Butoconazole is an antifungal medication used to treat yeast infections in the vagina. It belongs to a class of drugs known as azole antifungals. Butoconazole works by stopping the growth of yeast (fungus) that causes the infection. It is typically available as a cream or suppository and is applied directly into the vagina.

Gynazole or Butoconazole inhibits ergosterol synthesis which is an important component of the cell membranes of fungi. It is used for the local treatment of vulvovaginal candidiasis due to Candida albicans

Butoconazole Dose in Adults

Butoconazole Use in the treatment of Vulvovaginal candidiasis:  

• The typical dose of butoconazole is one applicatorful, which is about 5 grams, inserted into the vagina as a single dose.
• This is usually done using a special applicator that comes with the medication.

Butoconazole Dose in Childrens

Not applicable. 

Pregnancy Risk Factor C

• During pregnancy, using butoconazole for vaginal yeast infections poses some risk, categorized as Pregnancy Risk Factor C.
• Animal studies have shown adverse effects, and although only small amounts are absorbed into the body after vaginal use, caution is advised.
• Single-dose topical azole treatments aren't recommended for pregnant women with vulvovaginal candidiasis; instead, seven-day regimens of topical azole therapies are preferred.
• It's also important to note that this product might weaken latex or rubber condoms and diaphragms, as stated by the CDC.

Butoconazole use during breastfeeding:

• It's uncertain whether butoconazole is passed into breast milk. Therefore, caution is advised when using butoconazole in nursing mothers.
• The manufacturer recommends being careful when administering this medication to breastfeeding women to minimize any potential risks to the infant.

Butoconazole Dose in Renal Disease:

• The manufacturer's labeling does not specify any dosage adjustments for individuals with renal impairment.

Butoconazole Dose in Liver Disease:

• The manufacturer's labeling does not include any specific dosage adjustments for individuals with hepatic impairment.

Side effects of gynazole:

• Gastrointestinal:
  • Abdominal cramps
  • Abdominal pain
• Genitourinary:
  • Pelvic pain
  • Vulvovaginal burning
  • Vulvovaginal soreness
  • Vulvovaginal pruritus
• Local:
  • Local swelling

Contraindication to Butoconazole include:

• If you have a known hypersensitivity to butoconazole or any ingredient in its formulation, you should avoid using it.
• While there's limited documentation regarding allergenic cross-reactivity with other drugs in the same class as butoconazole, it's important to note that due to similarities in chemical structure or pharmacological actions, there's a possibility of cross-sensitivity.
• Therefore, even if you've had an allergic reaction to another medication in a similar class, it's essential to exercise caution.

Warnings and Precautions

• The vaginal cream formulation of butoconazole contains mineral oil, which has the potential to weaken latex or rubber materials such as condoms or diaphragms.
• It's advised to avoid using these products within 72 hours after using the cream to ensure their effectiveness.
• This precaution helps reduce the risk of condom or diaphragm breakage, which could lead to unintended pregnancy or the transmission of sexually transmitted infections.

Butoconazole: Drug Interaction

Note: Drug Interaction Categories:

• Risk Factor C: Monitor When Using Combination
• Risk Factor D: Consider Treatment Modification
• Risk Factor X: Avoid Concomitant Use

Monitoring parameters:

None required.

How to administer Gynazole (Butoconazole)?

• Use the Applicator: Make sure to use the applicator that comes with the cream.
• Insertion: Gently insert the cream into the vagina as far as possible without causing any discomfort.

Mechanism of action of Gynazole (Butoconazole)

• Butoconazole works by inhibiting the biosynthesis of ergosterol, which is essential for the fungal cell wall membrane in susceptible fungi like Candida.
• This action damages the cell wall, making it more permeable.
• As a result, the fungal cell loses its ability to retain nutrients and other essential substances, leading to leakage and eventual weakening or death of the fungus.

Absorption:

• Approximately 2% of butoconazole is absorbed into the bloodstream after application.

Time to Peak, Plasma:

• It takes about 12 to 24 hours for butoconazole levels in the bloodstream to reach their highest concentration after application.

Interantion Brands of Butoconazole:

• Butoconil
• Candimed
• Elibutacand
• Femstat
• Gynazol
• Gynazole
• Gynazole-1
• Gynofort
• Gynomyk
• Gynomyk CR
• Gynozol
• UMMA
• Vagizole

Butoconazole Brands in Pakistan:

Caspofungin for the treatment of invasive fungal infections