Summary of Product Characteristics last updated on medicines.ie: 9/4/2015
Canesten Thrush Cream
Canesten Thrush Cream
Each gram of cream contains 20mg Clotrimazole (2% w/w).
For excipients, see 6.1.
A white oil-in-water type cream.
4.1 Therapeutic indications
Canesten Thrush Cream is recommended for the treatment of candidal vulvitis. It should be used as an adjunct to treatment of candidal vaginitis.
It can also be used for treatment of the sexual partner's penis to prevent re-infection.
4.2 Posology and method of administration
Canesten Thrush Cream should be applied to the vulva and surrounding area.
It can also be applied to the sexual partner's penis to prevent re-infection.
Adults and children of 12 years of age and older:
The cream should be applied thinly two or three times daily and rubbed in gently.
Treatment should be continued until symptoms of the infection disappear.
If symptoms persist for more than 7 days the patient may have a medical condition that requires treatment by a doctor.
The treatment can be repeated if necessary, however, recurrent infections may indicate an underlying medical cause. Patients should seek medical advice if symptoms return within 2 months.
If the cream is being used for treatment of the sexual partner's penis it should be applied two or three times daily for up to two weeks.
Do not use tampons, intravaginal douches, spermicides or other vaginal products while using this product.
Avoidance of vaginal intercourse is recommended in case of vaginal infection while using this product because your partner could become infected.
Children under 12 years of age:
There is no clinical experience in the use of Canesten Thrush Cream in children.
Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.
4.4 Special warnings and precautions for use
Medical advice should be sought if this is the first time the patient has experienced symptoms of candidal vaginitis.
Before using Canesten Thrush Cream medical advice must be sought if any of the following are applicable:
- More than two infections of candidal vaginitis in the last six months,
- Previous history of a sexually transmitted disease or exposure to partner with sexually transmitted disease,
- Pregnancy or suspected pregnancy,
- Aged under 12 or over 60 years,
- Known hypersensitivity to imidazoles or other vaginal antifungal products.
Canesten Thrush Cream should not be used if the patient has any of the following symptoms whereupon medical advice should be sought:
- Irregular vaginal bleeding,
- Abnormal vaginal bleeding - (vaginal haemorrhage) or a blood-stained discharge,
- Vulval or vaginal ulcers, blisters or sores,
- Lower abdominal pain or dysuria,
- Any adverse events such as redness, irritation or swelling associated with the treatment,
- Fever (temperature of 38°C or above) or chills
- Nausea or vomiting,
- Foul smelling vaginal discharge.
- Back Pain
- Associated shoulder pain.
This product contains cetostearyl alcohol, which may cause local skin reactions (e.g. contact dermatitis).
Avoid contact with eyes and do not swallow.
4.5 Interaction with other medicinal products and other forms of interaction
Laboratory tests have suggested that, when used together, this product may cause damage to latex contraceptives. Consequently the effectiveness of such contraceptives may be reduced. Patients should be advised to use alternative precautions for at least five days after using this product.
4.6 Fertility, pregnancy and lactation
No human studies of the effects of clotrimazole on fertility have been performed, however, animal studies have not demonstrated any effects of the drug on fertility.
There are limited amount of data from the use of clotrimazole in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity (see section 5.3). As a precautionary measure, it is preferable to avoid the use of clotrimazole during the first trimester of pregnancy.
Available pharmacodynamic/toxicological data in animals have shown excretion of clotrimazole/metabolites in milk (see section 5.3). Breast-feeding should be discontinued during treatment with clotrimazole.
4.7 Effects on ability to drive and use machines
The medication has no or negligible influence on the ability to drive or use machinery.
4.8 Undesirable effects
The following adverse reactions have been identified during post-approval use of Clotrimazole. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency.
Immune system disorders
Allergic reaction (ME) (with symptoms such as urticaria (ME), dyspnoe (PT), hypotension (PT) and syncope (PT)).
Skin and subcuteaneous tissue disorders
Pruritus (ME), rash (ME), blisters (PT), peeling/exfoliation (PT), discomfort/pain (PT), stinging/burning (PT), edema (PT), burning (PT), irritation , erythema (PT).
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via HPRA Pharmacovigilance, Earlsfort Terrace, IRL - Dublin 2; Tel: +353 1 6764971; Fax: +353 1 6762517. Website: www.hpra.ie; E-mail: email@example.com.
In the event of accidental oral ingestion, routine measures such as gastric lavage should be performed only if clinical symptoms of overdose become apparent (e.g. dizziness, nausea or vomiting).
5.1 Pharmacodynamic properties
Pharmacotherapeutic group: Gynaecological antiinfectives and antiseptics – imidiazole derivatives.
ATC Code: G01AF02
Mechanism of Action
Clotrimazole acts against fungi by inhibiting ergosterol synthesis. Inhibition of ergosterol synthesis leads to structural and functional impairment of the cytoplasmic membrane.
Clotrimazole has a broad antimycotic spectrum of action in vitro and in vivo, which includes dermatophytes, yeasts, moulds, etc.
Under appropriate test conditions, the MIC values for these types of fungi are in the region of less than 0.062–8.0 μg/ml substrate. The mode of action of clotrimazole is fungistatic or fungicidal depending on the concentration of clotrimazole at the site of infection. In vitro activity is limited to proliferating fungal elements; fungal spores are only slightly sensitive.
In addition to its antimycotic action, clotrimazole also acts on, gram-positive microorganisms (streptococci/staphylococci/ Gardnerella vagiinalis) and gram-negative microorganisms (Bacteroides). It has no effect on lactobacilli.
In vitro, clotrimazole inhibits the multiplication of Corynebacteria and gram-positive cocci – with the exception of enterococci – in concentrations of 0.5–10 µg/ml substrate.
Primarily resistant variants of sensitive fungal species are very rare; the development of secondary resistance by sensitive fungi has so far only been observed in very isolated cases under therapeutic conditions.
5.2 Pharmacokinetic properties
Pharmacokinetic investigations after vaginal application have shown that only a small amount of clotrimazole (3 – 10%) is absorbed. Due to the rapid hepatic metabolism of absorbed clotrimazole into pharmacologically inactive metabolites the resulting peak plasma concentrations of clotrimazole after vaginal application of a 500mg dose were less than 10 nanog/ml, suggesting that clotrimazole applied intravaginally is unlikely to lead to measurable systemic effects or side effects.
5.3 Preclinical safety data
Non-clinical data reveal no special hazard for humans based on conventional studies of safety pharmacology, repeated dose toxicity, genotoxicity, carcinogenic potential and toxicity to reproduction and development.
6.1 List of excipients
6.3 Shelf life
6.4 Special precautions for storage
This medicinal product does not require any special storage conditions.
6.5 Nature and contents of container
Aluminium tubes (20g) with internal lacquer coating, latex stopper and HDPE screw top.
6.6 Special precautions for disposal and other handling
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how dispose of medicines no longer required. These measures will help to protect the environment.
Date of first authorisation:
02 March 1981
Date of last renewal:
02 March 2006