Terzhinan: for the safe treatment of gynecological infections

The results of an open comparative randomized multicenter clinical study to study the effectiveness and safety of TARZHIFORT® drugs, vaginal suppositories (JSC Avexima, Russia) in the treatment of vaginitis of various etiologies showed that the effectiveness of the domestic drug TARZHIFORT® in a number of very important indicators that directly affect the quality of life of patients, not lower, and the rate of disappearance of the symptoms “pain” and “burning” - 4.3 and 4.8 days - is statistically significantly higher than in patients receiving TERZHINAN® (5.6 and 5.8 days). The results of the study allow us to recommend the drug TARZHIFORT® for the treatment of vaginitis of various etiologies for women of fertile age as an effective and safe remedy, convenient for independent use

Target.

Study of the effectiveness and safety of the drug TARZHIFORT® in two parallel groups in 360 women aged 18 to 45 years with a clinical diagnosis of vaginitis in the acute stage, specified by laboratory. The task was set to assess the frequency of complete recovery in the study group 14 days after completion of treatment. The duration of therapy in both groups was 10 days. Materials and methods. In 2017–2018 In the Russian Federation, an open comparative randomized multicenter clinical study was conducted to study the effectiveness and safety of the drugs “TARGIFORT®, vaginal suppositories” (JSC Avexima, Russia) and “TERZHINAN®, vaginal tablets” (Bouchard-Recordati Laboratories, France) in the treatment of vaginitis of various etiologies. Results. The study shows that the effectiveness of the domestic drug TARZHIFORT® in a number of very important indicators that directly affect the quality of life of patients is no lower (no pain in 98.3%, burning in 97.8% and itching in 98.9% in patients of the TARZHIFORT group ® and 98.3%, 97.8% and 95.4% in patients of the TERZHINAN® group), and the rate of disappearance of the symptoms “pain” and “burning” – 4.3 and 4.8 days – is statistically significantly higher than in patients receiving TERZHINAN® (5.6 and 5.8 days).

Compound

Active ingredients: ternidazole - 200 mg, neomycin sulfate - 100 mg (65,000 IU), nystatin - 100,000 IU, prednisolone sodium metasulfobenzoate - 3 mg.
In addition to the active ingredients, the Terzhinan vaginal tablet includes: wheat starch (amylum tritici), colloidal silicon dioxide (silicii dioxydum colloidale), sodium starch (natrii amylum), magnesium stearate (magnesium stearate), lactose (lactose).

Terzhinan 10 pcs. vaginal tablets

pharmachologic effect

Combined antimicrobial agent (antibiotic-aminoglycoside + antimicrobial and antiprotozoal agent + antifungal agent + glucocorticosteroid).

Composition and release form Terzhinan 10 pcs. vaginal tablets

Tablets - 1 tablet:

• Active ingredients: Ternidazole - 0.2 g; Neomycin sulfate - 0.1 g or 65,000 IU; Nystatin - 100,000 IU; Prednisolone sodium metasulfobenzoate - 0.0047 g (equivalent to prednisolone - 0.003 g);
• Excipients: Wheat starch - 0.264 g; Lactose monohydrate - qs up to 1.2 g; Colloidal silicon dioxide - 0.006 g; Magnesium stearate - 0.01 g; Sodium carboxymethyl starch - 0.048 g.

6 or 10 tablets per strip (aluminum foil), one strip with instructions for use is packed in a cardboard box.

Description of the dosage form

The tablets are light yellow in color with possible inclusions of darker or lighter shades, flat, oblong, with beveled edges and printed in the form of the letter “T” on both sides.

Directions for use and doses

For vaginal use.

One tablet is inserted deep into the vagina in the “lying” position before bed. Before insertion into the vagina, the tablet should be kept in water for 20-30 seconds. After administration, you need to lie down for 10-15 minutes.

The average duration of the treatment course is 10 days; in case of confirmed mycosis, it can be extended to 20 days; The average duration of a preventive course is 6 days.

