{ "schema_version": 1, "kind": "condition", "id": "vulval-symptoms", "name": "Vulval Symptoms (Itching, Burning, Dryness)", "category": "acute", "sources": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clotrimazole monograph, Indications and Dosing: Adult - vulvovaginal candidiasis (chapter PDF p400, printed p390) · Hildebrand JP, Carlson K, Kansagor AT. Vaginitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Last Update: January 19, 2025. Bookshelf ID: NBK470302, PMID: 29262024.", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clotrimazole monograph, Indications and Dosing: Adult - vulvovaginal candidiasis (chapter PDF p400, printed p390) · Hildebrand JP, Carlson K, Kansagor AT. Vaginitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Last Update: January 19, 2025. Bookshelf ID: NBK470302, PMID: 29262024.", "verified_date": "2026-08", "treatments": [ { "id": 1962, "generic": "Clotrimazole", "line": 1, "is_adjunct": false, "form": "vaginal", "strength_mg": null, "adult_dose": "Insert 1 applicatorful of 1% clotrimazole vaginal cream at bedtime for 7 nights (or 2% cream for 3 nights), and apply the same cream externally to the vulva twice daily for up to 7 days for the itching and irritation. The external cream is an add-on to the vaginal course, not a treatment on its own.", "adult_duration": "7 nights intravaginally (3 nights if using 2% cream); external application up to 7 days", "dose_source": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clotrimazole monograph, Indications and Dosing: Adult - vulvovaginal candidiasis (chapter PDF p400, printed p390)", "rationale": "The formulary explicitly lists 'relief of associated external vulvar itching and irritation' as an indication for clotrimazole vaginal cream, and this external-application line is the most specific match for isolated vulval symptoms (as opposed to internal vaginal discharge).", "cautions": [ "No tampons, douches, spermicides or intercourse during treatment.", "Avoid with vaginal progesterone — vaginal antifungals may reduce its effect (interaction risk X).", "Reassess if symptoms do not improve within 3 days or last more than 7 days, rather than repeating the course.", "External cream alone will not clear the vaginal infection; give the intravaginal course with it.", "Covers candidal vulvitis only — the label is vaginal yeast infection and the external itching associated with it, not vulval dryness or non-candidal causes.", "A persistent lump, ulcer, or skin change on the vulva needs referral to exclude vulval cancer - not treated with an antifungal.", "If symptoms do not respond to a standard course, re-evaluate for dermatitis, lichen sclerosus, or atrophy rather than repeating antifungal treatment.", "Local irritation or hypersensitivity can occasionally occur with topical azoles." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Listed only for girls 12 years and older and adolescents, and only as vaginal cream: 1% at bedtime for 7 nights (some need 14) or 2% for 3 nights, each with the same twice-daily external application for up to 7 days. The monograph carries nothing for prepubertal vulval symptoms.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "LOCASTEN 2% VAGINAL CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALEXANDRIA", "price_egp": 29.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CANDISTAN 2% VAGINAL CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 40.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CANESTEN 3 2% VAGINAL CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS > BAYER HEALTHCARE", "price_egp": 51.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CANDISTAN 200 MG 3 VAG.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 8.5, "pack_count": null, "unit_price": null, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CANDISTAN 100 MG 6 VAG.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 9.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LOCASTEN 1 500 MG 1 VAG. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALEXANDRIA", "price_egp": 10.25, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KREMA-ROSA 100MG 6 VAG.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 10.5, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LOCASTEN 100 MG 6 VAG. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALEXANDRIA", "price_egp": 10.5, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "vulval-symptoms" } ] }