General

Pronunciation:
lak-tik as-id/sit-rik as-id/poe-tas-ee-um bye-tar-trate

Trade Name(s)

• Phexx

Ther. Class.

contraceptive nonhormonals

Indications

Rep:  Prevention of pregnancy in women of reproductive potential as an on-demand form of contraception.

Action

Lowers the pH in the vagina, which subsequently reduces sperm motility.

Therapeutic Effect(s):

Prevention of pregnancy.

Pharmacokinetics

Absorption: Systemic absorption not expected following vaginal administration.

Distribution: Systemic absorption not expected following vaginal administration.

Metabolism and Excretion: Unknown.

Half-life: Unknown.

TIME/ACTION PROFILE

Contraindication/Precautions

Contraindicated in:

• Hypersensitivity;
• OB:   Pregnancy;
• Rep:  History of recurrent urinary tract infection or urinary tract abnormalities.

Use Cautiously in:

Lactation:  Safety not established in breastfeeding.

Adverse Reactions/Side Effects

GU: vulvovaginal burning, vulvovaginal pruritus, bacterial vaginosis, cystitis, dysuria, genital discomfort, pyelonephritis, urinary tract infection, vagina discharge, vulvovaginal candidiasis, vulvovaginal pain

Misc: hypersensitivity reactions

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Drug-Drug

Avoid use with  vaginal rings.

Route/Dosage

Vag (Adults and Children [women of reproductive potential]): One prefilled applicator (5 g) immediately before or up to 1 hr before each act of vaginal intercourse. If ≥1 act of vaginal intercourse occurs within 1 hr, must insert another prefilled applicator.

Availability

Vaginal gel: lactic acid 90 mg/citric acid 50 mg/potassium bitartrate 20 mg in each 5-g prefilled applicator

Assessment

• Assess patient for history of recurrent urinary tract infections or urinary tract abnormalities. May cause cystitis and pyelonephritis.

Implementation

• Vag Administer one prefilled applicator vaginally immediately before or up to 1 hr before each act of vaginal intercourse. If >1 act of vaginal intercourse occurs within 1 hr, apply an additional dose.

Patient/Family Teaching

• Explain the purpose and side effects. Instruct patient in correct timing and technique for vaginal administration before vaginal sex. May be used during any part of menstrual cycle and as soon as it is safe to resume vaginal intercourse after childbirth, abortion, or miscarriage. Advise patient to read  Patient Information  before starting and with each Rx refill in case of changes.
• Advise patient that  Phexx  is not effective at preventing pregnancy when used after vaginal sex.
• Inform patient that  Phexx  may be used with hormonal contraceptives; latex, polyurethane, and polyisoprene condoms; and vaginal diaphragms. Avoid use with vaginal rings. May also be used concurrently with other products for vaginal infections (miconazole, metronidazole, tioconazole).
• Advise patient to notify health care provider if severe or prolonged genital irritation or symptoms of urinary tract infection (burning feeling when passing urine, cloudy urine, pain in the pelvis, back pain) occur. May also cause burning, itching, and pain in male partner.
• Inform patient that  Phexx  does not protect against HIV or other sexually transmitted infections.
• Advise patient to notify health care provider of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care provider before taking other medications.
• Rep:  Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected or if breastfeeding. There is no use for  Phexx  in pregnancy; discontinue use.

Evaluation/Desired Outcomes

Prevention of pregnancy.