Fluomizin: Effective Vaginal Infection Treatment

Dequalinium chloride, also known by the brand-name Fluomizin, is an antimicrobial agent that has broad activity against fungi and bacteria when applied vaginally.

Dequalinium chloride has low absorbency, making it a useful vaginal treatment option for infections, either bacterial or fungal in nature.

Dequalinium chloride works against gram-positive and gram-negative bacteria, yeasts, and protozoa – all relevant vaginal infection-related microbes (see list below). Dequalinium chloride can be used to treat straightforward vaginal infections or those which are uncertain in terms of diagnosis.

Resistance of pathogens to dequalinium chloride is unlikely because of the way the substance works. While dequalinium chloride has been tested in the lab against almost everything, the lab and test tubes present a very different environment to the real-life vagina, which has crevices, biofilms, and more bacteria at work.

The treatment can be very effective against planktonic bacteria, but there is no research into how dequalinium chloride affects biofilms.

If you need to do a biofilm treatment, at the moment we recommend following the Four-pronged Approach in Killing BV.

Results of dequalinium chloride are on par with antibiotics in terms of successful treatments of bacterial vaginosis, aerobic vaginitis, vaginal yeast infections and infections of unknown cause.

Dequalinium chloride is effective against many common vaginal pathogens:

Atopobium vaginae (anaerobic gram-positive)
Bacteroides spp. (anaerobic gram-negative)
Bacteroides fragilis (anaerobic gram-negative)
Bacteroides vulgatus (anaerobic gram-negative)
Candida spp. (yeast)
Candida albicans (yeast)
Candida glabrata (yeast)
Candida krusei (yeast)
Enterobacter spp. (aerobic gram-negative)
Enterococcus faecalis (aerobic gram-positive)
Escherichia coli (aerobic gram-negative)
Fusobacteria (anaerobic gram-negative)
Gardnerella vaginalis (anaerobic gram-positive)
Klebsiella spp. (aerobic gram-negative)
Lactobacillus spp. (aerobic gram-positive)
Listeria monocytogenes (anaerobic gram-positive)
Peptostreptococcus (anaerobic gram-positive)
Porphyromonas spp. (anaerobic gram-negative)
Prevotella spp. (anaerobic gram-negative)
Prevotella bivia (anaerobic gram-negative)
Prevotella disiens (anaerobic gram-negative)
Prevotella intermedia (anaerobic gram-negative)
Porphyromonas asaccharolytica (anaerobic gram-negative)
Pseudomonas spp. (aerobic gram-negative)
Serratia spp. (aerobic gram-negative)
Staphylococcus aureus (aerobic gram-positive)
Streptococcus agalactiae (Group B Streptococci, aerobic gram-positive)
Streptococcus pyogenes (Group A Streptococci, aerobic gram-positive)

Naturally dequalinium chloride-resistant bacteria

Proteus mirabilis (facultatively anaerobic, gram-negative)
Chlamydia trachomatis (aerobic gram-negative)
Trichomonas vaginalis (parasitic protozoa)

What is dequalinium chloride and how does it work?

Dequalinium chloride is an ammonium salt, which probably doesn’t mean much to you, and nor does it particularly matter. Dequalinium chloride is not an antibiotic and is available over the counter in some countries.

This substance has been used for a while now in lozenges to kill throat bacteria involved in sore throats. Dequalinium chloride works to kill microbes by increasing cell permeability, stopping the microbe’s enzyme activity.

Once microbes lose their enzymatic powers, they quickly lose their ability to survive. It may affect the microbe’s osmotic system, cell metabolism, energy production, and protein synthesis.

In the lab, the bactericidal (germ-killing) and fungicidal (fungus-killing) powers occurred within an hour and no resistance has been reported from any lab studies or clinical trials.

Orally and vaginally, absorption rates of dequalinium chloride are low, and therefore toxicity isn’t considered an issue. Animal studies have found no concerns for use during pregnancy.

About vaginal Fluomizin tablet treatments

Fluomizin tablets quickly disintegrate in the vagina and the active substance spreads throughout the vagina.

Once vaginal secretions dissolve the tablet, the dose in the vagina is from between four and eight times higher than what is required to inhibit the least susceptible bacteria (minimal inhibitory concentration, MIC).

Typically you would insert the tablets (or other product, however that is presented) deep into the vagina. The typical dose is 10mg, but how this is applied will depend on your infection and how you respond.

Biofilms may complicate the infection, and longer treatment doses may be required and treatment may fail due to this. If your condition comes with biofilms as a feature, it may be advisable to double the dose (10mg morning and before bed), and double the treatment time to 12 days.

Other products that contain dequalinium chloride

Dequadin 10mg vaginal pessaries
Dequavagyn 50mg controlled release ovules (8-10-day treatment)
Dequavagyn 20mg/10g cream, controlled release (8-10-day treatment)
Oestro-Dequavagyn 20mg/10g cream with 0.15mg oestriol (E3), controlled release (8-10-day treatment)
Oestro-Dequavagyn 20mg/10g cream with 2mg oestriol (E3), controlled release (8-10-day treatment)
Gyken ovules 20mg
Erosept vaginal foam 100mg/100g

Possible side-effects of dequalinium chloride

Over 3,000 women so far have been in clinical trials of dequalinium chloride, with the following side-effects observed:

Well tolerated overall
No serious adverse events recorded
Local reaction
Vaginal discharge
Itching
Burning

Dequalinium chloride safety in pregnancy

Many studies have tested dequalinium chloride in pregnant women with no adverse effects on pregnancy or the health of the foetus/baby.

