Gynogena 500

Gynogena 500 is an oral tablet whose active ingredient is tinidazole, 500 mg per tablet, with 4 tablets in each box made by British Dispensary. It is swallowed and absorbed into the blood, so it is not a vaginal tablet or pessary.

Tinidazole is a nitroimidazole that kills protozoa and anaerobic bacteria. According to the FDA label, inside the organism it is converted into reactive radicals that damage its DNA.

It acts only on protozoa and bacteria, so it is not an antifungal and does not treat viruses or colds. In the United States the same drug is sold as Tindamax, and this page draws on its FDA label.

The four uses listed on the box and in the FDA label are:

• Trichomoniasis: caused by the protozoan Trichomonas vaginalis, in women and men. It may cause unusual discharge, itching or burning when passing urine, but many people have no symptoms.
• Bacterial vaginosis (BV): thin grey-white discharge with a fishy smell, treated in adult women.
• Intestinal amoebiasis: an intestinal infection with Entamoeba histolytica.
• Giardiasis: an intestinal infection with Giardia that causes diarrhoea.

Unusual discharge has several causes, and a yeast infection needs an antifungal. If unsure which germ is involved, ask a pharmacist or see a clinic before buying.

Take with food and swallow whole with water. The adult dose depends on the condition.

• Trichomoniasis: a single 2 g dose (4 tablets), which is 1 box. Sexual partners must take the same dose at the same time to prevent re-infection.
• Giardiasis: a single 2 g dose (4 tablets), which is 1 box.
• Bacterial vaginosis: 2 g (4 tablets) once daily for 2 days, or 1 g (2 tablets) once daily for 5 days. The 2-day course needs 2 boxes (8 tablets); the 5-day course uses 10 tablets, so you need 3 boxes.
• Intestinal amoebiasis: 2 g (4 tablets) once daily for 3 days, which needs 3 boxes (12 tablets).

One box is enough only for trichomoniasis and giardiasis. Finish the course even if you feel better, do not share tablets, and ask a pharmacist if you are unsure of the dose.

In FDA data, 11.0% of 3,669 people given the single dose reported side effects. The most common:

• bitter or metallic taste, 3.7%
• nausea 3.2%, vomiting 1.5%, loss of appetite 1.5%
• stomach discomfort or cramps, 1.8%
• tiredness 2.1%, headache 1.3%, dizziness 1.1%

With multi-day courses these are more common, for example metallic taste 6.3% and nausea 4.5%. Darkened urine has also been reported, and a vaginal yeast infection can follow, which needs an antifungal.

Stop the medicine and see a doctor straight away for a seizure, numbness or tingling in the hands or feet, or a severe allergic reaction such as hives, facial swelling or difficulty breathing.

Do not take it if you have ever had an allergic reaction to tinidazole or another nitroimidazole such as metronidazole.

Avoid it in these situations

• Pregnancy, especially the first trimester. The CDC advises avoiding tinidazole in pregnant women.
• Breastfeeding. Stop breastfeeding during treatment and for 72 hours after the last dose, because the drug passes into milk.
• Long-term use. A related drug caused tumours in animals over long periods, so use it only for the listed infections.

Ask a pharmacist first if you have had seizures, a nervous system disease, a blood disorder such as low white cell count, liver disease or dialysis.

Children: weight-based doses exist only for giardiasis and amoebiasis over age 3, so children should not take it on their own. Older adults need care; severe kidney impairment usually needs no dose change.

Compared with the oral tablets in the store only.

• Metronidazole is a different drug, 400 mg per tablet, taken twice a day for 7 days. Pick it for the standard, widely used regimen.
• Metrolex (Metronidazole) has the same ingredient, only the brand differs, with the same 7-day regimen.
• Gynogena 500 (Tinidazole) has a shorter course: one dose for trichomoniasis, 2 days for BV, and it also covers intestinal infections.

The CDC lists the 7-day metronidazole regimen as recommended for women, with tinidazole as an alternative. Both need alcohol avoided.

In short: choose Gynogena 500 for a shorter course; choose Metronidazole or Metrolex for the 7-day regimen. Ask a pharmacist to match the medicine to the condition.

Alcohol: do not drink during treatment or for 3 days after it. This includes products containing ethanol or propylene glycol, because abdominal cramps, nausea, vomiting, headache and flushing may occur.

Medicines to tell a pharmacist about

• Warfarin: its blood-thinning effect may increase, and the dose may need adjusting for up to 8 days after stopping.
• Disulfiram: do not use tinidazole if you took disulfiram within the last 2 weeks.
• Lithium, cyclosporine, tacrolimus, fluorouracil: levels or side effects may need monitoring.
• Phenobarbital, rifampin, phenytoin may lower tinidazole levels; cimetidine and ketoconazole may raise them.
• Cholestyramine: take it at a different time.

Also mention any vitamins or medicines you buy yourself.

After all 4 tablets are taken on an empty stomach, the blood level peaks at about 1.6 hours on average. Taking it with food delays the peak by about 2 hours and lowers it by about 10%, while the total amount absorbed stays the same.

The half-life is about 12-14 hours. The level falls from 14.3 micrograms/mL at 24 hours to 0.8 micrograms/mL at 72 hours, so some drug is still in the body.

How fast symptoms improve depends on the condition and the person, and the label gives no number of days. If symptoms persist after the course, see a doctor or ask a pharmacist.

Where can you buy Gynogena 500?

Order online from Intimo Life. Delivery across Thailand takes 1-3 business days, packed discreetly for your privacy, with no product name shown on the parcel.