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" What is it used for?  Vaginal thrush (candidal vaginitis).  Thrush affecting the penis (candidal balanitis).  This medicine can be bought from pharmacies to treat thrush in adults aged 16 to 60 years. If you are under 16 or over 60 you should consult your doctor.   How does it work? Canesten oral and cream duo consists of Canesten oral capsule, which is a single dose oral treatment for vaginal thrush, and Canesten thrush cream, which is applied to the outside of the vagina (vulva and labia) to relieve the external symptoms of the infection. Both medicines can also be used to treat men who are suffering from thrush on the penis.  Canesten oral capsule contains the active ingredient fluconazole and Canesten thrush cream contains the active ingredient clotrimazole. Both these are antifungal medicines used to treat infections with fungi and yeasts.  Vaginal thrush is the common term for infections of the vagina with Candida species of fungi, in particular Candida albicans. This infection causes inflammation and discharge from the vagina. In men it causes soreness and redness of the penis, tightness of the foreskin, or a white, odourless discharge from the penis. Clotrimazole and fluconazole both kill the Candida fungi causing the infection by interfering with their cell membranes. They work by stopping the fungi from producing a substance called ergosterol, which is an essential component of fungal cell membranes. The disruption in production of ergosterol causes holes to appear in the fungal cell membrane.  The cell membranes of fungi are vital for their survival. They keep unwanted substances from entering the cells and stop the contents of the cells from leaking out. As clotrimazole and fluconazole cause holes to appear in the cell membranes, essential constituents of the fungal cells can leak out. This kills the fungi and treats the infection.    How do I use it?  Canesten oral capsule is a single-dose treatment taken by mouth.  The capsule should be swallowed whole with a glass of water. It can be taken either with or without food. Canesten thrush cream should be applied to the outside of the vagina (vulva and labia) and to the penis to help provide relief from the external symptoms of the infection, such as itching, inflammation and soreness. It can be used two to three times a day until the symptoms of the infection have cleared up. Rub it in gently. Wash your hands after applying the cream. You should consult your doctor if your symptoms have not got better within a week of taking the Canesten oral capsule.   Warning!  You should consult your doctor before using this medicine if you are not sure about the cause of your symptoms, if you or your partner have been exposed to a sexually transmitted disease, if you have had thrush more than twice in the last six months, if you are allergic to other antifungals or thrush treatments, or if you are aged under 16 or over 60 years of age. Consult your doctor before taking the Canesten oral capsule if you suffer from kidney disease, liver disease, unexplained jaundice (yellowing of the eyes and skin) or any other chronic illness or disease, or if you are taking any other medicines, particularly those listed at the end of this factsheet. Women should consult their doctor before taking this medicine if they are pregnant, suspect they could be pregnant or are breastfeeding, or if they have any of the following symptoms: abnormal or irregular vaginal bleeding, blood-stained or foul-smelling vaginal discharge, vulval or vaginal ulcers, blisters or sores, lower abdominal pain or pain passing urine.  Men should consult their doctor before taking this medicine if their sexual partner does not have vaginal thrush, or if they have penile sores, ulcers or blisters, an abnormal penile discharge, if their penis has started to smell, or if they have pain on passing urine. If your sexual partner also has symptoms of thrush it is important that they are treated at the same time as you to prevent you being re-infected. Ask your doctor or pharmacist for advice.  Canesten thrush cream is for external use only and must not be taken by mouth.  Canesten thrush cream may damage latex (rubber) condoms and diaphragms (caps) and so make them ineffective at preventing pregnancy and STIs. You should use an alternative method of contraception for at least five days after using this medicine, or preferably avoid having sex until after the infection has cleared up. Remember that having sex while you still have the infection is likely to transmit the infection to your partner, who could then transfer it back to you.    Canesten oral capsule should not be used in  People who are allergic to other azole antifungal medicines, eg itraconazole. Hereditary blood disorders called porphyrias. People with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption (Canesten oral capsule contains lactose).  The oral capsule and cream should not be used if you are allergic to one or any of their ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.   Canesten oral capsule should be used with caution in  Kidney disease. Liver disease. People with an irregular or slow heartbeat. People with an abnormal heart rhythm seen as a &amp;#039;prolonged QT interval&amp;#039; on a heart monitoring trace (ECG).   