Klion-D 100
Klion-D 100: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. For violations of liver function
- 12. Drug interactions
- 13. Analogs
- 14. Terms and conditions of storage
- 15. Terms of dispensing from pharmacies
- 16. Reviews
- 17. Price in pharmacies
Latin name: Klion-D 100
ATX code: G01AF20
Active ingredient: metronidazole (Metronidazole) + miconazole (Miconazole)
Manufacturer: Gedeon Richter (Hungary); Gedeon Richter-Rus (Russia)
Description and photo updated: 2018-29-11
Prices in pharmacies: from 318 rubles.
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Klion-D 100 is a combined antimicrobial drug for topical use in gynecology with antibacterial, antiprotozoal and antifungal activity.
Release form and composition
Dosage form - vaginal tablets: biconvex, oval, with a pointed end, white, on one side - engraving "100" (10 pcs. In aluminum strips, in a cardboard box 1 strip and instructions for use Klion-D 100) …
Composition of 1 tablet:
- active substances: metronidazole and miconazole nitrate - 100 mg each;
- auxiliary components: crospovidone, magnesium stearate, colloidal silicon dioxide, sodium lauryl sulfate, hypromellose, sodium carboxymethyl starch (type A), lactose monohydrate, tartaric acid, sodium bicarbonate, povidone.
Pharmacological properties
Pharmacodynamics
Klion-D 100 is a drug of combined composition, the effect of which is determined by the properties of active components.
Metronidazole is a nitro-5-imidazole derivative, antimicrobial and antiprotozoal agent. The mechanism of its action is due to the biochemical reduction of the 5-nitro group of metronidazole by intracellular transport proteins of anaerobic microorganisms and protozoa. The reduced 5-nitro group of metronidazole, suppressing the synthesis of nucleic acids of a bacterial cell, interacts with their DNA, as a result of which it causes the death of protozoa and bacteria.
Metronidazole is effective in diseases caused by the following microorganisms: Giardia lamblia, Gardnerella vaginalis, Entamoeba histolytica, Trichomonas vaginalis, Veillonella spp., Fusobacterium spp., Obligate anaerobes Bacteroides spp. (including Bacteroides distasonis, B. thetaiotaomicron, B. ovatus, B. fragilis, B. vulgatus), Prevotella spp. (Prevotella buccae, P. bivia, P. disiens), some gram-positive microorganisms (Clostridium spp., Peptostreptococcus spp., Peptococcus spp., Eubacterium spp.). The minimum inhibitory concentration (MIC) for these strains is 0.125-6.25 μg / ml.
Facultative anaerobes and aerobic microorganisms show resistance to metronidazole. However, with mixed flora (anaerobes and aerobes), metronidazole acts synergistically with antibiotics that are effective for aerobes.
Miconazole has antifungal activity against yeasts and dermatophytes. When used intravaginally, the substance is effective mainly against Candida albicans. The mechanism of action of the drug is due to the ability to suppress the biosynthesis of ergosterol in fungi and change the composition of other lipid components in the membrane, which causes the death of fungal cells. Miconazole does not affect the pH and composition of the normal vaginal microflora.
Pharmacokinetics
Metronidazole
After intravaginal administration, metronidazole is absorbed into the systemic circulation. The maximum concentration (Cmax) in the blood is observed after 6-12 hours and is approximately half of the Cmax observed after a single oral administration of the same dose of metronidazole (after 1-3 hours).
The substance penetrates into most tissues, through the blood-brain barrier, into the placenta and breast milk.
No more than 20% binds to plasma proteins.
It undergoes metabolism in the liver (the main pathways of biotransformation are hydroxylation, oxidation and glucuronidation) with the formation of the main metabolite 2-oxymetronidazole, the activity of which is 30% of that of the parent compound.
Up to 60-80% of the dose of the drug absorbed into the systemic circulation is excreted by the kidneys (of which 20% - unchanged), 6-15% - through the intestines.
The metabolite 2-oxymetronidazole contains a water-soluble pigment (formed during the metabolism of metronidazole), which stains urine reddish-brown.
Miconazole
After intravaginal administration, miconazole undergoes low systemic absorption.
Poorly overcomes histohematogenous barriers. It is rapidly destroyed in the liver.
8 hours after application of the drug, 90% of the substance is still found in the vagina.
Unchanged miconazole is not detected either in plasma or urine.
Indications for use
Klion-D 100 is prescribed for the treatment of vaginitis of mixed etiology caused by Candida spp. and Trichomonas spp. at the same time.
Contraindications
Absolute:
- liver failure;
- organic lesions of the central nervous system (including epilepsy);
- leukopenia (currently or in history);
- children under 12 years old;
- I trimester of pregnancy;
- period of breastfeeding;
- hypersensitivity to any component of the drug or other azoles.
Klion-D 100 should be used with caution in patients with diabetes mellitus and patients with microcirculation disorders.
Method of administration and dosage
Klion-D 100 tablets are intended for intravaginal use: they should be injected deep into the vagina, pre-moistened with water. The procedure is performed before bedtime.
The recommended dosage regimen is 1 tablet 1 time per day for 10 days.
