What it is and what it is used for

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Canesten Thrush Combi Pessary & External Cream is a complete treatment for vaginal thrush because it treats both the internal cause and external symptoms.

Only use this product if you have been previously diagnosed by your doctor as having vaginal thrush.

The active substance in Canesten Thrush Combi is clotrimazole. Clotrimazole belongs to a group of medicines called azoles and is an antifungal agent which fights the cause of infections such as vaginal thrush.

2. BEFORE YOU USE CANESTEN® THRUSH COMBI

Do not use Canesten Thrush Combi Pessary & External Cream:

¢ — Ifyou are allergic (hypersensitive) to clotrimazole or any of the other ingredients, including cetostearyl alcohol or benzyl alcohol, of Canesten Thrush Combi Pessary & External Cream (see Section 6. Further Information).

¢ During your period as it may be less effective.

¢ To treat nail and scalp infections.

Before using Canesten® Thrush Combi Pessary & External Cream, you should see your doctor if: e You are unsure whether you have thrush or this is the first time you have had these symptoms. ¢ You have had more than two infections of thrush in the last six months. ¢ — You or your partner have ever had a sexually transmitted disease. ¢ You are aged under 16 or over 60. ¢ You have ever had an allergic reaction to Canesten or any other vaginal antifungal products. ¢ You have any of the following symptoms: ¢ — Irregular vaginal bleeding. ¢ Abnormal vaginal bleeding or a blood-stained discharge. ¢ Ulcers, blisters or sores of the vagina or vulva. ¢ — Lower abdominal pain. ¢ — Pain or difficulty in passing urine. ¢ Fever or chills. ¢ Feeling sick or vomiting. ¢ Diarrhoea. ¢ A foul smelling discharge from the vagina.

This is because Canesten Thrush Combi Pessary & Cream may not be the right treatment for you.

Important information about some of the ingredients:

The cream contains cetostearyl alcohol which may cause local skin reactions (e.g. contact dermatitis). It also contains 20mg benzyl alcohol in each gram of cream. Benzyl alcohol may cause allergic reactions and mild local irritation.

Special precautions:

As with other creams and pessaries, this product may reduce the effectiveness of rubber contraceptives, such as condoms or diaphragms. Consequently, you should use alternative precautions for at least five days after using this product.

Do not use tampons, intravaginal douches, spermicides or other vaginal products while using this product.

Avoid vaginal intercourse while you have thrush and during use of this product because your partner could become infected.

Using other medicines:

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

Inform your doctor if you are taking tacrolimus or sirolimus (used to reduce the immune response to prevent rejection after an organ transplant).

Pregnancy and breastfeeding:

Canesten Thrush Combi Pessary & External Cream can be used in pregnancy and breastfeeding.

If you are pregnant, breastfeeding or trying for a baby, tell your doctor or midwife before using Canesten Thrush Combi Pessary & External Cream.

If you have informed your doctor or midwife already, follow his/her instructions carefully.

To treat internal thrush, your doctor may recommend that you use the pessary without the help of an applicator.

Thrush Combi Pessary & E External Cream 500mg pessary & 2% w/w cream

BAYER

How to take it

The Pessary:

The applicator should be used to insert the pessary as high as possible into the vagina, preferably before going to sleep at night for convenient and comfortable treatment.

Wash your hands before handling the applicator and the foil blister pack and again afterwards when you have used the applicator.

= 1. a"

Image 1 shows all the components (apart from the cream) included in the Canesten Thrush Combi Pessary and External Cream pack.

Remove the applicator from the packaging and pull out the plunger (with the red lock attached) from the applicator.

Pessary GS Applicator Plunger Red Lock

Remove the pessary from the foil blister pack and place into the open end of the applicator with the curved edge of the pessary facing down. Push the plunger and lock into the applicator until you feel a click.

e 2.

3. Once you have felt the click, remove the lock from the plunger.

4. Carefully insert the applicator as deep as is comfortable into the vagina (this is easiest when lying on your back with your knees bent up) up to the patterned grip zone. Hold the applicator at the patterned grip zone. Carefully push the plunger all the way until it stops to dispense the vaginal pessary.

5. Remove the applicator. Dispose of the applicator in a safe place, out of the reach of children.

The applicator cannot be flushed down the toilet.

As the pessary dissolves in the vagina, it may be helpful to wear a panty liner. It may leave a white chalky residue after using the pessary, which does not mean that the treatment has not worked.

However, if you notice pieces of undissolved pessary, speak to your doctor or a pharmacist, as the treatment may not have worked properly.

The Cream:

Before use, pierce the tube seal by inverting the cap over the end of the tube and press.

To treat the itching and soreness of the vulva (vulvitis) the cream should be thinly and evenly applied to the area around the entrance of the vagina, 2 or 3 times a day and smoothed in gently. The symptoms of thrush should disappear within three days of treatment.

¢ If no improvement is seen after seven days you must tell your doctor.

¢ If the infection returns after seven days you may use one further treatment.

