Drug Guide
Nonoxynol-9
Classification
Therapeutic: Contraceptive, spermicide
Pharmacological: Surfactant and spermicidal agent
FDA Approved Indications
- Contraception (spermicide use before sexual intercourse)
Mechanism of Action
Nonoxynol-9 destroys sperm cell membranes, leading to immobilization and death, thereby preventing fertilization.
Dosage and Administration
Adult: Applied as a cream, foam, gel, film, or suppository into the vagina prior to intercourse, following package instructions.
Pediatric: Not typically used or indicated.
Geriatric: No specific dosage adjustments; use as directed for contraception.
Renal Impairment: No specific adjustments needed.
Hepatic Impairment: No specific adjustments needed.
Pharmacokinetics
Absorption: Minimal systemic absorption; primarily local effect.
Distribution: Localized within vaginal mucosa.
Metabolism: Hydrolyzed by esterases in mucosal tissues.
Excretion: Metabolized locally; minimal systemic excretion.
Half Life: Not applicable; local action with rapid local metabolism.
Contraindications
- Allergy to Nonoxynol-9 or other spermicides.
- Use with certain latex or other material allergies.
Precautions
- Repeated frequent use may cause vaginal irritation or mucosal damage; increased risk of HIV or other STIs with repeated use.
Adverse Reactions - Common
- Vaginal irritation (Common)
- Allergic reactions (e.g., redness, itching) (Uncommon)
Adverse Reactions - Serious
- Vaginal or urinary tract infection (Rare)
- Severe allergic reaction (rare) (Very rare)
Drug-Drug Interactions
- None significant with other medications.
Drug-Food Interactions
- None
Drug-Herb Interactions
- None known
Nursing Implications
Assessment: Assess for allergic reactions and vaginal mucosa integrity.
Diagnoses:
- Risk for allergic reaction
- Risk for infection due to mucosal irritation
Implementation: Apply as per instructions, ensuring correct placement and timing before intercourse.
Evaluation: Monitor for adverse reactions, effectiveness in contraception, and mucosal irritation.
Patient/Family Teaching
- Use as directed; apply before each intercourse.
- Reapply with each act of intercourse.
- Use additional contraceptive methods if advised.
- Report any irritation, allergic reactions, or discomfort.
Special Considerations
Black Box Warnings:
- No black box warnings.
Genetic Factors: No known genetic considerations.
Lab Test Interference: No known interference.
Overdose Management
Signs/Symptoms: Local irritation or allergic reactions.
Treatment: Remove application, rinse thoroughly, and provide symptomatic treatment if needed.
Storage and Handling
Storage: Store at room temperature, away from heat and moisture.
Stability: Stable until expiration date, keep in original container.