Due to a decrease in immunity, which is necessary for the normal bearing of a baby, many pregnant women face a fungal infection. A disease of a fungal nature can be dangerous for the baby and cause severe discomfort in the expectant mother, therefore, special antifungal agents are used to treat it.
However, not all of them are considered safe. For example, during pregnancy with regard to such a popular medicine for thrush as "Fluconazole" increased caution is required. Although it has proven itself well in candidiasis and receives many positive reviews, the instructions for use do not recommend such a medicine in the early stages. Only a doctor can decide whether treatment with Fluconazole is acceptable in the 1st, 2nd and 3rd trimesters.
Features of the drug
Fluconazole is produced by several pharmaceutical companies both in our country and abroad. is he sold over the counter in capsule and tablet form. "Fluconazole" capsules are packaged in blisters or jars, and one package usually contains 1, 7 or 10 capsules. They have a dense blue, green, yellow, white or two-color gelatin shell, and inside is a white powder.
The tablet preparation is usually presented as white round tablets, which are sold in 1, 2 or 10 pieces per pack. In addition, there is a prescription "Fluconazole" - a solution for injections. It is produced in glass and polyethylene bottles with a capacity of 50-100 ml. It is a yellowish or colorless transparent liquid.
The main ingredient of capsules, tablets and solution is a substance that, like the drug itself, is called fluconazole. Solid forms contain it at a dose of 50, 100 or 150 mg, and each milliliter of injection solution at a dosage of 2 mg.
It is this compound that has a specific effect on pathogenic fungi.
It can inhibit an enzyme called cytochrome P450. As a result, metabolic reactions in fungal cells are disrupted, and the permeability of their membranes also increases, which leads to the death of the pathogen. The drug is especially active in relation to candida, but it is also capable of destroying cryptococci, trichophytons and other pathogens that provoke mycoses.
When is it appointed?
The most common reason for using Fluconazole is candidiasis... The drug is prescribed if pathogenic fungi of the Candida genus have affected the skin, lungs, oral mucosa, genitals, and so on. Less commonly, a medication is prescribed for other mycoses. Prophylactic use of "Fluconazole" is in demand in situations where there is a high risk of fungal complications, for example, if the patient has had chemotherapy or transplantation.
Is it allowed during pregnancy?
The annotation to all forms of "Fluconazole" contains information that No controlled and validated studies have been conducted on the safety of this drug for pregnant women. Therefore, in no case can you use this drug on your own, and the need for use during pregnancy is assessed by the attending physician.
If a specialist expects such benefits from "Fluconazole" that will exceed the possible risk to the fetus, then he will decide to prescribe the drug on an individual basis, choosing the optimal dosage regimen. Then the task of the expectant mother will be strict adherence to the doctor's instructions.
In most cases, the use of this antifungal agent should be abandoned, as this can lead to negative consequences. The reason to prescribe "Fluconazole" to a pregnant woman can only be a severe fungal infection threatening the child, which must be cured as soon as possible.
Wherein in the early stages, the medication is strictly contraindicatedto prevent the occurrence of malformations. In the second or third trimesters, the doctor may prescribe pills or capsules to drink if the expectant mother has an active fungal infection that requires immediate therapy. Fluconazole can also be used in cases where safer drugs with antifungal action did not give the expected effect. As for the injection solution, in this form, "Fluconazole" is not prescribed to pregnant women.
The active substance of the drug can have a toxic effect on the internal organs of the fetus and its musculoskeletal system, therefore, even in tablets and capsules, the medication is used only after a medical examination in situations where it is justified. In order not to expose the expectant mother and baby to unnecessary risk, in all cases when taking "Fluconazole" can be avoided, doctors prefer to use other drugs that effectively destroy disease-causing fungi.
What to replace?
Fluconazole has a lot of analogs by the active substance. These are drugs such as "Flucostat", "Diflucan", "Flucorus", "Mikosist", "Flukorem" and others.
They are presented in capsules, tablets and injections, are used for the same indications and have the same limitations.
This means that their use during pregnancy is justified only in cases where the disease is more dangerous for the woman and the fetus than the side effects of the drug. In other situations, doctors prefer to prescribe the following medications.
- "Pimafucin". Such suppositories and tablets contain natamycin, an antibacterial substance that destroys many microorganisms, including Candida albicans. The product is also available in the form of a cream. All drug options are allowed to be used while waiting for the baby at any time. They can be prescribed even in the first days of pregnancy, if there are indications for this, the doctor examined and took into account possible contraindications. An analogue of this medication is Primafungin suppositories containing the same active substance.
- "Clotrimazole". These vaginal tablets and suppositories are inexpensive and available at almost any pharmacy. They have a pronounced antifungal effect, therefore they are effective for thrush. However, in the 1st trimester, "Clotrimazole" is contraindicated, therefore it is prescribed for candidiasis only in the 2nd or 3rd trimester, taking into account the possible risks and expected benefits. It is also available as a vaginal cream, topical solution, gel, ointment and skin cream. Its analogues in terms of the active substance are "Candide", "Candizol", "Kanizon" and "Candide-B6".
- "Nystatin"... Many doctors consider this anti-candidiasis agent to be outdated, but it can still be prescribed to a future mother in the second or third trimester (they try to avoid it in the early stages) with thrush. The drug is available in tablets and rectal suppositories, as well as in the form of ointments and vaginal suppositories.
- Livarol. The active ingredient in such vaginal suppositories is ketoconazole. This ingredient destroys pathogenic yeasts and dermatophytes. Suppositories are not prescribed early, but can be used with caution in 2-3 trimesters.
- "Neo-Penotran"... These suppositories, which must be inserted into the vagina, contain two active ingredients. The first of these is miconazole, which provides the drug with antifungal activity, and the second is metronidazole. This combination makes the drug in demand for mixed infection, when a smear of a pregnant woman showed the presence of not only Candida, but also Trichomonas. The remedy is also prescribed for bacterial vaginosis. The first trimester is a contraindication for him, but in 2-3 trimesters the doctor may prescribe "Neo-Penotran" if he sees the need for such treatment.
- "Polygynax"... Such a multicomponent medicine acts on fungi due to nystatin, but additionally inhibits pathogenic bacteria, since it contains substances with antimicrobial properties. In the 1st trimester, such capsules are not used, but in the last weeks of gestation, they are used quite often in order to prevent infection of the infant.
For more information on Fluconazole, see below.
