What is Zidoval 0.75% gel?
Zidoval Vaginal Gel 0.75% is an antibiotic that contains 7.5g of metronidazole as main ingredient used to treat different infections due to its different faculties fighting against bacteria, helminths and protozoan microorganisms. Mostly used to treat infections when different pathogens are identified such as:
- Gardnerella vaginalis
- Entamoeba histolytica
- Giardia lamblia
- Balantidium coli
- Fusobacteria Clostridia
Zidoval 0.75% vaginal gel comes with 40 gm of the gel plus 5 disposable vaginal applicators to help you apply the adequate amount of 5 gm of gel.
What other substances does Zidoval 0.75% vaginal gel contain?
- Propyl parahydroxybenzoate
- propylene glycol
- carbomer (carbopol) 974P
- purified water
- disodium edetate
- methyl parahydroxybenzoate
What is Zidoval 0.75% vaginal gel mainly used for?
Zidoval vaginal gel 0-75% is mostly used to treat Bacterial Vaginosis (BV).
What is Bacterial Vaginosis?
Bacterial Vaginosis is a type of inflammation in your vagina caused by the multiplication and overgrowth of the microorganisms that are naturally found in your vagina, called Lactobacilli. It is also known as nonspecific vaginitis.
Commonly known as BV, is considered to be one of the most common vaginal affection in women of reproductive age (14-49 years old). Normally, the vaginal flora consists of different microorganisms, being one of the most important Lactobacilli. Lactobacili have different sub-types and are different according to your ethnicity. These microorganisms maintain your vagina in an acidic environment (pH levels), preventing harmful bacteria to reproduce. When this barrier fails, “bad” bacteria start multiplying and that’s when the bacterial vaginosis occurs.
What are the risk factors of contracting BV?
- Changes in your body: Pregnancy can lead to a higher prevalence and it is found that around 7-22% of pregnant women will suffer from this condition.
- Multiple sexual partners throughout your lifetime
- New sexual partner.
- Birth control devices such as IUD (intrauterine device)
- Vaginal hygiene products that contain perfume: vaginal deodorants, perfumed bubble baths
- Vaginal douches
- Use of strong detergents to wash underwear
- Tight clothing such as underwear or pants.
- Underwear made out of synthetic fibers.
- History of induced abortion
- Recent antibiotic treatment for other infections.
- Recent studies have identified vitamin D deficiency as a risk factor in pregnant women
- BV can be associated with hormonal factors since it develops most often around the time of menstruation, and may resolve spontaneously mid-cycle.
- Natural lack of Lactobacilli.
It is important to know that bacterial vaginosis can’t be transmitted from using public toilet seats, swimming pools, bed sheets or through contact.
Sexual activity has an indirect role in this disease. Women who have never had any type of sexual intercourse including oral, vaginal or anal sex can still be affected by this disease, but the prevalence of BV has a significant increase based on the number of sexual partners throughout your lifetime.
What are the signs and symptoms of BV?
The most common symptoms are usually recognized after sexual intercourse and include:
- Distinctive “fish-like” vaginal odor
- Increase in vaginal discharge
- Change in color of vaginal discharge: White to grayish color.
- Vulvar irritation or itching
- Burning pee sensation or pain decrease in the amount of urine. ( Less commonly.)
What are the complications if you don’t get treated?
BV can be spontaneously cure because of the hormonal changes that occur throughout your menstrual cycle, but it is important to take certain precautions and use medicine so that complications do not develop and mostly in pregnant women.
Some of the complications are:
- Susceptibility to other sexually transmitted infections such as chlamydia, gonorrhea, HIV, herpes simplex virus and others.
- Pelvic Inflammatory disease: also known as PID, is a complication of sexually transmitted disease that affects the uterus and Fallopian tubes that increase the risk of being infertile.
- Cervicitis: inflammation of the cervix, usually goes hand in hand with other infections such as gonorrhea, chlamydia and HSV (herpes simplex virus)
- Endometritis: Inflammation of the endometrium which can cause abnormal bleeding
- Higher predisposition to suffer from urinary tract infections
- Spontaneous abortions
- Salpingitis: inflammation of Fallopian tubes
- Bacteremia: Presence of bacteria in the bloodstream
When should you visit a doctor?
You should make an appointment with your doctor if you
- notice that your vaginal discharge is different in color and or smell
- presence of fever
- you’ve tried over the counter medicines and symptoms are still persistent
- if you present the symptoms and have a new sexual partner
- if you have had vaginal infections in the past but this time it appears different
- if you are pregnant or plan to get pregnant
- if you are breastfeeding
- if you experience abdominal or pelvic pain
Who should consider other alternatives over Zidoval 0.75% vaginal gel?
Zidoval 0.75% vaginal gel’s active ingredient is metronidazole and has a Black Box Warning, meaning that studies with animals have shown it can produce a carcinogenic effect, therefore might have the same effect in humans. Zidoval 0.75% vaginal gel should only be used when prescribed by a doctor.
You should consider other options over Zidoval 0.75% vaginal gel if you suffer or have:
- Known hypersensitivity to metronidazole or other medicines that contain nitrimidazoles.
- If you are pregnant in your first trimester.
- Suffer from Liver disease: A doctor will either change medication or change the therapeutic dosage.
- Suffer from Kidney disease
- Suffer from blood dyscrasia: a health condition that occurs when blood components, ( red blood cells, white blood cells or platelets) are impaired and tend to either increase or decrease in abnormal levels.