Pharmacodynamics

Combined drug for local use in gynecology. Has antimicrobial, anti-inflammatory, antiprotozoal, antifungal effects; ensures the integrity of the vaginal mucosa and pH constancy.

Ternidazole is an antifungal agent from the group of imidazole derivatives, reduces the synthesis of ergosterol (a component of the cell membrane), changes the structure and properties of the cell membrane. It has a trichomonacid effect and is also active against anaerobic bacteria, in particular gardnerella.

Neomycin is a broad-spectrum antibiotic from the aminoglycoside group. It has a bactericidal effect against gram-positive (Staphylococcus, Streptococcus pneumoniae) and gram-negative (Escherichia coli, Shigella dysenteriae, Shigella flexneri, Shigella boydii, Shigella sonnei, Proteus spp.) microorganisms; against Streptococcus spp., inactive.

Microbial resistance develops slowly and to a small extent.

Nystatin is an antifungal antibiotic from the group of polyenes, highly effective against yeast-like fungi of the genus Candida, changes the permeability of cell membranes and slows down their growth.

Prednisolone is a dehydrated analogue of hydrocortisone, has a pronounced anti-inflammatory, anti-allergic, anti-exudative effect.

Indications for use Terzhinan 10 pcs. vaginal tablets

Treatment of vaginitis caused by microorganisms sensitive to the drug, including:

• bacterial vaginitis;
• vaginal trichomoniasis;
• vaginitis caused by fungi of the genus Candida;
• mixed vaginitis.

Prevention of urogenital infections/vaginitis, including:

• before gynecological operations;
• before childbirth and abortion;
• before and after installation of intrauterine devices;
• before and after diathermocoagulation of the cervix;
• before hysterography.

Contraindications

Hypersensitivity to any component of the drug.

Application Terzhinan 10 pcs. vaginal tablets during pregnancy and breastfeeding

The drug can be used from the second trimester of pregnancy. The use of the drug in the first trimester of pregnancy and lactation is possible only in cases where the potential benefit to the mother outweighs the risk to the fetus or infant.

special instructions

In the case of treatment of vaginitis and trichomoniasis, simultaneous treatment of sexual partners is recommended.

Treatment should not be stopped during menstruation.

Overdose

There are no data on cases of overdose.

Side effects Terzhinan 10 pcs. vaginal tablets

Burning sensation, itching and irritation in the vagina (especially at the beginning of treatment).

In some cases, allergic reactions are possible.

Drug interactions

Not found.

pharmachologic effect

Terzhinan is a drug from the group of combined antimicrobial, antifungal and antiseptic drugs used in gynecological practice.

The physiological effect and pharmacological properties of the drug are determined by the activity of the active components included in its composition. During treatment with Terzhinan, pronounced:

• trichomonacid effect;
• antibacterial effect;
• antifungal effect;
• anti-inflammatory effect.

Pharmacodynamics and pharmacokinetics

ternidazole, which is part of Terzhinan, is aimed at the death of Trichomonas. In addition, it provokes the death of anaerobic microorganisms and, in particular, is active against facultative anaerobes of the genus Gardnerella.

Neomycin is an antibiotic from the aminoglycoside group. The mechanism of its action is associated with the ability to irreversibly disrupt protein synthesis in the cells of pathogenic microorganisms at the ribosomal level.

By suppressing protein synthesis, neomycin causes disturbances in the transcription of the genetic code and provokes the death of microbial cells. It has been experimentally proven that aerobic bacteria, as a rule, are sensitive to it: corynebacteria (C. amycolatum), Listeria (Listeria), as well as methicillin -sensitive Staphylococcus aureus (MSSA).

In addition, it was found that gram-negative bacteria are also sensitive to neomycin, including aeruginosa , which is usually resistant to the action of this antibiotic.