¢ If you have more than two infections within six months you should see your doctor.

The pessary is for use in the vagina only. The cream is for external use only:

Do not put the pessary or cream in your mouth or swallow them.

If the pessary or cream are swallowed accidentally, tell your doctor straight away or contact the Accident and Emergency Department of your nearest hospital.

Possible side effects

Like all medicines Canesten Thrush Combi Pessary & External Cream can cause side effects,

although not everybody gets them.

As with all medicines, some people may be allergic to the pessary or cream. If you are allergic,

a reaction will occur soon after you have used the medicine. If you experience an allergic

reaction or the redness, burning, pain, itching or swelling get worse, stop using this product

and tell your doctor straight away or contact the Accident and Emergency Department of

your nearest hospital. Signs of an allergic reaction may include:

¢ Rash.

¢ — Swallowing or breathing problems.

¢ — Swelling of your lips, face, throat or tongue.

¢ Weakness, feeling dizzy or faint.

¢ Nausea.

After you use the pessary you might experience:

¢ Itching, rash, swelling, redness, discomfort, burning, irritation, vaginal peeling, discharge or bleeding.

¢ Pain (eg. abdominal pain, vulvovaginal pain).

¢ Nausea.

After you apply the cream you might experience: ¢ — Itching, rash, blisters, burning, discomfort, swelling, redness, irritation, pins and needles or peeling of skin.

If you experience any of the above effects, tell your doctor immediately.

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse.

This includes any possible side effects not listed in this leaflet.

You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

By reporting side effects you can help provide more information on the safety of this medicine.

How to store it

Keep this medicine out of the sight and reach of children. Do not store above 25°C.

Do not use the pessary or cream after the expiry date which is stated at one end of the carton, on the foil blister strip of the pessary and on the end of the tube of cream. The expiry date refers to the last day of that month.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

The applicator is made of recyclable materials.

6. FURTHER INFORMATION

What Canesten Thrush Combi Pessary & External Cream contains:

Pessary:

¢ The active substance is clotrimazole at a strength of 500mg.

¢ The other ingredients are lactose monohydrate, microcrystalline cellulose, lactic acid, maize starch, crospovidone, calcium lactate pentahydrate, magnesium stearate, colloidal anhydrous silica and hypromellose.

Cream:

¢ The active substance is clotrimazole at a strength of 2% w/w.

¢ The other ingredients are benzyl alcohol, polysorbate 60, sorbitan stearate, cetyl palmitate, cetostearyl alcohol, octyldodecanol and purified water. See Section 2 'Do not use' and 'Important information about some of the ingredients' for cetostearyl alcohol and benzyl alcohol advice.

What Canesten Thrush Combi Pessary & External Cream looks like and contents of the pack:

Canesten Thrush Combi Pessary & External Cream contains a full course of treatment, which consists of a single white pessary held inside a foil blister pack, one applicator for insertion of the pessary into the vagina and one 10g tube of white external cream.

Marketing Authorisation Holder: Bayer plc, 400 South Oak Way, Reading, RG2 6AD, UK.

Manufacturer:

GP Grenzach Produktions GmbH, 79639 Grenzach-Wyhlen, Germany.

Remember: If you have any doubts about using Canesten Thrush Combi Pessary & External Cream correctly, seek the advice of your doctor or pharmacist

Further information about vaginal thrush: Vaginal thrush (candidiasis) is a common infection that most women suffer from at some time in their lives and is not caused by lack of personal hygiene.

Thrush is caused by a yeast (fungus) called Candida which lives harmlessly in the vagina and other parts of the body, without you even noticing it. However, the natural balance that keeps Candida under control can be upset by many factors such as hormonal changes (menstruation, contraceptive pill, pregnancy, menopause), poor health, antibiotics, perfumed soaps, bath additives and tight clothing.

If the natural pH balance is altered, the level of yeast increases and can develop into a thrush infection causing any of the following symptoms: persistent burning and/or itching around the vagina and vulva, redness, swelling and soreness of the tissues of the vagina and vulva and a whitish, odourless discharge from the vagina. Not everybody who has thrush has all these symptoms; you may have only one of them.

How to avoid future recurrences:

Wear cotton knickers and loose clothing.

Wash daily.

After going to the toilet, wipe yourself from the front to back as a thrush infection may be transferred from the bowel.

Change your sanitary protection regularly.

Try to avoid wearing tights, nylon knickers and close fitting jeans.

Try to avoid washing with perfumed soaps or using vaginal deodorants.

Do not wash or rub yourself hard with sponges or flannels and avoid hot baths with strong perfumed oils.

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If you are still worried or have any questions about the symptoms or the treatment of thrush, do not hesitate to ask your doctor or pharmacist for advice.

For UK residents only: if you have any questions or would like more information, call our Canesten Advice Line on 0845 758 5030.

Calls charged at local rate.

This leaflet was last revised in February 2023.

Canesten is a registered trademark of Bayer AG, Germany.

Bayer

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