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Clotrimazole pessaries

Dr Roger Henderson
Reviewed by Roger HendersonReviewed on 29.04.2024 | 3 minutes read

Clotrimazole is an antifungal medication and is used to treat common fungal infections like the bugs that cause vaginal thrush. Pessaries (also known as vaginal tablets) are a way to treat the local area affected by inserting directly into the vagina. Canesten is a branded version of clotrimazole pessaries. Clotrimazole pessaries are available over the counter in different strengths. Combination packs with clotrimazole cream are also available.

Doctor’s advice

How do I use the medication?

Clotrimazole pessaries should be inserted into the vagina. Insert the pessaries as high as possible into the vagina, this can be easiest by lying down with your legs bent slightly, and using the applicator provided with the medicine.

There are different strengths of clotrimazole pessaries, and the treatment course will differ depending on which one you use. Be sure to follow the advice, or speak with your pharmacist if you are not sure.

Rubber contraceptives such as condoms and diaphragms can be damaged by clotrimazole pessaries, so if you are going to have sex you should consider other contraceptive methods. Because thrush can cause soreness, generally advice is to avoid sex until you have completed a treatment course. There is also a small chance of passing it to your partner, although this is uncommon.

Speak to your doctor if your symptoms have not improved after 7 days. You can repeat the treatment course after if thrush symptoms return. If you have had thrush more than twice in the previous 6 months, it would be best to speak to your doctor to discuss whether there are any other things you could be doing to avoid thrush.

How does it work?

Vaginal thrush is a fungal infection caused by a type of fungus called Candida. Clotrimazole kills this fungus by disrupting the production of important components needed for its cell membrane. This leads to a relief in thrush symptoms. Moisture in the vagina allows pessaries to dissolve, releasing clotrimazole to treat thrush locally where the infection is.

Who should not take the medication?

Do not use clotrimazole pessaries if you have previously had an allergic reaction to clotrimazole or another ingredient listed in the medication. Clotrimazole pessaries are less effective during your period, so it is best to wait until your period has finished before using them.

You should speak to your doctor before using clotrimazole pessaries if you – are under 16 or over 60, are pregnant or breastfeeding. It would be best to speak with your doctor if you have thrush symptoms for the first time or are not sure if you are suffering from thrush.

If you have had unprotected sex and have not had a recent sexual health test, now is as good a time as ever to speak to your doctor about getting a simple checkup.

Clotrimazole pessaries can interact with other medicines called tacrolimus and sirolimus. If you take any prescription, over-the-counter or herbal medicines, ask your doctor or pharmacist to check they are safe to take alongside clotrimazole pessaries.

Are there any side effects?

Side effects can include lower abdominal pain, pelvic pain and vaginal problems such as vaginal bleeding, itching, swelling, redness, discomfort, burning and irritation. If you suffer from vaginal dryness, you may find undissolved pessary pieces in your vagina the following morning.

As with any medication, seek urgent medical advice if any symptoms develop of an allergic reaction such as a skin rash, shortness of breath, wheezing, or swelling of the tongue, mouth, lips, face or throat.

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Dr Roger Henderson
Reviewed by Roger Henderson
Reviewed on 29.04.2024
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