Nystatin is an antimycotic agent from the group of polyene antibiotics. to ergosterol contained in the membranes of fungal cells , it causes their damage and thereby provokes the death of fungi. Nystatin only affects eukaryotes. Fungi belonging to the genus Candida are sensitive to it, including strains of Candida albicans and Candida glabrata.

Prednisolone is a glucocorticoid drug. When applied topically, its therapeutic activity is determined by its anti-inflammatory, antiallergic and antiexudative effects. The latter is due to the vasoconstrictor effect of prednisolone.

The excipients included in the vaginal tablets ensure the integrity of the vaginal epithelial tissue in various infectious and inflammatory diseases, and also maintain the pH balance within the physiological norm.

The pharmacokinetic characteristics of Terzhinan have not been studied, which is due to the low systemic absorption of this drug.

The mechanism of action of Terzhinan tablets

The instructions for the drug inform that Terzhinan has a pronounced antimicrobial and antiseptic effect, eliminates fungal infections, inflammatory processes, and helps restore the balance of internal microflora. The combination of active substances in it allows you to successfully treat advanced infectious diseases, including those of a combined nature, caused by several pathogens:

• gram-positive and gram-negative bacteria;
• pathogenic fungi;
• Trichomonas.

Terzhinan helps maintain the integrity of the epithelial covers of the mucous membranes, prevents exudative infiltration, the development of erosive and other lesions during inflammatory reactions, normalizes the pH level, alleviates the symptoms of the acute phase of diseases, helps to quickly get rid of itching, burning, tissue swelling and pathological discharge.

The high concentration of components ensures the rapid destruction of all pathogens sensitive to them before they have time to develop resistance to Terzhinan. It is likely that the active substances in the drug enhance the effectiveness and duration of action of each other.

Antibiotics and prednisolone in the medication are active only in the area of ​​placement. They are not absorbed through the mucous membranes into the systemic circulation. The concentrations of active substances penetrating into the body are negligible.

Indications for use of Terzhinan

What does Terzhinan treat and when is it advisable to prescribe it?

Indications for the use of vaginal tablets are infectious diseases of the female external genitalia accompanied by inflammatory processes, caused by the entry and active activity of pathogenic microorganisms sensitive to Terzhinan into the vagina.

So, vaginal pills, what are they for? The medicine is prescribed to women who have been diagnosed with:

• vaginitis , provoked by banal pyogenic microflora;
• chronic recurrent colpitis (nonspecific vaginitis);
• vaginal dysbiosis;
• trichomonas vaginitis;
• vaginitis caused by the activity of fungi Candida albicans;
• vaginitis of mixed origin.

Terzhinan is also often prescribed as a prophylactic agent to prevent the development of vaginitis in women who are undergoing minor and major surgical interventions in the pelvic area.

In particular, the medicine is used before childbirth, the procedure of surgical abortion , diathermocoagulation (it is advisable to administer tablets both before and after the procedure), contrast X-ray examination of the uterine cavity and the patency of the fallopian tubes ( metrosalpingography ), before the installation of intrauterine contraceptives and after this procedure and etc..

Terzhinan is also used as a means of preventing complications of antibacterial therapy.

The use of Terzhinan suppositories for ureaplasmosis

Despite the fact that the active growth of ureaplasmosis is most often associated with malfunctions of the immune system, treatment with immunomodulatory drugs does not always achieve the desired result.

In this situation, they resort to prescribing special antibacterial agents or antibiotics. Very often, for ureaplasma, doctors recommend Terzhinan, which acts on a wide range of pathogenic microorganisms and provides a pronounced anti-inflammatory effect.

A valuable property of the drug is that, while provoking the death of microbes and fungi, it does not disturb the natural microflora of the vagina.

Terzhinan for thrush

Terzhinan is recommended for the treatment of women whose thrush is accompanied by suspected secondary inflammation and/or infection with secondary microflora.

In addition, the use of Terzhinan is resorted to in cases where the symptoms are so pronounced that they should be stopped as quickly as possible.

In some cases, the drug is indicated as a substitute for complex therapy if previous treatment with other antifungal agents was ineffective.

