- Treatment for vaginal thrush with Canesten 500 mg pessary
- Access Canesten 500 mg pessary following an online medical consultation
- What is Canesten 500 mg pessary?
- What is vaginal thrush?
- How clotrimazole works
- How to use Canesten 500 mg pessary
- Is Canesten 500 mg pessary suitable for you?
- Side effects
- How DoktorABC works
- Canesten 500 mg pessary active substance and excipients
- Canesten 500 mg pessary patient information leaflet
Treatment for vaginal thrush with Canesten 500 mg pessary
Canesten 500 mg pessary is a single-dose antifungal treatment for vaginal thrush (candidal vaginitis) in adults. Manufactured by Bayer plc, it contains clotrimazole 500 mg as a white, convex vaginal pessary, supplied with an applicator in a cardboard carton. It is inserted once, at night, and works directly at the site of infection.
Access Canesten 500 mg pessary following an online medical consultation
Start the online consultation and complete the medical questionnaire. A UK-registered prescriber will review your answers and, where appropriate, issue a prescription for Canesten 500 mg pessary.
Important information
DoktorABC UK is a digital health platform that connects patients with independent, UK-registered prescribers. DoktorABC UK does not itself provide medical care, issue prescriptions, or dispense medicines. All clinical decisions are made by the UK-registered prescriber following an individual medical assessment.
What is Canesten 500 mg pessary?
Canesten 500 mg pessary is an antifungal vaginal pessary licensed for the treatment of candidal vaginitis, the clinical term for vaginal thrush. It contains clotrimazole, an antifungal medicine belonging to the azole class, at a single therapeutic dose of 500 mg.
Each pack contains one pessary and one applicator. It is intended for internal use only and does not include an external cream. It does not treat symptoms affecting the vulva or surrounding skin. If external itching or soreness is also present, a separate topical antifungal cream applied to the vulva may be considered alongside internal treatment; a prescriber or pharmacist can advise.
What is vaginal thrush?
Vaginal thrush is a common infection caused by an overgrowth of Candida, a yeast that is normally present in the vagina in small amounts. When the natural vaginal balance is disrupted, such as by hormonal changes, antibiotic use, or changes in health, Candida can multiply and cause symptoms. Thrush is not caused by poor hygiene and is not classified as a sexually transmitted infection.
Typical symptoms of vaginal thrush include:
- A white, thick, cottage cheese-like vaginal discharge that is usually odourless
- Itching, irritation, or soreness around the vulva and vagina
- Redness or swelling of the vulva
- Stinging or discomfort when urinating or during sex
Important: Some symptoms suggest a cause other than thrush and require clinical assessment before treatment. These include discharge with an unusual or unpleasant smell, vaginal bleeding outside of your normal period, sores or blisters, fever, pelvic pain, or pain on urination. If any of these apply, seek assessment from your GP or a sexual health clinic before using this product.
How clotrimazole works
Clotrimazole works by disrupting the cell membrane of the Candida fungus, causing it to break down and die. Applied directly inside the vagina, it reaches the site of infection and acts locally to clear the yeast overgrowth responsible for thrush.
Most people find that symptoms begin to improve within a day or two of treatment. However, complete symptom resolution may take a few days, and individual responses vary. If symptoms have not improved within seven days, or if they return shortly after treatment, contact your GP or prescriber.
Good to know: Canesten 500 mg pessary treats the internal vaginal infection only. It does not relieve external symptoms on the vulva or surrounding skin. If you also have external itching or irritation, a separate antifungal cream for the vulva may be needed alongside this treatment. A pharmacist or prescriber can advise.
How to use Canesten 500 mg pessary
The following guidance is based on the current UK patient information leaflet (Canesten 500 mg pessary, Bayer plc, medicines.org.uk, last revised 2023). Always read the full PIL supplied with your medication before use.
Preparation
- Wash your hands thoroughly before handling the applicator and the foil blister pack.
- Remove the pessary from the foil blister carefully.
- Attach the pessary to the applicator as directed in the PIL.
Inserting the pessary
- Lie on your back with your knees bent, or stand with one foot raised, whichever is more comfortable.
- Gently insert the applicator as far as is comfortable into the vagina.
- Push the plunger slowly and firmly to release the pessary as high up into the vagina as possible.
- Remove the applicator carefully.
- Wash your hands again after use.
The pessary should be inserted at night before going to sleep, so that it remains in place and has time to dissolve.
Important: The applicator cannot be flushed down the toilet. Dispose of it in household waste after use.
