Pimafucin during pregnancy: safe treatment of fungal diseases. Pimafucin during pregnancy - safe treatment of fungal infections
Pimafucin is a truly invaluable drug in the treatment of various fungal infections of the skin and mucous membranes. The drug belongs to the broad-spectrum antifungal polyene antibiotic. The medicine is prescribed for various types, and for otomycosis, and for external otitis media caused by fungi, and for candidiasis of the skin, nails, intestines, and vagina. Often, doctors, in the absence of other such harmless drugs for such diseases, prescribe this particular drug during pregnancy. After all, the use of Pimafucin is allowed at all stages of pregnancy and during lactation. At least, because there are no data on adverse effects on the fetus.
Pimafucin is produced in three dosage forms. These can be coated tablets, usually 20 pieces per pack. It can be - suppositories - vaginal - usually three pieces per pack. Pimafucin is also produced in a cream for external use 2%, 30 g each in a tube. And pimafucin is also produced in the form of a suspension for topical use of 2.5% - in 20 ml vials complete with a pipette.
One tablet or one Pimafucin suppository contains 100 mg of natamycin. In one gram of cream - 20 mg of natamycin, and in 1 ml of suspension Pimafucin - 25 mg.
As you might have guessed from the composition of the drug, the active ingredient in Pimafucin is natamycin. It's all about the mechanism of its action - natamycin. It binds sterols of cell membranes, disrupting their integrity and function, and leads to the death of harmful microorganisms. Therefore, natamycin is not actually absorbed from the gastrointestinal tract, from the surface of the skin and mucous membranes. If the drug is taken in tablets, then it acts only in the intestines.
Doses of the drug are prescribed by the doctor, he also considers the most appropriate form of release for the pregnant woman. For a future mother, as a rule, the best option is candles, but there are cases when the drug is prescribed in other dosage forms.
The most common disease in which Pimafucin is prescribed during pregnancy is. This is due to the fact that a woman during pregnancy has a change in hormonal levels. The immune system of the expectant mother is greatly weakened, the natural defenses of the body, respectively, are reduced, and therefore violations of the normal bacterial flora often occur.
Side effects that may occur with the use of Pimafucin are nausea, diarrhea (especially often occur in the first days of admission, as treatment progresses quickly).
As for skin irritations, they are also possible. Burning is also possible.
If the disease is chronic or advanced, then Pimafucin cream can also be prescribed for use, for example, tablets. Doctors do not prohibit sexual activity (unless there are any contraindications associated with the course of pregnancy), but it is very desirable to conduct a full examination of sexual partners. If the husband also has an infection, then he will have to undergo treatment. At the same time, it is very desirable to use barrier contraceptives during sexual intercourse.
Especially for- Maria Dulina
From Guest
I also treated thrush with pimafucin, it helped, the thrush never returned.
From Guest
I treated thrush during pregnancy, since nothing was possible, they treated me with pimafucin. It helped well, the thrush passed and did not return.
Pregnancy is a long-awaited and joyful event in the life of almost every woman. But often this condition is overshadowed by unpleasant fungal diseases: thrush, colpitis or vaginitis. Treatment should be effective and safe for both the baby and the expectant mother. One of the most popular drugs prescribed by doctors to solve this delicate problem is Pimafucin.
Is Pimafucin harmful during pregnancy
Thrush (the correct name is "candidiasis") - one of the unpleasant companions of pregnant women. According to statistics, almost half of expectant mothers face it. The main reasons for the development of this fungal disease are changes in the hormonal background and a general decrease in immunity. Thrush must be treated, as it poses a potential danger to the embryonic organs of the fetus. Infection of the child often occurs during childbirth, but it is also possible during the period of gestation. In addition, characteristic discharge and itching cause severe discomfort to a pregnant woman.
Pimafucin is a modern and effective remedy, with the appointment of which gynecologists often begin the treatment of fungal infections in expectant mothers. It is considered safe for pregnant women at any time.
The active substance of the drug is natamycin. It is a broad spectrum topical antibiotic. It has a detrimental effect on yeast-like fungi, yeasts, dermatophytes and fungi of the genus Candida.
