Another reason for not formulating vaginal ovules with lipophilic excipients is the damage that the drug could create locally: when the active ingredient is melted too quickly (therefore released in a very short time), the vaginal mucosa could be heavily affected, and become hypersensitive, red or irritated.
The most suitable excipients are hydrophilic ones, therefore soluble in water, capable of slowly melting: these substances allow the active principle to be spread gradually, so that the vaginal mucosa comes into contact with the drug for the appropriate time, which ensures its " desired therapeutic action.
There glycerin glycerin constitutes the most widely used excipient of all for the formulation of vaginal ovules; from Manual of galenic preparations, it appears that the classical composition of this excipient is formulated with 10% gelatin, 25% purified water and 65% glycerol.
The quantity of each single component of glycerin glycerin can vary according to the active ingredient: some substances, in fact, increase or decrease the consistency of the product, therefore, to obtain an ideal solidity, it is essential to modulate the quantity of the excipients.
As an alternative to glycerin glycerin, the so-called PEG, acronym for polyethylene glycol, can be used, widely used in the pharmacological (and cosmetic) sector for their plasticising properties. For example, in vaginal tablets, PEGs increase the plastic properties of the outer film.
Many vaginal pessaries are also formulated with tartaric or lactic acid to achieve a pH in the pessary very similar to that of the vagina.
From these premises, we understand how the choice of excipients heavily affects the quality of the drug: it is therefore necessary to pay particular attention not only to the choice of the active ingredient, but also to the selection of the excipient.
ACTIVE PRINCIPLES: the active ingredients used in the vaginal ovules are various; the choice of one drug over another clearly depends on the problem that afflicts the woman. For example, for vaginal fungal infections, it is recommended to take vaginal suppositories formulated with specific antifungals, while for the treatment of bacterial vaginal infections antibiotics exert their therapeutic effect excellently. In the form of vaginal ovules, lactobacilli are also available which, acting directly at the vaginal level, exert their therapeutic effect to the fullest; for example, to rebalance the composition of the vaginal bacterial flora in a short time, the application of vaginal ovules is more suitable than the oral intake of lactobacilli which, although having a good therapeutic effect, require more time.
Examples of active ingredients and medicinal specialties:
- Econazole (eg. Pevaryl, Ecodergin, Ecomí, Ganazolo, Ifenec Ginec OVULI): indicated for the treatment of Candida albicans
- Miconazole (eg Daktarin, Micotef): indicated for the treatment of infections with Candida albicans
- Metronidazole (eg Flagyl): indicated for the topical treatment of Trichomonas vaginalis vaginitis
- Lactobacilli (eg Candinorm, Floragyn, Softigyn VAGINAL OVULES): indicated for the restoration of the vaginal bacterial flora
- Triticum vulgare + 2-phenoxyethanol (eg. Fitostimoline vaginal ovules): indicated for inflammatory and dystrophic diseases of any origin, affecting the female genitals
- Clindamycin phosphate (eg. Cleocin vaginal ovules): antibiotic indicated for the treatment of trichomoniasis
- Kanamycin (eg. Keimycin): indicated for the treatment of vaginitis, bacterial cervicitis and vulvovaginitis (broad spectrum antibiotic, which acts against staphylococci, E. coli, A. aerogenes)
- Nonoxinol-9 (eg Patentex Oval): indicated for contraceptive purposes, to be inserted into the vagina 10 minutes before the start of sexual intercourse
Read the in-depth study: Ovules for Candida
; after having extracted the egg from the package, insert it deeply (and gently) into the vagina. In this way, the active principle is dissolved.It is advisable to apply a vaginal ovum in the evening, before going to bed: the extended position favors the permanence of the drug along the vaginal canal, an indispensable element to allow the active ingredient to best exert its therapeutic action.
The antibacterial and antifungal drugs contained in the vaginal ovules, as well as some excipients with an emollient action, could damage condoms by interacting with the latex with which they are formulated; for this reason, it is not recommended to use latex condoms or diaphragms at the same time during the whole therapy with vaginal suppositories.
