Vaginal antiseptic for bacterial vaginosis Vablys now available in Canada

Duchesnay is introducing Vablys (dequalinium chloride 10 mg vaginal tablets) for the treatment of bacterial vaginosis in adult women under 55 years of age.1 Dequalinium chloride is a quaternary ammonium antiseptic agent with anti-infective properties. It is a surface-active agent that acts locally within the vagina. Its antimicrobial activity is primarily based on an increase in bacterial cell permeability and the subsequent loss of enzyme activity, which results in cell death.1 Vablys is dosed as one tablet inserted intra-vaginally at bedtime for six consecutive days. Patients should be advised to continue treatment for the full six days even if symptoms (itching, discharge, odour) have resolved. If symptoms persist at the end of the six-day treatment or if the condition recurs, patients should consult a physician.1 Read: OB-GYN society launches data collection initiative on Canadian maternal mortality Instruct patients to insert the tablet deeply into the vagina, using a finger or the applicator provided in the box. Insertion will be easier if the patient is in a lying position, with legs slightly bent. It is best to start therapy six days before the next menses or directly after menses, since heavy bleeding during menses could wash out the drug. Advise patients to refrain from sexual intercourse during treatment.1 In situations of severe vaginal dryness, the vaginal tablet may not dissolve and may be discharged from the vagina intact. If this occurs, recommend that patients moisten the vaginal tablet with a drop of water before reinsertion into the vagina.1 The most common adverse effects of vaginal dequalinium chloride are local reactions, including vaginal discharge, vulvovaginal pruritus, vaginal candidiasis and vulvovaginal burning sensation. Alert patients that Vablys tablets contain excipients that do not dissolve completely, so small tablet remnants may occasionally be found in undergarments.1 Drug interactions with systemic drugs are not expected with vaginal dequalinium chloride. Compatibility with condoms and other intravaginal devices and genitourinary products (e.g., diaphragms, menstrual tampons and cups) has not been established. Concomitant intravaginal use of soaps, spermicides or vaginal douches/washes is not recommended as they may reduce the antimicrobial activity of dequalinium chloride.1 Read: Slynd: second oral progestin-only contraceptive now available in Canada In a single-blind randomized clinical trial, treatment of bacterial vaginosis with a six-day course of dequalinium chloride 10 mg vaginal tablets was equally effective as a seven-day course of clindamycin 2% vaginal cream. Clinical cure rates one and four weeks after the end of therapy were similar for both treatments. No statistically significant difference in adverse effects was seen between the two treatments.2 Vablys will be supplied in boxes containing six vaginal tablets plus a plastic applicator.1 Dequalinium chloride (brand name, Fluomizin) has been available for the treatment of bacterial vaginosis in the United Kingdom since 2015.3 References 1. Duchesnay Inc. Vablys (dequalinium chloride vaginal tablets) product monograph. Blainville, QC; September 1, 2021. https://pdf.hres.ca/dpd_pm/00063156.PDF (accessed June 7, 2022). 2: Weissenbacher ER, Donders G, Unzeitig V, et al; Fluomizin Study Group. A comparison of dequalinium chloride vaginal tablets (Fluomizin) and clindamycin vaginal cream in the treatment of bacterial vaginosis: a single-blind, randomized clinical trial of efficacy and safety. Gynecol Obstet Invest 2012;73(1):8-15. https://www.karger.com/Article/Pdf/332398 (accessed June 7, 2022). 3. Anon. Dequalinium for bacterial vaginosis. Drug Ther Bull 2017;55(5):54-57. doi: 10.1136/dtb.2017.5.0478

Vaginal antiseptic for bacterial vaginosis Vablys now available in Canada

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