Natamycin does not enter the bloodstream and does not penetrate the utero-placental barrier. Therefore, Pimafucin is prescribed at any stage of pregnancy, but in the first trimester it is used with caution to reduce the risk of any negative effect on the developing fetus.
Release form: suppositories, tablets, cream
Pimafucin is available in three forms:
- suppositories (candles) - are used intravaginally;
- tablets - are taken orally as an addition to suppositories in case of a severe or chronic fungal disease, as well as to treat a focus of infection in the intestines;
- cream - applied externally. Can be used in a sexual partner to prevent the recurrence of the disease.
Expectant mothers are assigned primarily suppositories. The course of treatment can be, if indicated, supplemented by taking pills. The cream is used for infection of the external genitalia.
Thrush, colpitis and other indications
According to the instructions, Pimafucin is used in the following cases:
- vulvovaginal candidiasis;
- colpitis;
- vulvitis;
- fungal diseases of the gastrointestinal tract;
- treatment of systemic diseases of a fungal nature;
- fungal diseases of the skin and nails;
- dermatomycosis;
- ear candidiasis.
Pimafucin is not contraindicated not only for pregnant women, but also for lactating women, as well as for newborns.
Contraindications and side effects, including in early pregnancy
Side effects of Pimafucin depend on the form of its release. Tablets at the beginning of the course of treatment can cause nausea and diarrhea after taking, which pass on their own and do not require the drug to be discontinued. From the cream and suppositories there is a short-term local reaction in the form of irritation and burning in the vagina. Cancellation of the drug is required only with a pronounced and intensifying reaction with each use..
The only direct contraindication to the use of Pimafucin is hypersensitivity to natamycin and the auxiliary components that make up the drug.
An overdose of natamycin is extremely unlikely due to the low absorption of the drug.
Instructions for correct use
Suppositories are administered once a day (unless otherwise prescribed by the doctor) in a horizontal position, preferably at bedtime. This is necessary so that the medicine released from the candle does not leak out. The course of treatment is usually from 3 to 9 days and depends on the woman's well-being.
The course of treatment with tablets is a week or more. The doctor calculates the dose. The cream is applied to the affected areas once or twice a day. It must be used until the symptoms disappear completely.
If necessary, the course of treatment with the drug can be repeated. There is no limit on the number of courses.
If Pimafucin does not help
Obviously, despite all its advantages, Pimafucin may not be suitable individually due to an allergic reaction to one of the components of the composition or the lack of a therapeutic effect. Pharmacological analogues based on natamycin are not prescribed in this case, the doctor selects an antifungal drug with another active ingredient. Some replacement options are discussed in the table. However, many of them are contraindicated in early pregnancy.
Table: Clotrimazole and other analogues of Pimafucin according to the therapeutic effect used in different trimesters of pregnancy
| Name | Active substance | Application during pregnancy | Release forms | Contraindications |
|
clotrimazole |
clotrimazole | Acceptable in the II and III trimester |
|
Hypersensitivity |
| Betadine | Povidone-Iodine |
|
|
|
| Gino Pevaril | Econazole |
|
|
|
| Terzhinan |
|
Used in the II and III trimester | Vaginal tablets | Hypersensitivity |
| Livarol | Ketoconazole |
|
Suppositories vaginal | Hypersensitivity |
From this article you will learn about the use of Pimafucin during pregnancy in the 1st, 2nd and 3rd trimester. This is a fairly popular and well-known remedy for women.
Pimafucin is the trade name, that is, the brand under which the joint Dutch-Japanese company Astellas produces the drug substance natamycin. Pimafucin is produced by the company in several dosage forms - vaginal suppositories (or suppositories), cream for external or internal (vaginal) use, tablets for oral administration. The drug is used mainly for the treatment of thrush (candidiasis).
Today we will mainly talk about the vaginal form - suppositories or suppositories. The company produces them in the amount of three or six candles per pack. The number of suppositories and the mode of their administration is prescribed by the gynecologist after examination and confirmation of the diagnosis.
