| Name | Bacterial Vaginosis (BV) & Vaginal Candidiasis (Yeast Infection) - Compounded & Branded Medications |
| Uses | Treatment of bacterial vaginosis (BV) and vaginal yeast infections (candidiasis). |
| Route Of Administration | Oral (tablet/capsule), Intravaginal (cream, suppository, gel). |
| Frequency Of Use | Single-dose or multi-day regimen, depending on medication and severity. |
| Concentration(s) | Metronidazole (500 mg oral, 0.75% gel), Clindamycin (2% cream, 300 mg oral), Fluconazole (150 mg oral), Miconazole (2% cream, 1,200 mg ovule). |
| Maximum Dosage (Day, Wk) | Metronidazole: 500 mg orally BID for 7 days; Fluconazole: single 150 mg dose, may repeat in 3 days if needed. |
| Contraindications | Pregnancy (caution with metronidazole in first trimester), hypersensitivity to medications, severe hepatic disease. |
| Possible Side Effects | Common: nausea, headache, vaginal irritation, mild GI upset. Rare: allergic reaction, liver enzyme elevation, dizziness. |
| Compatibility With Other Treatments/Drugs | Avoid alcohol with metronidazole (risk of disulfiram reaction). Caution with warfarin (increased bleeding risk). |
| Allergies | Assess for hypersensitivity to metronidazole, clindamycin, azole antifungals, or cream bases. |
| Administration Time | Oral: with or without food. Vaginal: at bedtime to reduce leakage. |
| Dosing/Settings | BV: Metronidazole 500 mg BID x 7 days or gel QHS x 5 days. Yeast: Fluconazole 150 mg single dose or Miconazole ovule QHS x 3 days. |
| Test Spot Requirement | Not required for these treatments. |
| Pre-Treatment Guidelines | Confirm diagnosis via symptom assessment or wet mount/KOH prep if available. |
| Provider Clearance Guidelines | NP, PA, MD, or DO must approve; review pregnancy status and medication interactions before prescribing. |
| Pre-Treatment Screening Workflow | 1. Assess for abnormal discharge, itching, odor. 2. Confirm no pregnancy contraindications. 3. Review medication allergies. |
| What To Do If Adverse Reaction Occurs | Mild: manage symptoms supportively. Severe: discontinue, provide antihistamines or emergency care if anaphylaxis occurs. |
| Clinic Implementation Guidelines | Ensure proper patient education on medication use and avoidance of alcohol during treatment (if applicable). |
| Photographic Documentation Protocol | Not required for vaginal infection treatments. |
| Post-Treatment Care | Encourage completion of the full course, probiotics for microbiome support, and follow-up if symptoms persist or recur. |
| Additional Documentation Requirements | Signed informed consent, prescription logs, adverse reaction reporting if necessary. |