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7.6 Vaginal and vulva conditions

First line drugs Second line drugs Specialist drugs Secondary care drugs

 

Traffic light status (TLS) explained:

  • Green: Routine prescribing within licensed indication
  • Amber 1: specialist recommendation followed by GP initiation and continuation
  • Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
  • Amber 3: specialist initiation and stabilisation followed by GP continuation
  • Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
  • Red: Hospital or specialist prescribing only
  • Double Red: These medicines have been evaluated and rejected by MKPAG and are NOT approved for use within MK. They are not recommended for use because of lack of clinical effectiveness, cost effectiveness or safety.

 

 

 

7.6.1 Vaginal and vulval infections, bacterial

 

Clindamycin 

  • Cream

 

Metronidazole

  • Gel 0.75% 

 

 

 

7.6.2 Vaginal and vulval infections, fungal

Clotrimazole

  • Cream (topical) 1%  
  • Intravaginal cream 10%
  • Pessary 500mg     

 

Miconazole nitrate (Amber 1)

  • Intravaginal cream 2%
  • Pessary   

Notes:

   

 

Fluconazole

  • Capsule 150mg 

 

 

7.6.3 Vaginal atrophy

 

Estriol   

  •  Gynest® Intravaginal cream  containing 0.01% estriol

Note: 

  • Gynest's excipients include arachis (peanut) oil  

 

  • Ovestin® intravaginal cream containing 0.1% estriol    

 

 

Vaginal moisturisers (Double Red for all new patients - not recommended for prescribing)   

  • Gynomunal® Gel 15mL, 50mL plus applicator
  • Hyalofemme® Gel 30g plus applicator
  • Regelle® Prefilled applicators
  • ReplensMD® Prefilled applicators
  • Sylk® Prefilled applicators
  • YES VM® Prefilled applicators

Notes:

  • All vaginal moisturisers are not recommended for prescribing in Milton Keynes and are therefore classified Double Red for all new patients.
  • They are low priority and patients should be advised to buy them.

 

 

 

 

 

 

Traffic light status (TLS) explained:

  • Green: Routine prescribing within licensed indication
  • Amber 1: specialist recommendation followed by GP initiation and continuation
  • Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
  • Amber 3: specialist initiation and stabilisation followed by GP continuation
  • Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
  • Red: Hospital or specialist prescribing only
  • Double Red: These medicines have been evaluated and rejected by MKPAG and are NOT approved for use within MK. They are not recommended for use because of lack of clinical effectiveness, cost effectiveness or safety.

 

 

 

 

 

 

Return to Chapter: 7. Obstetrics, Gynaecology and Urinary-tract Disorders

Last updated by: Dupe Fagbenro on 12-03-2019 19:38