Reviews of suppositories for thrush left by patients and practicing gynecologists suggest that Terzhinan successfully cures a fungal infection without causing the development of unwanted side reactions.

Main purposes for the drug Terzhinan

According to the instructions, vaginal tablets are indicated for use:

• for trichomonas and vaginitis caused by pyogenic pathogens
• acute and chronic colpitis of nonspecific or mixed origin, including recurrent ones;
• vaginal candidiasis;
• vaginal dysbiosis;
• ureaplasmosis.

To prevent the development of infectious inflammation in the uterine cavity and adjacent tissues, Terzhinan is prescribed:

• before childbirth;
• insertion of intrauterine devices;
• surgical interventions;
• carrying out abortions, diagnostic curettages;
• before checking the patency of the fallopian tubes.

Medical experience shows that the drug is much more effective than its analogues in treating complicated cases of diseases and rarely causes disturbances in the internal microflora. Terzhinan is better than other intravaginal medications in relieving the symptoms of recurrent thrush and exacerbations of ureaplasmosis.

Side effects

Terzhinan quite rarely provokes side effects. Since suppositories are used topically, their constituent components are absorbed into the systemic circulation in very small concentrations.

Therefore, in most reported cases, they provoked exclusively local reactions, which were expressed in the form of allergy symptoms, burning sensation, tingling, itching, pain and irritation at the site of drug administration.

Systemic effects during treatment with the drug occur in isolated cases. A possible reaction to the use of glucocorticosteroids (and, in particular, to prednisolone ) is a slowdown in the healing processes of wounds and cracks, and atrophic processes in the mucous membrane may also occur in some patients.

Terzhinan suppositories, instructions for use (Method and dosage)

Instructions for use of Terzhinan recommend inserting vaginal tablets deep into the vagina, one once a day, every day for ten days.

Before inserting the tablet into the vagina, it should be immersed in water for about 30 seconds (or held in a wet hand for about two minutes). If the tablet is administered during the day rather than in the evening, you should lie down for at least ten minutes after administration.

The optimal time for the procedure is evening. This is due to the fact that in the morning after the administration of Terzhinan, a yellowish discharge may appear, which is normal when undergoing a course of treatment with the drug.

If the goal of treatment is to normalize the imbalance of microflora in the vagina and relieve symptoms of inflammation, then the duration of treatment, depending on the clinical picture and the doctor’s prescription, is from six to ten days.

If the reason for using the drug is thrush , the course of therapy is increased to 20 days. Three days after its completion, it is recommended to undergo a re-examination and take tests, which will either confirm complete recovery or indicate the need for a repeat course.

During pregnancy, the dose and duration of treatment are determined by the attending physician depending on the clinical situation.

Is it possible to use suppositories during menstruation?

Very often, patients who are indicated for treatment with Terzhinan wonder whether these pills can be used during menstruation. In the instructions for the drug, the manufacturer indicates that menstruation is not an indication for stopping treatment.

How to use Terzhinan

The medication is indicated for use in patients over 16 years of age. Terzhinan is not recommended for adolescents due to the imperfection of the internal vaginal microflora.

1. Before use, it is recommended to moisten the tablet in warm water.
2. Lying on your back, carefully insert the drug deep into the vagina.
3. After administering Terzhinan, do not stand up for 10–15 minutes so that the candle does not accidentally fall out. The best time for the procedure is in the evening, before bed.

General treatment regimen: 1 tablet once every day for 6–20 days. For a preventive course, a week of use is enough. For acute conditions and recurrent pathologies, it is advisable to use the product for at least two weeks in a row. In case of menstrual flow, it is not recommended to interrupt treatment. The exception is an increase in tissue sensitivity and the appearance of irritation of the mucous membrane when exposed to the drug on these days.

During the period of using vaginal tablets, it is important to take good care of hygiene. Due to the specific secretions of the dissolved drug, more frequent changes of underwear are required. It is recommended to use gaskets with a sufficient degree of protection.