- Are under the age of 12 years old
- If you have your period or are about to start your mestrual cycle.
Should you be tested for other sexually transmitted diseases?
Since bacterial vaginosis tends to increase the percentage of acquiring a sexually transmitted disease it is recommended for women to be tested for other infections such as gonorrhea, chlamydia, herpes simplex virus (HSV) and HIV depending on the life style habits and risk factors present in the patient.
It is important to know that chronic use of metronidazole may alter the flora found in the vagina which may lead to a predisposition to vaginal candidiasis.
Are there medicines that have interactions with Zidoval 0.75% vaginal gel?
- Alcohol: Alcohol consumption is not recommended when using this medication because it contains metronidazole.
- Disulfiram: Mixing with Zidoval 0.75% vaginal gel can provoke psychotic reactions such as hallucinations, confusion and delusion.
- Antiepileptic medication: Phenobarbital and phenytoin affects the efficiency of Zidoval 0.75% vaginal gel, therefore the treatment might not work correctly if taken with these medications.
- Psychiatric medications: Lithium taken with Zidoval 0.75% vaginal gel may cause renal damage. Therefore, the amount of metronidazole should be adjusted accordingly to these patients.
- Anticoagulant therapy: Zidoval 0.75% vaginal gel will cause Warfarin to be potentiated, therefore dosage and coagulation times on patients taking this medication should be adjusted and controlled.
- Cancer treatment: Busulfan should not be given in conjunction with Zidoval 0.75% vaginal gel because of possible toxicity by Busulfan.
How should you use Zidoval 0.75% vaginal gel?
The usual adult dosage is 5 g (one applicator) inserted into the vagina, once a day before bedtime for five days.
Before using Zidoval 0.75% vaginal gel, be sure to wash your hands thoroughly with water and soap. Every applicator is disposable, therefore it should only be used once for each dose. Squeeze the gel from the tube to insert it in the applicator. After removing it from the tube, insert the applicator into the vagina and push the gel inside. After using the applicator, discard it in the trash bin.
Can Zidoval 0.75% be used in pregnant or breastfeeding women?
If you are pregnant or breastfeeding be sure to tell your GP about it so that the dosage or medication is changed according to your situation. Studies have not shown adverse effects in pregnant women using metronidazole after first trimester but there are no studies made with Zidoval vaginal gel. Precaution should be taken if you are pregnant or breastfeeding.
Should your sexual partner be treated as well if you were diagnosed with BV?
It is not necessary for your sexual partner to be treated if he/she does not present any symptoms, so no prophylactic treatment is necessary for this.
What should you do if you miss a dose?
If you miss a dose of Zidoval 0.75% vaginal gel, be sure to apply it as soon as you remember. If you are close to using the next dosage, do not use double the dosage to try to make up for the forgotten one. Continue your treatment as stated. Be sure to use your medications every day at the same hour to avoid forgetting any dosage. Since probable vaginal secretion is expected, it is recommended to be used at night. If you forgot to use an applicator, you can take other precautions such as using pads to avoid uncomfortable incidents such as secretion.
When should you stop taking the medication?
Always take the medication as prescribed by your doctor. Never stop the regimen just because you feel better or your discharge has stopped. This will lead to recurrent bacterial vaginosis or bacterial antibiotic resistance that will lead to complications.
What should you do if you took the medicine and the symptoms didn’t disappear?
Recurrent symptoms after 3 months are common in around 30% of women who suffer from bacterial vaginosis and 50% of women may present it in the upcoming 6 months. A 7 day oral or vaginal cream treatment may be used. Either Metronidazole or Clindamycin should work, with the only exception that if the first time you took metronidazole orally, next time change the treatment to Clindamycin in cream prospective and vice-versa. Be sure to visit your doctor if you present more than three bacterial vaginosis episodes in between 12 months, since the treatment will have to change.
Is there a risk of overdose by using Zidoval 0.75% vaginal gel?
There have been no reported cases of overdose because of Zidoval 0.75% vaginal gel. Therefore it is safe to use if used just as prescribed.
Like all medicines Zidoval gel can cause side effects, although not everybody gets them.
Common side effects (may affect up to 1 in 10 people)
- Headache and dizziness
- Stomach cramps
- Being sick
- Unpleasant taste in your mouth
- Unusual feeling on your tongue
- Vaginal thrush (candidiasis)
- Dry skin
- Redness of the skin (erythema)
- Itching of the skin (pruritus)
- Skin discomfort (burning, pain of skin / stinging)
- Skin irritation
- Vaginal discharge
- Discomfort around your pelvis
- Decreased appetite.
Uncommon side effects (may affect up to 1 in 100 people)
- Feeling irritable
- Difficulty in sleeping
- An unusual feeling in your fingers and toes
- Bloated or gurgling stomach
- A dry mouth or feeling thirsty
- Metallic taste in your mouth
- Feeling sick
- Muscle cramps
- Darkened urine
- Urinary tract infections (UTIs) that may cause pain or a burning sensation when you pass water, or may make you need to pass water more often or more urgently
- Swelling of your vulva (the outside of your vagina)
- Changes in your periods such as spotting or bleeding between periods or increased discomfort during your period.
The Patient Information Leaflet (PIL) is the leaflet included in the pack with a medicine. It is written for patients and gives information about taking or using a medicine. It is possible that the leaflet in your medicine pack may differ from the PDF-version from this website because it may have been updated since your medicine was packaged or the medicine is from another brand.