migraine-type headache, pregnancy. Women should speak to a doctor if the
applicators llowcard or
suggests an increased risk of breast cancer in women taking combined oestrogen-progestagen and possibly information can be found at www.mhra.gov.uk/ye Trade BV GEL 7S GB 6 £8.87 £16.19 12% 34% 395-0862
following conditions are present, have previously occurred or have been aggravated during pregnancy or taking
oestrogen-only systemic HRT that is dependent on the duration of taking HRT. Use of oestrogen-only systemic search for MHRA Yellow Card in the Google Play or Apple App
For full product information please refer to the SmPC which can be obtained from the Marketing
hormone treatment: leiomyoma; risk factors for thromboembolic disorders; risk factors for oestrogen-dependent
HRT has been associated with a slightly increased risk of having ovarian cancer. Systemic HRT is associated with Store. Adverse events should also be reported to Novo Nordisk 1% CREA TUBE 20g fungiGB 20g 10 £1.95 £5.09 12% 54% 329-5722 Save
Authorisation Holder: Novo Nordisk Limited, 3 City Place, Beehive Ring Road, Gatwick, West Sussex, RH6 0PA.
a 1.3- to 3-fold risk of developing venous thromboembolism (VTE) especially in the fi rst year of use. Consider risk Limited (Telephone Novo Nordisk Customer Care Centre 0800 023
tumours; hypertension; liver disorders; diabetes mellitus with or without vascular involvement; cholelithiasis;
Tel: 01293 613555.
factors for VTE. Consider temporarily stopping HRT four to six weeks prior to surgery if prolonged immobilisation 2573). Calls may be monitored for training purposes.
migraine or severe headache; systemic lupus erythematosus; epilepsy; asthma and otosclerosis.
expected; do not restart until woman completely mobilised. Carefully consider benefi t-risk of use of HRT in 1% CREA TUBE 20g MT/GB 20g 10 £2.42 £6.39 12% 55% 034-9175
Continued suitability of treatment should be verifi ed at each supply with special consideration given to any
women on anticoagulant treatment. Patients should contact their doctor immediately if they become aware Up
of a potential thromboembolic symptom. Systemic oestrogen only therapy is associated with up to a 1.5-fold Date last revised: July 2022 Adverse events should be reported. Reporting forms and 500mg VT BLI 1 Pharmacy MT/GB 500mg 12 £6.09 £12.19 11% 40% 010-9207 To 20% Off
symptoms of endometrial hyperplasia or carcinoma. It is not recommended to add a progestagen. Evidence
increased risk of ischaemic stroke. The risk increases with age. Oestrogens may cause fl uid retention, monitor information can be found at www.mhra.gov.uk/yellowcard or
suggests an increased risk of breast cancer in women taking combined oestrogen-progestagen and possibly
patients with cardiac or renal dysfunction. Women with pre-existing hypertriglyceridaemia should be followed Gina ® is a trademark owned by search for MHRA Yellow Card in the Google Play or Apple App CREAM COMBI GSL UK 6 £9.97 £19.79 10% 40% 281-1016
oestrogen-only systemic HRT that is dependent on the duration of taking HRT. Use of oestrogen-only systemic
closely during oestrogen replacement or HRT. Oestrogens may increase plasma proteins including thyroid, Novo Nordisk Health Care AG. Store. Adverse events should also be reported to Novo Nordisk
HRT has been associated with a slightly increased risk of having ovarian cancer. Systemic HRT is associated with
corticoid and sex-hormone-binding globulin leading to increased circulating corticosteroids and sex steroids. UK23GIN00150 August 2023 Limited (Telephone Novo Nordisk Customer Care Centre 0800 023
a 1.3- to 3-fold risk of developing venous thromboembolism (VTE) especially in the fi rst year of use. Consider risk Thrush 2% CREA TUBE 20g MT/GB 20g 10 £5.32 £10.59 10% 40% 263-5209
factors for VTE. Consider temporarily stopping HRT four to six weeks prior to surgery if prolonged immobilisation 2573). Calls may be monitored for training purposes. Trade
expected; do not restart until woman completely mobilised. Carefully consider benefi t-risk of use of HRT in Case Buying Trade POR THRUSH DUO GB 6 £9.22 £18.09 10% 39% 302-0328
Product
women on anticoagulant treatment. Patients should contact their doctor immediately if they become aware Size Size Price/Single RRP Offer % % Pip Code
of a potential thromboembolic symptom. Systemic oestrogen only therapy is associated with up to a 1.5-fold Date last revised: July 2022 Thrush Fluconazole Capsule GB 6 £7.02 £13.39 10% 37% 291-8738
increased risk of ischaemic stroke. The risk increases with age. Oestrogens may cause fl uid retention, monitor
GINA
patients with cardiac or renal dysfunction. Women with pre-existing hypertriglyceridaemia should be followed Gina ® is a trademark owned by CanestenCom 500mgVT1+2%CREA10g GSL MT/GB 10g 7 £9.97 £19.79 10% 40% 304-7719
closely during oestrogen replacement or HRT. Oestrogens may increase plasma proteins including thyroid, Novo Nordisk Health Care AG. 36 £17.17 £29.99 11% 31% 420-9771
24
Gina 10 micrograms x 24 vaginal tablets
corticoid and sex-hormone-binding globulin leading to increased circulating corticosteroids and sex steroids. UK23GIN00150 August 2023 500mg CAPS 1 GB 500mg 4 £7.78 £14.79 10% 37% 368-6292