Sexual rest during therapy is not necessary, but may be recommended by a gynecologist. It is important to remember that nystatin in Terzhinan may reduce the effectiveness of barrier contraception.

After 5–7 days after the end of the course of treatment, a repeat laboratory test should be done to determine the presence of infection.

special instructions

The results of studies of the effectiveness of the components of the drug Terzhinan demonstrated that the concentrations of the active components in this drug for local therapy (but not for oral administration) are higher than the toxic concentrations that determine the development of immunity to the antibacterial component.

Under such conditions, it is assumed that the activity of strains of the infectious agent that are theoretically resistant to the active substance will be suppressed by its high concentrations.

In addition, it is very likely that high concentrations of all active components of Terzhinan can have a synergistic (increasing effect of each other) effect on pathogenic microflora, which, in terms of its spectrum of action, is much wider than that of each individual active component.

It should be remembered that drugs containing nystatin intended for intravaginal use may damage latex contraceptives.

Considering that the active components of Terzhinan can potentially be slightly absorbed into the systemic circulation, it should be remembered that when using systemic glucocorticosteroids in patients diagnosed with osteoporosis , arterial hypertension and heart failure , supervision by specialists in the appropriate field is required.

Specialist supervision is also required for existing or history of peptic ulcers , tuberculosis , glaucoma , hypothyroidism , serious emotional disorders, myopathy provoked by the use of glucocorticosteroids, liver failure , epilepsy , diabetes mellitus , recent myocardial infarction .

Terzhinan is an effective remedy for women. What about for men?

Gynecologists constantly remind us that all infectious and inflammatory diseases for which Terzhinan is indicated must be eliminated from both the woman and the man. To do this, both partners must undergo a course of treatment with antibacterial drugs.

Neglecting this point risks the fact that all the unpleasant symptoms that appear with a particular disease will return. It is also recommended to abstain from sex for the entire period of treatment, but some doctors sometimes still allow partners to have a normal sex life.

The main conditions are the mandatory use of a condom and the complete absence of any side effects from the reproductive system (for both women and men).

For example, some women may experience a strong burning sensation during sexual intercourse (or some time after it), while complaints from men are more often associated with unpleasant sensations and some discomfort.

In any of these cases, the optimal solution is to abstain from sexual activity until the course of treatment is completed. It is important to remember that sexual intercourse must occur only before the next evening vaginal tablet is administered (not after!).

