How to use Vagirux

The usual dose for Vagirux is one vaginal tablet a day for 2 weeks. After this initial dose, this can be lowered to one vaginal tablet twice a week with 3 to 4 days between each dose.

Vagirux pessaries should be applied using the following method:

1. Wash your hands and remove the applicator from its sealing foil.
2. While holding the tube, gently pull the plunger out of the applicator until it comes to a stop.
3. Take a vaginal tablet from the separate blister and place it firmly in the holder of the applicator end (wide end).
4. Insert the applicator carefully into the vagina and stop when you can feel some resistance at around (8-10 cm).
5. Gently press the push button until the end of the plunger to release the vagirux tablet. The tablet will stick to the wall of the vagina.
6. After each use, clean the tube and plunger using mild soap and warm water.
7. Air dry the tube and plunger by laying them on a clean surface.
8. Introduce the plunger again in the applicator tube.
9. The applicator can be used up to 24 times and a new applicator should be used with every new pack.

How long can you use Vagirux?

To experience the best results, Vagirux tablets should be used for at least 8-12 weeks to give the treatment a chance to replace your oestrogen levels. However, once you stop using Vagirux, your symptoms may return. Vagirux can be used on a long-term basis if needed, but it’s best to have regular discussions with your GP to assess your treatment.

Vagirux ingredients

The active substance is estradiol (as estradiol hemihydrate). Each vaginal tablet contains 10 mg of estradiol (as estradiol hemihydrate).

Other ingredients: hypromellose, lactose monohydrate, maize starch and magnesium stearate.

The film coating contains hypromellose and macrogol.

Sources

Vagirux patient information leaflet: https://www.medicines.org.uk/emc/files/pil.11752.pdf

What are the possible side effects of Vagirux?

Like all medicines, there is a risk of possible side effects for some users of Vagirux tablets.

The following diseases are reported more often in women using HRT medicines which circulate in the blood compared to women not using HRT. These risks apply less to vaginally administered treatments such as Vagirux:

• Ovarian cancer
• Blood clots in the veins of the legs or lungs (venous thromboembolism)
• Stroke
• Probable memory loss if HRT is started over the age of 65

Common side effects: may affect up to 1 in 10 people

• Headache
• Stomach pain
• Vaginal bleeding, discharge or discomfort

Uncommon: may affect up to 1 in 100 people

• An infection of the genitals caused by a fungus
• Feeling sick (nausea)
• Rash
• Weight increase
• Hot flush
• Hypertension

Very rare: may affect up to 1 in 10,000 people

• Diarrhoea
• Fluid retention
• Migraine aggravated
• Generalised hypersensitivity (e.g. anaphylactic reaction/shock).

The following side effects have been reported with systemic oestrogen treatment:

• Gallbladder disease
• Various skin disorders, including:
  • Discolouration of the skin, especially of the face or neck; known as ‘pregnancy patches’ (chloasma)
  • Painful reddish skin nodules (erythema nodosum)
  • A rash with target-shaped reddening or sores (erythema multiforme).

Stop using Vagirux and see a doctor immediately if you notice any of the following side effects:

• Migraine-like headaches happen for the first time
• Yellowing of your skin or the whites of your eyes (jaundice). These may be signs of liver disease
• Swollen face, tongue, or throat, difficulty swallowing, hives, difficulty breathing — all of which are suggestive of angioedema
• A sudden, large increase in your blood pressure (symptoms may be a headache, tiredness, dizziness)
• Blood clots, such as painful swelling and redness of the legs, sudden chest pain, or difficulty in breathing

If you do experience any of the above side effects, it’s best to stop taking any further treatment and discuss your options with your GP. For serious side effects, visit your local A&E department or call 111 for advice.

Vagirux warnings

Vagirux vaginal tablets are not an appropriate treatment option for everyone. Always speak honestly about your existing medical conditions and medical history to ensure the treatment is safe for you.

Do not use Vagirux if any of the following applies to you:

• You are allergic to any of the other ingredients of this medicine.
• You have or have ever had breast cancer, or you are suspected of having it.
• You have or have ever had cancer which is sensitive to oestrogens, such as cancer of the womb lining (endometrium), or you are suspected of having it.
• You have any unexplained vaginal bleeding.
• You have excessive thickening of the womb lining (endometrial hyperplasia) that is not being treated.
• You have or have ever had a blood clot in a vein (thrombosis), such as in the legs (deep venous thrombosis) or the lungs (pulmonary embolism).
• You have a blood clotting disorder (such as protein C, protein S or antithrombin deficiency).
• You have or have recently had a disease caused by blood clots in the arteries, such as a heart attack, stroke or angina.
• You have or have ever had a liver disease and your liver function tests have not returned to normal.
• You have a rare blood problem called ‘porphyria’, which is passed down in families (inherited).

If any of the above conditions appear for the first time while using Vagirux, stop using it at once and consult your doctor immediately.

Tell your doctor if you have or have ever had any of the following problems before you start the treatment, as these may return or become worse during treatment with Vagirux:

• Asthma
• Epilepsy
• Diabetes
• Gallstones
• High blood pressure
• Migraines or severe headaches
• A liver disorder, such as a benign liver tumour
• Growth of womb lining outside your womb (endometriosis) or a history of excessive growth of the womb lining (endometrial hyperplasia)
• A disease affecting the eardrum and hearing (otosclerosis)
• A disease of the immune system that affects many organs of the body (systemic lupus erythematosus, SLE)
• Increased risk of getting an oestrogen-sensitive cancer (such as having a mother, sister or grandmother who has had breast cancer)
• Increased risk of developing blood clots (see ‘Blood clots in a vein (thrombosis)’)
• Fibroids inside your womb
• A very high level of fat in your blood (triglycerides)
• Fluid retention due to cardiac or kidney problems
• Hereditary and acquired angioedema