BORIC ACID
Patient Counselling
Patient Counselling
Administration of boric acid suppositories/intravaginal capsules:
· Wash and clean the vaginal area with mild soap and water and dry completely
· For suppository tablets/capsules: remove the medication from the wrapper and place inside the applicator
· Get into position by standing with your feet apart and knees slightly bent or lie on your back with your knees bent and legs spaced apart
· Slowly and gently insert the applicator into the vagina. Insert the applicator only as far as it goes comfortably.
· Push the plunger of the applicator until it stops
· Remove the applicator from the vagina
· Discard the applicator if it is disposable or if a reusable applicator is used then pull the pieces apart and wash with mild soap and water and let air-dry.
Dosage instructions:
· Boric acid is either administered once or twice daily. If it is administered once daily the preferred dosage time is in the evening before bed. If it is twice a day it should be administered in the morning and then again at bedtime. If the patient begins menstruating during the course of therapy, do not stop the dosing regimen, and do not use a tampon but instead use a sanitary pad.
· This product must be used for the full course of therapy even if the symptoms disappear after a couple of days. In most reported cases, symptoms resolution occurred within the first 72 hours, but the mycological cure rate requires a full 14 day treatment for recurrent infections, or a 5 day treatment for women with uncomplicated vaginal candidiasis that are resistant to azoles or have documented azole-sensitivity.
Safety information for the patient: · The most commonly documented side effect is vaginal burning that occurs in less than 10% of women studied but although it is uncomfortable it is important to encourage the patient that it will get better during the course of therapy and unless it is intolerable.
· The other major safety consideration to counsel patients on is the potential for acute toxicity if they ingest this medication, or they use the suppository/capsule on burned, abraded, denuded, or macerated skin. Signs and symptoms of acute toxicity include primary symptoms of vomiting, diarrhea, and rash. In addition, secondary symptoms include drowsiness, fever, low blood pressure, decreased urine output, twitching, convulsions, and blisters on the surface of the skin.
· Generally a very small amount of boric acid is systemically absorbed when administered intravaginally. Reports are estimated at approximately 6% systemic absorption with use of intravaginal capsules or suppositories.
Follow-up and Monitoring:
Patient should being to see symptom resolution in 2-3 days and it would be appropriate to contact patient after 72 hours to see if there has been any signs of symptom resolution. At this point it is important to encourage patient to continue using for full course of therapy, or if absolutely no symptoms resolution at this point or severe burning/itching then to make an appointment with their doctor.
Administration of boric acid suppositories/intravaginal capsules:
· Wash and clean the vaginal area with mild soap and water and dry completely
· For suppository tablets/capsules: remove the medication from the wrapper and place inside the applicator
· Get into position by standing with your feet apart and knees slightly bent or lie on your back with your knees bent and legs spaced apart
· Slowly and gently insert the applicator into the vagina. Insert the applicator only as far as it goes comfortably.
· Push the plunger of the applicator until it stops
· Remove the applicator from the vagina
· Discard the applicator if it is disposable or if a reusable applicator is used then pull the pieces apart and wash with mild soap and water and let air-dry.
Dosage instructions:
· Boric acid is either administered once or twice daily. If it is administered once daily the preferred dosage time is in the evening before bed. If it is twice a day it should be administered in the morning and then again at bedtime. If the patient begins menstruating during the course of therapy, do not stop the dosing regimen, and do not use a tampon but instead use a sanitary pad.
· This product must be used for the full course of therapy even if the symptoms disappear after a couple of days. In most reported cases, symptoms resolution occurred within the first 72 hours, but the mycological cure rate requires a full 14 day treatment for recurrent infections, or a 5 day treatment for women with uncomplicated vaginal candidiasis that are resistant to azoles or have documented azole-sensitivity.
Safety information for the patient: · The most commonly documented side effect is vaginal burning that occurs in less than 10% of women studied but although it is uncomfortable it is important to encourage the patient that it will get better during the course of therapy and unless it is intolerable.
· The other major safety consideration to counsel patients on is the potential for acute toxicity if they ingest this medication, or they use the suppository/capsule on burned, abraded, denuded, or macerated skin. Signs and symptoms of acute toxicity include primary symptoms of vomiting, diarrhea, and rash. In addition, secondary symptoms include drowsiness, fever, low blood pressure, decreased urine output, twitching, convulsions, and blisters on the surface of the skin.
· Generally a very small amount of boric acid is systemically absorbed when administered intravaginally. Reports are estimated at approximately 6% systemic absorption with use of intravaginal capsules or suppositories.
Follow-up and Monitoring:
Patient should being to see symptom resolution in 2-3 days and it would be appropriate to contact patient after 72 hours to see if there has been any signs of symptom resolution. At this point it is important to encourage patient to continue using for full course of therapy, or if absolutely no symptoms resolution at this point or severe burning/itching then to make an appointment with their doctor.