results

Analysis of the primary effectiveness parameter - the proportion of patients who achieved complete (clinical and microbiological) recovery, did not reveal a statistically significant difference between the groups and showed that the proportion of patients who achieved clinical and microbiological recovery among those receiving the drug TARZHIFORT® was TERZHINAN® - 65.9 %, which is 4.1% less, but not statistically significant (p = 0.237).
The resulting 95% CI for the difference in proportions ranged from -6.1% to 14.3%. The lower limit of the CI for the difference in the proportions of patients who achieved clinical and microbiological recovery was -0.061, which does not reach the value of -0.15, designated as the non-inferiority limit. Assessment of the etiology of vaginitis in both groups (assessment at the screening stage) allows us to conclude that there are no statistically significant differences (Fig. 1). There were also no significant differences in the type of microbiocenosis (Table 1). When assessing the effectiveness parameter “Decrease in the number of leukocytes in the field of view during microscopy on VPN”, it was shown that in patients receiving the drug TARZHIFORT®, the number of leukocytes in the field of view during microscopy on VPN decreased in absolute terms. 81.7% of cases in patients receiving the drug TERZHINAN®, in absolute terms. 73.2% of cases (8.5% more in the TARZHIFORT® group). Analysis of the effectiveness parameter showed that this difference is not significant and statistically insignificant (p = 0.072), and the 95% CI of the difference in proportions ranged from -0.7% to 17.6%. An assessment of the proportion (percentage) of patients with normal vaginal acidity (pH≤4.5) showed that in the TARZHIFORT® treatment group, 93.3% of patients achieved normalization of vaginal acidity (pH≤4.5), and in the TERZHINAN® treatment group – 91.6% of patients. However, there was no statistically significant difference between the two treatment groups (p=0.678), the 95% CI of the difference in proportions was -4.3% to 7.7%. At the screening visit, all patients were asked about the presence of symptoms of NV, and then, until the end of the study, they were asked to keep self-observation diaries. On VPN, the number of patients experiencing symptoms of vaginitis of varying severity changed as follows (Table 2). Thus, after treatment with TARZHIFORT®, out of 180 patients, 177 (98.3%) did not experience pain, 176 (97.8%) did not experience burning, 178 (98.9%) did not experience itching, after treatment with TERZHINAN® out of 179 patients 176 (98.3%) did not experience pain, 175 (97.8%) did not experience burning, 171 (95.5%) did not experience itching. From these data it is obvious that TARZHIFORT® relieves the main symptoms of NV to the same extent as the comparison drug. When comparing the average duration of disappearance of symptoms, a statistically significant difference was revealed between treatment groups in the time of disappearance of the symptoms “pain” and “burning”. Thus, the average number of days until pain disappeared in the group of patients taking the drug TARZHIFORT® was 4.3 (3.36) days, and in the group of patients taking the drug TERZHINAN® - 5.6 (4.03) days, t .e. 1.3 days faster in the TARZHIFORT® group. The difference was statistically significant when compared using the Wilcoxon test (p=0.01). The average time until the burning sensation disappeared in the group of patients taking the drug TARZHIFORT® was 4.8 (3.03) days, and in the group of patients taking the drug TERZHINAN® - 5.8 (3.63) days, i.e. 1 day faster in the TARZHIFORT® group, p=0.04 - the data are also statistically significant. The results we obtained allow us to conclude that the drug TARZHIFORT® has proven comparable effectiveness compared to the comparison drug TERZHINAN®. There were no statistically significant differences between the groups in the incidence of adverse events (AEs) and other signs of AEs.

Terzhinan's analogs

Many patients, having received a prescription for the drug from a doctor, try to find a cheaper alternative to Terzhinan.

Currently Terzhinan has no analogues. For women diagnosed with bacterial vaginosis or vaginitis , a number of medications may be prescribed, such as:

• Neotrizol
• Polygynax
• Meratin Combi

Despite the fact that they are similar in action to Terzhinan, the latter is unique in its composition and ability to have a complex effect on inflammatory and infectious processes affecting the mucous membrane of the female external genital organs.

The average price of analogues of Terzhinan candles varies from 400 to 700 rubles.

Which is better: Terzhinan or Polygynax?

The effect exerted by the drug Polygynax is identical to the effect exerted by Terzhinan. However, studies aimed at comparatively assessing the activity of the components of these two drugs in in vitro models showed that Terzhinan, unlike Polygynax, has no effect on MRSA (methicillin-resistant Staphylococcus aureus), streptococci and enterococci. At the same time, it showed great activity against Gardnerella vaginalis (G. vaginalis).

Which is better: Hexicon or Terzhinan? Terzhinan or Penotran?

Both of these drugs have a similar effect to Terzhinan, but differ from the latter in composition.

That is, the active ingredients of each of these drugs may exhibit different activity against the same microorganisms. Consequently, only the attending physician can decide which drug is better and which will be less effective in each specific case.

Terzhinan during pregnancy and lactation

Why are Terzhinan suppositories prescribed to pregnant and lactating women?

The instructions for Terzhinan during pregnancy allow the use of the drug during this period of a woman’s life, but only under the supervision of a doctor managing the pregnancy.

The tablets are contraindicated in the 1st trimester; in the 2nd and 3rd trimester during pregnancy, the drug is usually prescribed for inflammation of the vagina (vaginitis) , which is caused not by one pathogen, but by several (that is, bacteria and fungi). This disease is called combined, and combination medications, which include an antibiotic and an antimycotic agent, are suitable for its treatment.

