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standards of non-Merck sources.
Pronunciation
(ter KONE a zole)
Generic Available (U.S.)
Yes
Index Terms
U.S. Brand Names
Canadian Brand Names
Pharmacologic Category
Pharmacologic Category Synonyms
Use: Labeled Indications
Local treatment of vulvovaginal candidiasis
Pregnancy Risk Factor
C
Lactation
Excretion in breast milk unknown/not recommended
Contraindications
Hypersensitivity to terconazole or any component of the formulation
Warnings/Precautions
Concerns related to adverse effects:
• Irritation: If irritation or sensitization occurs, discontinue use.
Dosage form specific issues:
• Petrolatum-based: Petrolatum-based vaginal products may damage rubber or latex condoms or diaphragms; separate use by 3 days.
Other warnings/precautions:
• Lack of response: Microbiological studies (KOH smear and/or cultures) should be repeated in patients not responding to terconazole in order to confirm the diagnosis and rule out other pathogens.
Adverse Reactions
1% to 10%:
Central nervous system: Fever, chills
Gastrointestinal: Abdominal pain
Genitourinary: Vulvar/vaginal burning, dysmenorrhea
<1% (Limited to important or life-threatening): Vulvar itching, soreness, edema, or discharge; polyuria; burning or itching of penis of sexual partner; flu-like syndrome
Drug Interactions
There are no known significant interactions.
Storage
Store at room temperature of 13°C to 30°C (59°F to 86°F).
Mechanism of Action
Triazole ketal antifungal agent; involves inhibition of fungal cytochrome P450. Specifically, terconazole inhibits cytochrome P450-dependent 14-alpha-demethylase which results in accumulation of membrane disturbing 14-alpha-demethylsterols and ergosterol depletion.
Pharmacodynamics/Kinetics
Absorption: Extent of systemic absorption after vaginal administration may be dependent on presence of a uterus; 5% to 8% in women who had a hysterectomy versus 12% to 16% in nonhysterectomy women
Dosage
Adults: Female:
Terazol® 3, Zazole™ 0.8% vaginal cream: Insert 1 applicatorful intravaginally at bedtime for 3 consecutive days
Terazol® 7, Zazole™ 0.4% vaginal cream: Insert 1 applicatorful intravaginally at bedtime for 7 consecutive days
Terazol® 3 vaginal suppository: Insert 1 suppository intravaginally at bedtime for 3 consecutive days
Patient Education
Sexual partner may experience irritation; best to refrain from intercourse during period of treatment. Suppositories may cause breakdown of rubber/latex products such as diaphragms; avoid concurrent use. Report persistent vaginal burning, itching, irritation, or rash.
Geriatric Considerations
Assess patient's ability to self-administer; may be difficult in patients with arthritis or limited range of motion.
Additional Information
Watch for local irritation; assist patient in administration, if necessary; assess patient's ability to self-administer, may be difficult in patients with arthritis or limited range of motion
Dental Health: Effects on Dental Treatment
No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
None reported
Mental Health: Effects on Psychiatric Treatment
None reported
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Cream, vaginal: 0.4% (45 g); 0.8% (20 g)
Terazol® 7: 0.4% (45 g)
Terazol® 3: 0.8% (20 g)
Zazole™: 0.4% (45 g [DSC]); 0.8% (20 g [DSC])
Suppository, vaginal: 80 mg (3s)
Terazol® 3: 80 mg (3s) [contains coconut oil (may have trace amounts), palm kernel oil (may have trace amounts)]
Pricing: U.S. (www.drugstore.com)
Cream (Terazol 3)
0.8% (20): $51.99
Cream (Terazol 7)
0.4% (45): $53.99
Cream (Terconazole)
0.4% (45): $39.99
0.8% (20): $34.99
Suppository (Terazol 3)
80 mg (3): $53.99
References
Centers for Disease Control and Prevention (CDC), "Sexually Transmitted Diseases Treatment Guidelines, 2010," MMWR Recomm Rep, 2010, 59(RR-12):1-110.
International Brand Names
Lexi-Comp.com
Last full review/revision March 2011
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