The tool relatively recently entered the market, but managed to gain the trust of gynecologists, since it has a number of undoubted advantages that allow Pimafucin to be used in different categories of patients, including expectant mothers. Pregnant women are a complex group of patients who find it difficult to prescribe treatment, because almost all drugs in one way or another affect the growing fetus. Why is the remedy ideal for pregnant women?
The mechanism of action of the drug
Natamycin - the active ingredient of the drug Pimafucin - is a relatively new antifungal agent, to which fungi have not yet had time to form resistance and defense mechanisms. The drug is a pure antimycotic or antifungal agent - that is, it inhibits the growth and reproduction of only fungi, destroying their cell membranes, without touching viruses or bacteria. That is why you need to clearly know the nature of vulvovaginitis and the complaints associated with them - with pure candidiasis, Pimafucin is very effective, with a bacterial or mixed process, the effect will be insignificant.
The chemical formula of the active substance of natamycin, which is obtained by isolating from cultures of various bacteria - streptomycetes (Streptomyces natalensis). These bacteria are shown in the photo (view under a microscope)
The main advantage of natamycin is that the substance is practically not absorbed from the stomach and intestines when taken through the mouth and is also not absorbed anywhere from the vagina or from the surface of the skin when applied externally. This means that the drug molecules do not enter the mother's systemic circulation, and from her they do not pass through the placenta to the fetus. Thus, the drug is completely safe for the growing fetus and can be used at any stage of pregnancy, even in the most delicate first trimester. The drug has the same safety profile, proven in animal and human studies, both when administered vaginally in suppositories and when taken orally in the form of tablets.
Indications and contraindications
Let us designate the diseases in which the drug is effective:
Candles are indicated for acute and chronic vulvovaginitis of a fungal nature - usually a candidal infection.
The cream can be used for lesions of the external genitalia in both women and men. Also, the cream is used to treat fungal infections of the skin, nails, fungal infection of the outer ear.
Tablets are indicated for intestinal candidiasis, as well as as an additional therapy for persistent, often recurrent lesions of the genital organs.
The drug also won the approval of doctors and patients because it has practically no contraindications for use. Individual intolerance and allergic reactions are the only limitations to its use.
Rarely, but individual intolerance and an allergic reaction are possible during treatment with Pimafucin
Advantages and disadvantages of the drug Pimafucin
Let's start with the positive aspects of the drug:
- Available, since it is dispensed from pharmacies without a doctor's prescription, it is included in the list of drugs on the mandatory list, therefore it is available in almost every pharmacy.
- It is effective for vaginal candidiasis in the form of suppositories or cream, as well as for intestinal candidiasis when taken orally. Also, the drug acts against a wide range of other fungi and dermatophytes.
- Approved for use in children, pregnant women and nursing mothers, since it is not absorbed into the bloodstream and does not adversely affect the fetus or infant.
- It is convenient to use, usually the course of treatment with candles is from three to six days, and suppositories need to be inserted into the vagina once a day.
- Well tolerated, does not cause almost no side effects. A rare exception is local irritation, itching and an allergic reaction.
- It acts quickly, relief of symptoms occurs already on the first day after the introduction of the first suppository.
We also list the disadvantages that each drug has:
- The medicine is effective only against fungi, without having any effect on bacteria, viruses and protozoa, so mixed colpitis cannot be cured with Pimafucin suppositories.
- The drug is quite expensive. The price for a course of suppositories is on average $10-15, depending on the number of suppositories in the package.
- The drug has few analogues or generics, that is, it is not always possible to find a more budgetary replacement. At the moment, there are only three generics of Pimafucin - the Belarusian Natacin, the Russian Ecofucin and the Moldovan Primafungin.
How to take Pimafucin
Any treatment, especially during pregnancy, should be prescribed by the attending physician after examination and diagnosis. Here are 5 basic principles for the use of Pimafucin suppositories:
Candles are used to treat acute or chronic recurrent genital candidiasis in women. For concomitant treatment of the sexual partner, a cream of the same name can be used.
