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standards of non-Merck sources.
Pronunciation
(ter KONE a zole)
Generic Available (U.S.)
Yes
Index Terms
Brand Names: U.S.
Brand Names: Canada
Pharmacologic Category
Pharmacologic Category Synonyms
Use: Labeled Indications
Local treatment of vulvovaginal candidiasis
Pregnancy Risk Factor
C
Pregnancy Considerations
Following vaginal administration, terconazole is absorbed systemically; use should be avoided during the first trimester of pregnancy.
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
>10%: Central nervous system: Headache
1% to 10%:
Central nervous system: Chills, fever, pain
Gastrointestinal: Abdominal pain
Genitourinary: Dysmenorrhea; vulvar/vaginal burning, irritation, or itching
<1%, postmarketing, and/or case reports: Burning or itching of penis of sexual partner, flu-like syndrome
Metabolism/Transport Effects
None known.
Drug Interactions
There are no known significant interactions.
Storage
Store at room temperature of 15°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
Intravaginal: Adults: Females:
Terazol® 3 (0.8%) vaginal cream: Insert 1 applicatorful intravaginally at bedtime for 3 consecutive days
Terazol® 7 (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
Administration: Other
Intravaginal:
Vaginal cream: Use applicator provided by manufacturer. Insertion should be as far as possible into the vagina without causing discomfort. Wash applicator after each use; allow to dry thoroughly before putting back together.
Vaginal suppository: Remove foil package prior to use. Insertion should be as far as possible into the vagina without causing discomfort. If the provided applicator is used for insertion, wash and dry thoroughly prior to additional use.
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.
Cream, vaginal: 0.4% (45 g); 0.8% (20 g)
Terazol® 7: 0.4% (45 g)
Terazol® 3: 0.8% (20 g)
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 February 2012
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