Additional guidance from the PIL:
- Menstruation: Do not use this product during your period, as it may be less effective. If your period starts during treatment, continue as directed and use sanitary towels rather than tampons.
- Other intravaginal products: Do not use tampons, other vaginal products, or douches while using this pessary.
- If the pessary does not dissolve: Some women find the pessary does not fully dissolve overnight. This is not a sign the treatment has not worked, as the active ingredient is released on contact with vaginal moisture. Contact your pharmacist or prescriber if you have concerns.
- If symptoms do not improve: If your symptoms have not improved within seven days of treatment, or if they return, contact your GP or prescriber rather than repeating the treatment independently.
- If you accidentally use more than one pessary: Contact your GP or NHS 111 for advice.
Is Canesten 500 mg pessary suitable for you?
Canesten 500 mg pessary is not appropriate for everyone. A medical assessment is required before use in the following circumstances.
- First episode of thrush: If this is the first time you have had these symptoms, a clinical assessment is recommended to confirm the diagnosis before treating.
- Recurrent symptoms: If you have had more than two episodes of thrush in the past six months, or more than four in the past twelve months, seek assessment. Recurrent thrush may have an underlying cause that requires investigation.
- Age: This product is intended for adults. It should not be used in girls under 16 years of age without medical advice.
- Pregnancy and breastfeeding: Canesten pessary can be used in pregnancy and breastfeeding. If you are pregnant, breastfeeding or trying for a baby, tell your doctor or midwife before using this product and follow their instructions carefully. If pregnant, the applicator should not be used; the pessary should be inserted by hand instead.
- Diabetes or weakened immune system: People with diabetes or a weakened immune system, including those on immunosuppressant medicines, may need medical assessment rather than self-treatment, as thrush can be more persistent in these groups.
- Allergies: Do not use this product if you are allergic to clotrimazole or any of the other ingredients listed in the PIL.
- Tacrolimus or sirolimus: The PIL advises that patients taking tacrolimus or sirolimus should speak to their doctor before using clotrimazole, as an interaction between these medicines and clotrimazole has been reported.
Side effects
As with all medicines, Canesten 500 mg pessary can cause side effects, although not everyone will experience them.
Local reactions at the site of use:
The most commonly reported side effects are local reactions in the vaginal area, which may include mild burning, stinging, or itching after insertion. These are usually temporary and settle quickly.
Signs of an allergic reaction:
As with all medicines, some people may be allergic to the pessary. If you are allergic, a reaction will occur soon after you have used the medicine. If you experience an allergic reaction or the redness, burning, pain, itching or swelling gets worse, stop using this product and tell your doctor straight away or contact the Accident and Emergency Department of your nearest hospital. Signs of an allergic reaction may include swallowing or breathing problems, swelling of your lips, face, throat or tongue, or weakness, feeling dizzy or faint.
Effect on latex contraception:
Patients should be advised to use alternative precautions for at least five days after use of the pessary, as clotrimazole may damage latex condoms and diaphragms, reducing their reliability as contraception. Use an alternative method of contraception during this period.
If you notice any side effects not listed here, report them to the MHRA via the Yellow Card scheme.
How DoktorABC works
DoktorABC UK is a digital health platform that connects patients with independent, UK-registered healthcare professionals through a secure online process.
- Complete a short medical questionnaire covering your symptoms, medical history, and any relevant medicines.
- An independent UK-registered prescriber reviews your information and determines whether Canesten 500 mg pessary is clinically appropriate for you.
- If treatment is considered suitable, a prescription is approved by the UK-registered prescriber in accordance with UK regulations.
- Your medication is dispensed by a GPhC-registered pharmacy and delivered to your door in discreet packaging.
DoktorABC UK does not itself provide medical care, issue prescriptions, or dispense medicines. All clinical decisions are made by the independent prescribing healthcare professional following an individual assessment.
Canesten 500 mg pessary active substance and excipients
Active substance:
Clotrimazole 500 mg per pessary.
Other ingredients:
Lactic acid, microcrystalline cellulose, crospovidone, maize starch, lactose monohydrate, magnesium stearate, silica colloidal anhydrous. Please refer to the patient information leaflet supplied with your medication for the full list of excipients.
Marketing authorisation holder:
Bayer plc, 400 South Oak Way, Reading, RG2 6AD, UK.
Canesten 500 mg pessary patient information leaflet
Available at medicines.org.uk/emc/product/2205/pil