The low degree of absorption of Terzhinan into the systemic circulation eliminates the possibility of overdose and the possibility of transfer of drug components through the bloodstream to the developing fetus.

Thus, Terzhinan suppositories during pregnancy do not have a negative effect on the body of the unborn child. In addition, it is allowed to take the medicine regardless of taking oral medications, since its active components do not interact with the components of other medications.

The use of Terzhinan during lactation is also allowed. The main condition for prescribing the drug is a correctly diagnosed diagnosis confirming the need for treatment. The drug is prescribed if more gentle means and methods do not help eliminate itching and burning.

However, like any other drug, Terzhinan should not be used by pregnant and lactating women unless absolutely necessary and without first consulting a doctor.

Reviews about Terzhinan

In their reviews of Terzhinan suppositories, almost all women note that the main advantages of this drug are that the latter is very easy to use, accessible (Terzhinan tablets are relatively inexpensive medicines), in the vast majority of cases well tolerated and extremely rarely provokes the development of complications and unwanted side reactions.

If we talk about the effectiveness of the drug for thrush, then reviews of Terzhinan on the forums allow us to conclude that this drug has established itself as an effective and safe remedy that allows you to quickly cure chronic thrush, which becomes more active with any decrease in immunity.

Reviews of Terzhinan during pregnancy and breastfeeding indicate that very often this drug turns out to be an effective remedy (even in cases where other drugs did not help solve the problem).

Negative reviews are mainly associated with hypersensitivity reactions to the components of the drug.

Some women also write that they began to experience spotting after taking one or more Terzhinan tablets. Gynecologists assure that this phenomenon has nothing to do with the use of the drug and to establish the cause of its origin it is necessary to undergo additional examination.

results

Our study is consistent with the data of Russian and foreign researchers, since the average age of the patients in the studied group was 31.5 years.
Risk factors for the development of mixed vulvovaginitis are well known. These include a number of diseases (decompensated diabetes mellitus in the first place), the use of various methods of contraception (spermicides, hormonal contraceptives with a high content of estrogen component), the use of various hygiene products (pads, tampons, antibacterial hygiene products), wearing tight underwear and clothing ; taking broad-spectrum antibacterial drugs. Many authors believe that the activation of endogenous flora due to disruption of the protective role of the normal vaginal microbiota is of key importance in the development of vulvovaginitis; about 90% of cases of vaginitis are caused by nonspecific bacterial flora, Candida spp. and Trichomonas vaginalis [1, 3, 6]. Diagnosis of mixed vulvovaginitis is difficult due to the nonspecificity of complaints and the low level of sanitary and hygienic education of the population, associated with low appeal. The importance of timely diagnosis and treatment is due to the high frequency of relapses, complications and the difficulties of conservative treatment of complications that have arisen (infertility, adhesions) and the difficulties of managing pregnancy against the background of an active infectious process - the risk of preterm birth increases up to 7.3 times [8] and almost twofold the risk of spontaneous miscarriage increases times [10]. The choice of therapy for the treatment of mixed vulvaginal infections is determined by the clinical course of the disease, the results of microbiological examination (bacterioscopy and culture), PCR, immunological research methods (ELISA, etc.), as well as the characteristics of the drug, indications and contraindications for its use. Based on the “Clinical recommendations for the diagnosis and treatment of diseases accompanied by pathological discharge from the female genital tract” (Moscow, 2019), the basis of therapy is a two-stage method of treatment with combined topical drugs for intravaginal use due to a complex effect on different parts of the etiology and pathogenesis with a smaller number of unwanted drug reactions compared to systemic therapy. Taking into account the high prevalence of vulvovaginitis, as well as the risks of impact on women’s health and the course of pregnancy, it seems necessary to study the possibilities of using new combined topical drugs of domestic production for treatment, which in terms of effectiveness, safety, ease of use and pharmacoeconomic indicators are not inferior or superior to foreign analogues. This article presents the results of a study of the use of the drug "TARGIFORT®, vaginal suppositories" (JSC Avexima, Russia) and the drug "TERZHINAN®, vaginal tablets" (Bouchard-Recordati Laboratories, France) in the treatment of vaginitis of various etiologies. The purpose of this study was to study the effectiveness and safety of these drugs in two parallel groups. The results of the study allow us to recommend the Russian-made drug TARZHIFORT® for the treatment of vaginitis of various etiologies for women of fertile age as an effective and safe means of therapy, convenient for independent use. A comparison of the drugs TARZHIFORT® and TERZHINAN® shows that the effectiveness of the domestic drug TARZHIFORT® in a number of very important indicators that directly affect the quality of life of patients is no lower (no pain in 98.3%, burning in 97.8% and itching in 98, 9% in patients of the TARZHIFORT® group and 98.3%, 97.8% and 95.5% in patients of the TERZHINAN® group), and the rate of disappearance of symptoms “pain” and “burning” – 4.3 and 4.8 days – statistically significantly higher than in patients receiving TERZHINAN® (5.6 and 5.8 days). Not a single patient left the study early, which indicates high compliance with the drug and indicates its convenience for patients and good tolerability. When applying the results of the study in clinical practice, it should be taken into account that its data are associated with such limitations as criteria for inclusion of patients, duration of therapy, presence/absence of concomitant diseases and/or therapy with other drugs. Apparently, further studies (observational programs) are required, during which the effectiveness and safety of the use of the study drug for long-term (repeated use) will also be assessed, as well as a number of such important parameters as patient adherence to treatment, the effect of therapy on the quality of life etc. From a medical and social point of view, it is also important to analyze the pharmacoeconomic characteristics of the drug under study and its availability to the patient.