The regimen for an acute uncomplicated episode of "thrush" is three suppositories, but with a recurrent course, the course is extended to 6 or more suppositories, and sometimes supplemented by taking Pimafucin tablets inside.
Pimafucin during pregnancy is taken according to the general rules. Reception regimens are the same for pregnant women of all three trimesters, lactating women and ordinary patients.
Candles are inserted into the vagina as deeply as possible, preferably at night, so that the candle melted in the heat does not flow out of the vagina.
It is very important to complete the course of treatment prescribed by the doctor, regardless of whether the state of health has improved and whether the complaints have disappeared. In the event of an unauthorized interruption of the course, the transition of a fungal infection into a chronic form and the formation of drug resistance in the fungus is possible.
Owner and responsible for the site and content: Afinogenov Alexey.
Pregnancy is often accompanied by candidal colpitis, which bring a lot of inconvenience to a woman. And you always have to choose between effective and safe drugs, especially up to 12 weeks, when any negative impact can disrupt the normal development of the embryo.
One of the most popular and affordable means is pimafucin, which is approved for use in early pregnancy without any restrictions. How and when to use it correctly and what is better to choose - candles, cream or tablets?
Read in this article
The composition and properties of the drug
Pifamucin is based on the active substance natamycin, a drug that belongs to the polyene group and has antifungal activity. It is noteworthy that there is no sensitivity to this drug from, for example, candida. This opens up wide possibilities for drug therapy.
This drug is presented in various forms - tablets, ointments and suppositories. Therefore, for each clinical variant, you can choose your own, the most suitable one.
As for the tablets, each contains 100 mg of the main active ingredient.
How it works
Natamycin interacts with certain pathogen envelope structures. So it violates the foundations of their life, as a result, it leads to death.
A feature of the capsules is that when taken orally, they act only in the intestines, without being absorbed into the systemic circulation. The same is true when using cutaneous ointments - only local action. That is why pimafucin and its analogues can be used without fear during pregnancy, even in the early stages.
Indications for use
Pimafucin is used to treat all conditions when pathogenic microorganisms, in particular fungi, are sensitive to it. Preference is given in the following situations:
- With, vulvovaginitis, vulvitis (with involvement in the process not only of the vagina, but also of the external genital organs).
- If necessary, carry out sanitation from fungi in the intestines. Often such a need arises in case of serious immunodeficiency states (including HIV), against the background of taking cytostatics and antibacterial drugs, hormonal agents.
- In case of systemic fungal infection. In this situation, pimafucin can be used both externally and internally.
Before using the drug, you should make sure that the pathogenic flora is sensitive to it.
Is it possible during pregnancy
Pimafucin can be safely used during pregnancy throughout the entire gestation period. The drug does not have a detrimental effect on the developing fetus. This is largely due to the fact that the drug, when taken orally, is not absorbed into the systemic circulation, just like when used topically. As a result, chemical components simply do not reach the fetus.
Despite this, during pregnancy, especially in the early stages, preference is given to the use of suppositories, and only with more extensive indications and serious situations is it better to use tablets inside.
Watch the video about the drug:
Application schemes
Schemes of application and the form of the drug depend on the goals pursued and the general condition of the woman.
Tablets
The average dose is 1 tablet 4 times a day. Children are usually prescribed only 2 times a day. The duration of treatment differs. So, it's roughly like this:
- with intestinal candidiasis, you should take the remedy for a week;
- in case of damage to the nail fungus, the minimum duration of therapy is 2 - 3 months, until a new nail grows;
- if tablets are used as an adjunct to local treatment, for example, for vulvitis or skin pathologies, the average course is 2-3 weeks.
Candles
Suppositories are used to treat fungal infections of the external and internal genital organs.
Pimafucin (candles) in early pregnancy is prescribed one suppository deep into the vagina once a day. It is best to administer the medicine in the supine position, after which it is recommended to remain in a horizontal position for some time so that the dissolved suppository does not leak out. With this in mind, the remedy is usually laid at night.
The average course is from 3 to 6 - 7 days. Depending on the clinical picture, treatment can be extended up to 2-3 weeks or tablet forms can be added.
