Terconazole is an antifungal medication primarily used to treat vaginal yeast infections (vulvovaginal candidiasis). It belongs to the class of drugs known as triazoles, which work by inhibiting the growth of fungi.

Terconazole is available in various forms such as vaginal suppositories, creams, and vaginal tablets. It is typically applied intravaginally, and the dosage and duration of treatment depend on the severity of the infection as well as the specific product being used.

Terconazole is an antifungal medicine that is administered intravaginally as a topical agent.

It is used to treat patients with vulvovaginal candidiasis (moniliasis).

Since terconazole is effective only against the genus Candida, a KOH smear or culture should be performed prior to the local use of terconazole.

Terconazole Dose in Adults

Terconazole dose in the treatment of vulvovaginal Candidiasis:

• If you're using the cream at 0.4%, you insert one full applicator of the cream into your vagina at bedtime for 7 days in a row.
• If you're using the cream at 0.8%, you also insert one full applicator of the cream into your vagina at bedtime, but only for 3 days straight.
• If you're using the suppository, you insert one suppository into your vagina at bedtime for 3 nights in a row.

So, depending on which form you're using, the treatment lasts either 7 days or 3 days.

Terconazole Dose in Children

Not recommended for use in children

Pregnancy Risk category: C

• Some animal studies have shown possible risks during pregnancy with terconazole, especially in the first trimester due to absorption into the body.
• While the manufacturer suggests avoiding it in the first trimester and considering it later if needed, guidelines recommend using 7-day topical azole vaginal products instead for vaginal yeast infections during pregnancy.
• It's important to note that terconazole might weaken latex condoms and diaphragms, so additional contraceptive measures may be needed.

Terconazole use during breastfeeding:

• It's unclear whether terconazole passes into breast milk.
• Because there's a possibility of it causing problems in breastfeeding babies, the manufacturer suggests deciding whether to stop breastfeeding or stop taking the medication, considering how important the treatment is for the mother.

Terconazole Dose in Renal Disease:

• The manufacturer's instructions do not include specific dosage adjustments for individuals with kidney problems.

Terconazole Dose in Liver Disease:

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

Common Side Effects of Terconazole Include:

• Central nervous system:
  • Headache

Less Common Side Effects of Terconazole Include:

• Central Nervous System:
  • Chills
  • Pain
• Gastrointestinal:
  • Abdominal Pain
• Genitourinary:
  • Dysmenorrhea
  • Vaginal Discomfort (Burning
  • Irritation
  • Or Itching)
• Miscellaneous:
  • Fever

Contraindication to Terconazole Include:

• If someone has a known hypersensitivity to terconazole or any ingredient in the formulation, they should avoid using it.
• While there's limited documentation of allergenic cross-reactivity for imidazole antifungals like terconazole, there's a chance of cross-sensitivity due to similarities in chemical structure or pharmacologic actions.

Warnings and precautions

Dermatologic toxicities:

• If toxic epidermal necrolysis (TEN), a severe dermatologic reaction, happens while using terconazole, the therapy should be stopped immediately.
• Supportive care and monitoring should be initiated promptly.
• It's crucial not to restart the terconazole therapy once discontinued in cases of TEN.

Hypersensitivity and anaphylaxis

• In the event of hypersensitivity or anaphylaxis (a severe allergic reaction) during terconazole therapy, it's important to stop the treatment right away.
• Implement supportive care and monitoring for the individual.
• Under no circumstances should terconazole therapy be restarted if discontinued due to anaphylaxis.
• Instead, focus on providing immediate medical attention and managing the allergic reaction according to medical guidance.

Reactions that are unusual:

• If someone experiences idiosyncratic reactions such as fever, chills, or flu-like symptoms while using terconazole, it's advisable to discontinue the therapy immediately.
• Thereafter, refrain from restarting the terconazole treatment. Instead, seek medical advice for further evaluation and management of these symptoms.

Irritation

• If irritation or sensitization develops while using terconazole, it's recommended to discontinue its use immediately.
• Reinitiating therapy should be avoided.

Terconazole: Drug Interaction

Monitor: 

None required.

How to administer Terconazole?

Using Vaginal Cream:

• Use the applicator provided by the manufacturer.
• Insert the cream into the vagina as far as possible without causing discomfort.
• Wash the applicator after each use and let it dry completely before storing.

Using Vaginal Suppository:

• Remove the foil package before use.
• Insert the suppository into the vagina as far as possible without causing discomfort.
• If you're using the provided applicator for insertion, make sure to wash and dry it thoroughly before using it again.

Mechanism of action of Terconazole:

• Terconazole is an antifungal medication belonging to the triazole ketal class.
• It works by inhibiting a fungal enzyme called cytochrome P450, specifically targeting an enzyme known as 14-alpha-demethylase.
• By blocking this enzyme, terconazole prevents the formation of essential components in fungal cell membranes, leading to the accumulation of certain substances and depletion of ergosterol, a crucial component of fungal cell membranes.
• This disruption weakens the fungal cell structure, ultimately inhibiting fungal growth and helping to treat infections.

Absorption:

• When using the suppository form, approximately 70% of terconazole stays in the vaginal area, while around 10% is absorbed into the bloodstream.

Protein Binding:

• Terconazole is highly bound to proteins in the bloodstream, with about 94.9% of the medication binding to proteins.

Time to Peak Serum Concentration:

• It takes approximately 5 to 10 hours for terconazole to reach its peak concentration in the bloodstream.

Half-life Elimination:

• The half-life of terconazole elimination ranges from 6.4 to 8.5 hours, meaning it takes this amount of time for half of the medication to be eliminated from the body.

Excretion:

• After using the suppository form, about 3% to 10% of terconazole is excreted in the urine, while 2% to 6% is excreted in the feces.

International Brands of Terconazole:

• Terazol 3
• Terazol 7
• Zazole
• TARO-Terconazole
• Fungistat
• Fungistat 3
• Gyno-Fungix
• Gyno-Terazol
• Gynoconazol
• Tecomax
• Terazol
• Tercofam
• Terconal
• Terconer
• Terzol
• Viatrazo
• You Da

Terconazole Brands in Pakistan:

No Brands Available in Pakistan.