Simultaneously with Klion-D 100, the administration of metronidazole inside is shown.
Side effects
- local reactions: discharge (white, thick, mucous) from the vagina odorless or with a faint odor, pain, burning, itching, irritation of the vaginal mucosa, burning sensation or irritation of the penis in a partner;
- allergic reactions: itching of the skin, hives, rash;
- from the urinary system: urine staining in red-brown color, frequent urination;
- on the part of the digestive system: metallic taste in the mouth, change in taste, diarrhea / constipation, decreased appetite, nausea, vomiting, abdominal pain of a spastic nature;
- from the hematopoietic system: leukocytosis, leukopenia;
- from the central nervous system: headache, dizziness.
Overdose
Symptoms of miconazole overdose with vaginal administration have not been identified.
With isolated intravaginal use of metronidazole, there is no information on a possible overdose. In the case of simultaneous oral administration of the drug, there is a possibility of developing systemic effects, such as: metallic taste in the mouth, abdominal pain, nausea, vomiting, diarrhea, dark urine, generalized itching, leukopenia, paresthesia, dizziness, movement disorders (ataxia), peripheral neuropathy, convulsions.
In case of accidental ingestion of the drug Klion-D 100 in large doses, gastric lavage and the intake of activated carbon are recommended. There is no specific antidote for metronidazole. To remove the drug from the body, hemodialysis is performed. Therapy is symptomatic.
special instructions
Treatment is recommended for both sexual partners at the same time. During the period of therapy, one should refrain from sexual relations.
Under the influence of metronidazole, treponema can be immobilized, which leads to a false positive TPI test (Nelson's test).
During the period of therapy, minor leukopenia sometimes occurs. In this regard, it is recommended to monitor the blood picture at the beginning and end of the application of Klion-D 100.
When treating with the drug, it is strictly forbidden to consume alcoholic beverages, which is due to the high risk of developing disulfiram-like reactions.
Influence on the ability to drive vehicles and complex mechanisms
In some cases, Klion-D 100 causes side effects from the nervous system. Such patients are advised to refrain from performing potentially hazardous types of work during the period of therapy.
Application during pregnancy and lactation
In the first trimester of pregnancy, the drug is contraindicated. In the II and III trimesters, Klion-D 100 can be used only when the expected benefit is higher than the possible risks.
Metronidazole passes into breast milk, therefore, Klion-D 100 should not be used during lactation. If treatment is required, breastfeeding is stopped.
Pediatric use
Vaginal tablets Klion-D 100 can be used in girls over 12 years old.
For violations of liver function
The presence of liver failure in the patient is a contraindication to the appointment of Klion-D 100.
Drug interactions
Given the low systemic absorption of miconazole during intravaginal use, possible interactions of Klion-D 100 are due to the presence of metronidazole in its composition.
Inducers of microsomal oxidation enzymes in the liver (for example, phenobarbital or phenytoin) can accelerate the excretion of metronidazole, which may lead to a decrease in its plasma concentration.
Under the influence of cimetidine, the metabolism of metronidazole is suppressed, its concentration in the blood serum increases and, as a result, the risk of side effects increases.
In combination with ethanol, metronidazole, like disulfiram, can cause corresponding reactions: skin flushing, headache, nausea, cramping abdominal pain, vomiting. Therefore, alcohol should not be consumed. The simultaneous use of disulfiram is also prohibited - possibly an additive effect, the development of confusion.
Metronidazole may increase the effect of indirect anticoagulants, as a result of which prothrombin time increases. Dose adjustment of anticoagulants is required.
It is not recommended to combine Klion-D 100 with treatment with non-depolarizing muscle relaxants (for example, vecuronium bromide).
Metronidazole can increase the plasma concentration of lithium. Before prescribing Klion-D 100, it is necessary to reduce the dose of the lithium drug or temporarily cancel it.
Metronidazole is compatible with antibiotics and sulfonamides.
Analogs
The analogues of Klion-D 100 are Vagiferon, Vagisept, Ginalgin, Gainomaks, Ginokaps, Klomegel, Metrogyl Plus, Macmiror complex, Neo-Penotran, etc.
Terms and conditions of storage
Store at a temperature of 15 to 30 ° C out of the reach of children, protected from light and moisture.
The shelf life is 5 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Klion-D 100
Reviews about Klion-D 100 are somewhat contradictory. Many women point to the high antifungal efficacy of the drug, its fast action, an easy-to-administer tablet form, and an affordable cost. However, there are many reports in which patients write about the ineffectiveness of the drug in their cases.
The disadvantages of Klion-D 100 include the frequent development of local adverse reactions, a long course of treatment, the presence of sodium lauryl sulfate in the tablets, as well as the poor solubility of the tablets, even if they are used before bedtime.
Price for Klion-D 100 in pharmacies
The approximate price for Klion-D 100 for a pack of 10 vaginal tablets is 318–473 rubles.
Klion-D 100: prices in online pharmacies
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Drug name Price Pharmacy |
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Klion-D 100 100 mg + 100 mg vaginal tablets 10 pcs. RUB 318 Buy |
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