Where to buy dequalinium chloride

Order Fluomizin from My Vagina.

If you live in Europe, the United Kingdom, Russia or Asia, you are likely to have over-the-counter access to Fluomizin at a pharmacy in person or online. Some Europeans may need a prescription.

Research into vulvovaginal infections and dequalinium chloride (DQC)

Study #1

Weissenbacher, 2012¹, bacterial vaginosis, Fluomizin vaginal tablets vs clindamycin two per cent cream, six days

At week 1, cure rates were 81.5 per cent for DCQ and 75 per cent in clindamycin group.
At week 4, cure rates were 80 per cent for DCQ and 78 per cent in clindamycin group.
Well tolerated

_________

Study #2

Radzinsky et al, 2011², non-specific vaginitis, Fluomizin vaginal tablets six days versus standard anti-infective treatment, with Gynoflor restoration afterwards

Fluomizin group saw 78 per cent cure
Standard anti-infective treatment saw 77 per cent cure

_________

Study #3

Dankovich and Gopchuk, 2006³, abnormal vaginal flora, Fluomizin vaginal tablets, six days, pre-surgery preventative

Out of 45 women undergoing surgery, just one had complications after surgery
Vaginal flora became healthy in 44 women
No adverse effects

_________

Study #4

Grishchenko et al, 2006⁴, bacterial vaginosis in pregnant women, Fluomizin versus povidone iodide vaginally

Resulted in favourable conditions for pregnancy and healthy baby

_________

Study #5

Grischenko et al, 2006⁵, mixed infection, Fluomizin versus chlorhexidine bigluconate

Fluomizin cure rate was 97 per cent
Chlorhexidine bigluconate cure rate was 66 per cent

_________

Study #6

Demina et al, 2005⁶, bacterial vaginosis and opportunistic flora vaginitis, Fluomizin versus povidone iodine vaginally

Vaginal flora recovery in all pregnant women of one group after one treatment
Vaginal clearance seen in 92 per cent of women
No Candida albicans seen after Fluomizin

_________

Study #7

Petersen, 2002⁷, bacterial vaginosis, yeast infections and trich, Fluomizin vaginal tablets versus povidone-iodine vaginally

Fluomizin group saw a decrease in symptoms from 5.13 to 1.33
BV: Fluomizin group cure rate was 96 per cent; the povidone-iodine group cure rate was 82 per cent
Yeast infections: symptom decrease from 6.5 to 1.1
Aerobic vaginitis: symptoms decreased from 5.0 to 1.3
Some local irritation in some women

_________

Study #8

Schmidt, 2000⁸, bacterial vaginosis, trich, yeast and flora imbalance in pregnant women, Fluomycin 10mg DQC vaginally for six days

Distinct improvement in all documented clinical symptoms

Study #9

Della Casa et al, 2002⁹, dequalinium chloride, povidone-iodine and clotrimazole tested against 18 pathogens

Fluomizin was effective with the exception of Proteus mirabalis

_________

References

Della Casa V, Noll H, Gonser S, Grob P, Graf F, Pohlig G. Antimicrobial activity of dequalinium chloride against leading germs of vaginal infections. Arzneimittelforschung. 2002;52(9):699-705.

1.
Mendling W, Weissenbacher ER, Gerber S, Prasauskas V, Grob P. Use of locally delivered dequalinium chloride in the treatment of vaginal infections: a review. Arch Gynecol Obstet. Published online October 27, 2015:469-484. doi:10.1007/s00404-015-3914-8
2.
Radzinsky V, Chetvertakova E, Ordiyants I, Misuno O. Two Stage therapy for Vaginal Infections. Akusherstvo i Ginekologiia. 2011;2011(5):78–81.
3.
Dankovich D, Gopchuk E. New opportunities in preparation of women with reproductive tracts microbiocenosis disorder for gynaecologic intervention. Women’s Health. 2006;2006(2):1–4.
4.
Grishchenko O, Lahno I, Dudko V, Stupak I, Storchak A. Clinical and prognostic aspects of bacterial vaginosis treatment in pregnant women. Women’s Health. 2006;2006(4):69-72. https://www.kup.at/kup/pdf/11938.pdf
5.
Grishchenko O, Dudko V, Lahno I, Dudko L, Storchak A. Clinical and prognostic aspects of mixed etiology vaginitis treatment. Women’s Reprod Health. 2006;2006(2):8-10.
6.
Demina T, Pilipenko O, Jotenko B, Baksheeva O. The role of anti-microbial therapy in complex treatment of women with miscarriage. Women’s Reprod Health. 2005;2005(3):99-102.
7.
Petersen E, Weissenbacher E, Hengst P, et al. Local Treatment of Vaginal Infections of Varying Etiology with Dequalinium Chloride or Povidone Iodine. Arzneimittelforschung. Published online December 26, 2011:706-715. doi:10.1055/s-0031-1299955
8.
Schmidt (Unknown). Unpublished. Presented at the: Open, drug utilisation trial; 2000.
9.
Casa V, Noll H, Gonser S, Grob P, Graf F, Pohlig G. Antimicrobial Activity of Dequalinium Chloride against Leading Germs of Vaginal Infections. Arzneimittelforschung. Published online December 26, 2011:699-705. doi:10.1055/s-0031-1299954