Does this thrush treatment from my Dr sound right?

[Fagin99]

I'm 12 weeks pregnant and pretty sure I have the joys of vaginal thrush. I spoke to my GP on the phone who prescribed a course of canesten pessaries - one a night for a week. But each pessary is the full strength 500mg (when normally just one pessary is adequate for treatment). I asked the pharmacist and he said it's the normal dose for pregnant women.

Has anyone else been prescribed this? Does this sound right? It sounds like a huge amount and I thought you were meant to limit medication in pregnancy.

Thanks in advance!

Sounds about right
It's usually a course of pessaries for thrush in pregnancy

https://www.sps.nhs.uk/articles/thrush-or-vaginal-candida-treatment-during-pregnancy/

Says:First lineClotrimazole pessary 500 mg intravaginally at night for up to 7 consecutive nights first-line (if aged 16 years and older).

Well thank you for your post- I'm a GP and I've just learned something! When I read this I thought hmm oh dear someone has made a mistake but I then went and checked NICE guidelines and BASHH (British association for sexual health) guidelines and your GP is right. Apparently it's harder to clear in pregnancy so they advise a longer course of treatment first line. I'll know for my patients from now on as well!

https://cks.nice.org.uk/topics/candida-female-genital/management/during-pregnancy/search

It's correct. I'm a GP and I explain to my patients that the immune system is a little less efficient in pregnancy so it takes a longer course to clear infection. It has to be like that because the fetus is 'alien' so you wouldn't want maternal immune system attacking it.

Good for you learning something new. One for your appraisal portfolio perhaps!

Quite haha

Yep, I was prescribed this before I even knew I was pregnant. I told the pharmacist I was trying to conceive but it was too early to test and she advised I contact my GP. I did and they treated me as if I was pregnant. Same as you, 7 day course of pessaries. Found out I was pregnant a few days later 😁

Thank you so much everyone for your replies. They are all very reassuring - good to know I'm not being overdosed, ha. And the explanation about the lowered immune system makes a lot of sense.

It's amazing how this particular regimen isn't widely known about. I thought I was a thrush expert having been plagued with it many times, but even gynaecologists have never suggested to try this method (albeit when not pregnant, but I've have some pretty stubborn episodes.)

Anyway, thanks again and here's hoping it works!

I wish this had been the protocol when I was pregnant with my youngest. Plagued by thrush pretty much the whole pregnancy.

So the drama continues!
I went to collect the prescription today as they had to order it in. I saw a different pharmacist and she basically refused to give it to me! I mean, she said I could take it, but that it strongly wasn't what they would recommend at all, and that pessaries could risk damaging the cervix (even if using a finger) so she suggested asking for an internal cream instead. She was so passionate in her stance that I shouldn't use it, that it actually made me quite upset and also angry as I know deep down she's completely wrong, unprofessional, and shouldn't scare pregnant women like that.

I was so fed up after her 10-minute argument, that I just said I'd talk to my GP again on Monday and left as quickly as I could.

I'm honestly so cross and confused now. I just want to feel comfortable again!

Oh no! And you know she's wrong seeing as the actual guidelines have been shared here in a couple of forms. I'd go back and ask the pharmacist to contact the GP to discuss it. I've had this exact thing, actually, and other similar queries and I take great delight in telling the pharmacist they're wrong!

It's frustrating when that happens
I used to be on 4 of the same antihistamine a day and the drama over it

Are you sure it's right? This is an overdose? It's very dangerous you know
Yes, I've been taking 4 a day for the past 20 years and I'm still not dead....