Terzhinan price, where to buy

How much do candles cost in Russia?

The price of Terzhinan No. 10 tablets is about 600 rubles. The price of Terzhinan No. 6 candles is about 500 rubles. You can find out the exact cost of 6 or 10 tablets either on the website of a specific pharmacy chain or by calling the desired pharmacy.

Terzhinan price in Ukraine

The average price of Terzhinan No. 10 candles in Ukraine is 200 UAH. You can buy tablets No. 6 for an average of 150 UAH.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Terzhinan tablets vaginal.
  6 pcs.Sofartex RUR 538 order
• Terzhinan tablets vaginal. 10 pcs.Sofartex

  RUR 736 order

Pharmacy Dialogue

• Terzhinan (tab. vag. No. 6)Lab.Bouchara-Recordati

  RUR 533 order

• Terzhinan vaginal tablets No. 10Lab.Bouchara-Recordati

  RUR 733 order

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Pharmacy24

• Terzhinan N10 tablets Sofartex, France
  194 UAH. order
• Terzhinan N6 tablets Sofartex, France

  147 UAH order

PaniPharmacy

• Terzhinan tablets Terzhinan vaginal tablets No. 6 France, Sofartex

  159 UAH order

• Terzhinan tablets Terzhinan vaginal tablets No. 10 France, Sofartex

  224 UAH order

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Dosage form and composition of the drug Terzhinan

Terzhinan is a combined broad-spectrum antimicrobial drug. It is produced in the form of tablets for local and intravaginal use. These are suppositories similar to suppositories, but have a flatter shape and differ in structure. They do not contain wax.

The packaging of the drug contains 6 or 10 yellowish tablets, packaged in plastic or metallized blisters with individual cells. One dose of the medicine contains 4 active ingredients:

• 200 mg. tenidazole: an antibiotic effective against anaerobic bacteria;
• 100 mg. neomycin: an aminoglycoside that destroys proteins of aerobic microbes;
• 100,000 IU nystatin: antifungal agent;
• 4.7 mg. prednisolone derivative: glucocorticoid hormone with anti-inflammatory effect.

Auxiliary compounds of the drug: starch, lactose, silicon dioxide, magnesium stearate and others.