Cream
The cream is used for lesions of the skin, nails or for application to the external genitalia, as well as for the treatment of candidiasis in men. The agent is applied up to 3-4 times a day with a thin layer.
Possible complications and side effects
Despite the fact that the drug is approved during pregnancy, various adverse reactions and complications can be observed with its use.
When taking pimafucin tablets, nausea, loosening of the stool may occur. However, these minor disorders go away on their own with further use of the remedy.
When applying the cream and suppositories, burning and slight irritation of the tissues may occur. Such conditions do not require additional treatment and soon pass on their own.
Pimafucin should not be taken if allergic reactions of any manifestation (rash, swelling, etc.) have ever been recorded on the components of the drug.
It is noteworthy that the remedy can be combined with others, since it is not absorbed in the intestines and the surface of the skin, and does not interact with other drugs.
Analogues
There are drugs that also contain 100 mg of natamycin in the composition and have the same methods, indications and contraindications for use. These include:
- Natamycin. Its cost varies from 200 to 400 rubles.
- Primafungin. Price from 220 rubles for three vaginal suppositories.
- Ecofucin is also only in the form of candles.
Thus, there are analogues for this drug, but they are not presented in all forms, only pimafucin has a variety (cream, tablets).
Often during pregnancy, one has to deal with manifestations of a candidal infection of the genital organs in a woman. The doctor and the expectant mother always face a choice - effective or safe to use the medicine.
Pimafucin is a drug that can be safely prescribed even in the early stages of pregnancy and continue to be taken until the very birth, if necessary. Baby and mom will be safe using this medicine.
During pregnancy, chronic diseases are often exacerbated or diseases appear that have not bothered until that time. The fungus can cause discomfort, as well as affect the well-being of the mother and the health of the unborn baby. Will Pimafucin help in this case and is it safe?
Is Pimafucin harmful during pregnancy
Pimafucin is a topical antibiotic that is indicated for the treatment of fungal diseases of the mucous membranes and skin. According to the instructions, this drug can be used during pregnancy. It is indicated that there are no data on the effect on the fetus. Most often, expectant mothers are prescribed this medicine for thrush, or candidiasis.
Of course, no clinical trials of drugs for pregnant women are carried out, but this drug is considered one of the safest.
Pimafucin can be prescribed by a doctor even in early pregnancy. In the first trimester, fungal diseases of a woman are potentially dangerous for the unborn child: there is a possibility of miscarriage or missed pregnancy. In the II and III trimesters, the infection is fraught with intrauterine infection of the fetus. Also, during childbirth, the baby can become infected with a fungal disease. Therefore, throughout pregnancy, it is important to listen to your condition and start treatment on time if necessary. However, there is another medical opinion.
Thrush is considered the physiological norm of pregnancy, since increased growth of the fungus is observed in 80-90% of pregnant women. It is not dangerous for both the pregnant woman and the fetus and newborn.
E.P. Berezovskaya
http://www.komarovskiy.net/faq/beremennost-i-molochnica.html
Composition, action and form of release
The active ingredient in Pimafucin is the antibiotic natamycin. It acts only locally and is not absorbed into the blood. Its content varies depending on the form of release of the drug.
Pimafucin is available in suppositories, tablets and in the form of a cream. With thrush, vaginal suppositories are most often prescribed. If the focus of infection is in the intestines, then the doctor can supplement the treatment regimen with taking pills. The cream in such cases is used when the fungus affects the external genital organs of a woman and her sexual partner.
Photo gallery: Pimafucin release forms
Pimafucin tablets are intended for oral administration with intestinal candidiasis 
Pimafucin cream has a local antifungal effect on the skin and mucous membranes 
Pimafucin vaginal suppositories are most often prescribed for thrush
What helps: thrush, colpitis and other indications
In most cases, during pregnancy, vaginal candidiasis is treated with Pimafucin, however, the range of application of this local antibiotic is wide, which allows it to be successfully used for other fungal infections. Indications are slightly different for different forms of release of the drug.
