dequalinium chloride: clinical use

Prescribing considerations

• Confirm bacterial vaginosis and consider assessment for alternative diagnoses or sexually transmitted infection where appropriate.
• Review persistent symptoms or early recurrence.
• Clinical efficacy and safety data are lacking below age 18 and above age 55.

Contraindications and cautions

• Hypersensitivity to dequalinium chloride or an excipient.
• Ulceration of the vaginal epithelium or vaginal portion of the cervix.
• Use before the first menstruation.

Monitoring

• Assess clinical response and investigate persistent or recurrent discharge.
• Review new vaginal pain, bleeding, ulceration or significant irritation.
• No routine systemic laboratory monitoring is specified in the SmPC.

Clinical pharmacology

A surface-active quaternary ammonium antiseptic that increases bacterial-cell permeability and causes loss of enzyme activity. It acts locally, with negligible expected systemic exposure after vaginal administration.

Formulation and product differences

• The selected UK presentation is a white or almost-white oval vaginal tablet for local treatment.
• Excipients include lactose monohydrate, microcrystalline cellulose and magnesium stearate.
• Some excipients do not dissolve fully, so harmless tablet residue may remain in underwear.

Vaginal tablet

Route: Vaginal

Strengths: 10 mg