Uses

This product is used to treat certain types of vaginal infections (such as mixed fungal and bacterial infections). It is a combination of 2 medications, nystatin and metronidazole. Nystatin is an antifungal that stops the growth of fungus. Metronidazole is an antibiotic that stops the growth of certain bacteria (Trichomonas-type). This product helps to reduce itching and irritating discharge.

How To Use

This product is for vaginal use only. Using the applicator, insert 1 applicatorful of cream deep into the vagina, usually once daily before bedtime for 10 days or as directed by your doctor.

Wash hands before and after using this medication. Follow the manufacturer's directions for placing the cream into the applicator. Insert the applicator high into the vagina and press the plunger to release the medication. After each use, clean the applicator with warm soapy water and rinse well.

Do not drink alcohol while using this medication and for at least 24 hours after stopping the medication. Drinking alcohol while using this medication may cause stomach cramps, flushing, nausea, vomiting, and headache.

Continue to use this product until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the product too early may result in a return of the infection.

If your symptoms worsen, or if they have not improved within 10 days, tell your doctor promptly. You may require additional medication to treat your condition.

Your sexual partner may also require medication to prevent re-infection. Consult your doctor.

Side Effects

Vaginal burning/itching, gritty feeling in the vagina, bitter taste in the mouth, stomach pain, or nausea may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these rare but very serious side effects occur:

• seizures
• tingling/numbness of the hands/feet

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before using nystatin/metronidazole, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as paraben preservatives), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

• seizure disorders
• liver disease
• nervous system problems
• blood disorders

During pregnancy, this medication should be used only when clearly needed. Antibiotics taken by mouth have been used to treat vaginal infections during pregnancy (especially pregnancies with problems such as risk of early childbirth). Consult your doctor for more details and to discuss the risks and benefits.

The metronidazole in this product passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Drug Interactions

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.

This drug should not be used with the following medication because a very serious interaction may occur:

• disulfiram

If you have been taking disulfiram, it is recommended that you wait 2 weeks before starting treatment with a product containing metronidazole. Check with your doctor to see if waiting 2 weeks is okay for you.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of:

• "blood thinners" (such as warfarin)
• lithium
• phenytoin

Check the labels on all your liquid medicines, including liquid-filled capsules (such as cough-and-cold products, diet aids, nonsteroidal anti-inflammatory drugs known as NSAIDs for pain/fever reduction) to see if they contain alcohol or propylene glycol. Do not take products containing alcohol or propylene glycol while using this medication and for at least 24 hours after stopping treatment. Ask your pharmacist for more details.

This document does not contain all possible interactions. Before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

Overdose

This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 9-1-1. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

Notes

Do not share this medication with others.

This medication has been prescribed for your current condition only. Do not use it later for another infection unless your doctor tells you to.

Missed Dose

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

Storage

Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.