Pregnancy and breastfeeding Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.  The safety of Canesten oral capsule for use during pregnancy has not been established. It should not be used during pregnancy unless considered essential by your doctor. If you are or think you could be pregnant, you should seek medical advice from your doctor or midwife for treating thrush. The safety of Canesten thrush cream when used during pregnancy has not been specifically studied. It has been used by a large number of women during pregnancy without any apparant harmful effects. However, as with all medicines, you should consult your doctor before using the cream during pregnancy.  If you are breastfeeding it is important to get medical advice from your doctor before taking Canesten oral capsule. Fluconazole passes into breast milk. A single dose of 150mg is generally considered to be safe to take by mothers who are a nursing a full-term infant. However, there is less experience with the medicine in babies who were born prematurely. Seek medical advice from your doctor. Since very little clotrimazole is absorbed into the bloodstream from the vagina, it is unlikely that any of the medicine will pass into breast milk after using Canesten thrush cream. However, as with all medicines, you should seek medical advice from your doctor or pharmacist before using this cream if you are breastfeeding.   Side effects Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect. Side effects associated with Canesten thrush cream:  Irritation in area of use, for example burning, stinging, itching, redness, rash, blistering or peeling. Stop using the cream and consult your doctor or pharmacist if you have a severe reaction to it.   Side effects associated with Canesten oral capsule:  Common (affect between 1 in 10 and 1 in 100 people)  Abdominal pain. Nausea and vomiting. Diarrhoea. Headache. Rash (you should not use Canesten oral capsule again if you get a rash after taking it).   Uncommon (affect between 1 in 100 and 1 in 1000 people)  Excess gas in the stomach and intestines (flatulence). Indigestion. Taste disturbance. Decreased appetite. Dizziness or sensation of spinning. Seizures. Jaundice. Feeling tired, weak or generally unwell. Itching. Blistering skin reaction (hives).   Rare (affect between 1 in 1000 and 1 in 10,000 people)  Disturbance in the normal numbers of blood cells in the blood. Liver problems. Abnormal heart rhythm. Severe allergic skin reactions. Hair loss.  The side effects listed above may not include all of the side effects reported by the medicine&amp;#039;s manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.   How can this medicine affect other medicines? Canesten thrush cream is not known to affect other medicines. If you are already taking any medicines, including herbal medicines and those bought without a prescription, you should check with your doctor or pharmacist before taking Canesten oral capsule. This is so they can check that the combination is safe. You should not take Canesten oral capsule if you are taking any of the following medicines:  astemizole cisapride ergot medicines, for example ergotamine, methysergide pimozide terfenadine.  The following interactions can occur with longer courses or higher doses of fluconazole. It is not clear if these interactions can happen with the single dose of fluconazole in Canesten oral capsule. If you are taking any of the medicines mentioned below you should check with your doctor or pharmacist before taking Canesten oral capsule. The anti-blood-clotting effect of anticoagulants such as nicoumalone and warfarin may be enhanced by fluconazole. As this may increase the risk of bleeding, people taking an anticoagulant medicine should have their blood clotting time (INR) monitored if they also take fluconazole. Fluconazole may reduce the antiplatelet effect of clopidogrel. The antibiotic rifampicin (used for tuberculosis) lowers the blood level of fluconazole. Your doctor may need to prescribe you a larger than normal dose of fluconazole if you need both these medicines. Fluconazole may increase the blood levels of the following medicines and so could potentially increase the risk of their side effects:  amitriptyline benzodiazepines, eg midazolam, triazolam, diazepam (this may cause increased drowsiness, and people taking both medicines may need a lower dose of benzodiazepine) bosentan bosutinib carbamazepine celecoxib ciclosporin cyclophosphamide disopyramide eplerenone fentanyl fluconazole flurbiprofen ibuprofen ivabradine ivacaftor lomitapide methadone nateglinide nevirapine parecoxib phenytoin or fosphenytoin quetiapine quinidine reboxetine rifabutin ruxolitinib sirolimus statins used to lower cholesterol such as atorvastatin, simvastatin sulphonylureas used for type 2 diabetes, eg glibenclamide, glipizide (this does not usually affect blood sugar control, but may rarely cause hypoglycaemia in some people)  tacrolimus theophylline zidovudine.   Other medicines containing the same active ingredients Canesten thrush cream and Canesten oral capsule are available as separate products. These are also available without brand names, ie as the generic medicines.  Last updated 07.04.2014 "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.netdoctor.co.uk/medicines/infections/a8571/canesten-oral-and-cream-duo/>