Tablets can be prescribed for:
- acute pseudomembranous and atrophic candidiasis;
- otomycosis, external, caused by fungi or complicated by candidiasis;
- skin and nail candidiasis;
- intestinal candidiasis;
- vaginitis (colpitis), vulvitis, vulvovaginitis, balanoposthitis;
- dermatomycosis.
Suppositories are successfully used from:
- vaginitis ();
- vulvitis;
- vulvovaginitis.
The cream can be prescribed in case of:
- vulvitis;
- vulvovaginitis;
- balanoposthitis;
- skin and nail candidiasis;
- otitis externa with candidiasis;
- dermatomycosis.
Despite the safety of the drug, you should not self-medicate. Only a doctor will be able to determine the exact diagnosis and select the appropriate form of medication and an individual treatment regimen.
Instructions for safe use
Features of the use of candles, tablets and cream
According to the instructions, Pimafucin in candles should be used 1 time per day for 3-6 days. The suppository should be administered at night in the supine position. This is necessary so that the medicine released when the candle melts does not leak out.
The drug in tablets is prescribed 4 times a day. The course usually lasts no more than 1 week. Treatment with tablets can be combined with the use of suppositories and creams.
Usually, after the disappearance of unpleasant symptoms, Pimafucin therapy is continued for several more days to prevent a recurrence of the infection.
The final duration of the course of treatment for all forms of the drug is set by the doctor individually, taking into account the patient's condition.
Contraindications and side effects
Among the direct contraindications in the instructions for Pimafucin, only hypersensitivity to natamycin and auxiliary components of the drug was noted. Local side effects - vaginal irritation and burning sensation - may appear when using Pimafucin in suppositories or in the form of a cream. They are short-term and usually do not require discontinuation of the drug. Tablets have a wider list of side effects:
- nausea,
- diarrhea,
Individual reactions associated with intolerance to the components of the drug are possible.
The active substance natamycin does not penetrate the placenta and into the bloodstream that connects the body of the mother and child. Therefore, Pimafucin is considered safe during pregnancy. If any serious side effect still occurs in a woman, then treatment should be stopped, since it is likely that a similar negative effect can happen to the fetus. For example, if a mother has an allergy, then the baby may be born with a tendency to have the same reaction.
What can replace Pimafucin in different trimesters of pregnancy
It also happens that Pimafucin does not help to cope with fungal diseases that bring severe discomfort. Some women note that after a course of treatment with this drug, discharge and other unpleasant symptoms continue to bother them. In this case, it is necessary to consult a doctor and choose another drug that is safe during pregnancy.
Table: Pimafucin analogues, clotrimazole and other antibiotics for the treatment of fungal diseases at different stages of pregnancy
| medicinal product | Release form | Active substance | Contraindications | Side effects | |
| Ecofucin | Suppositories vaginal | Natamycin | Hypersensitivity to the components of the drug | - |
|
| Suppositories vaginal | Natamycin | - |
|
||
| Vaginal tablets | It is not recommended to use during pregnancy (especially in the first trimester). |
|
|||
| The issue of prescribing the drug should be decided by the doctor individually. In this case, the use of the applicator is not recommended. | Rarely - a slight burning sensation immediately after the administration of the tablet | ||||
|
Not recommended for use in the first trimester of pregnancy. | allergic reactions | |||
| Tablets |
|
|
|||
| Vaginal capsules |
|
Not recommended for use in the first trimester of pregnancy. In the II and III trimesters, the use is possible only on prescription in cases where the expected benefit to the mother outweighs the potential risk to the fetus. |
|
||
Photo gallery: drugs prescribed for pregnant women with fungal infections
Polygynax is not recommended for use in the first trimester of pregnancy. 
According to the manufacturer, Nystatin can be taken during pregnancy 
Terzhinan vaginal tablets can cause mucosal irritation and allergic reactions. 
In the first trimester of pregnancy, clotrimazole is not recommended for use. 
Candide-B6 is not prohibited during pregnancy, but the benefit to the mother and the risk to the fetus should be weighed 
Primafungin is a pharmacological analogue of Pimafucin
