intravaginal administration


Summary: The insertion of drugs into the vagina to treat local infections, neoplasms, or to induce labor. The dosage forms may include medicated pessaries, irrigation fluids, and suppositories.

Top Publications

  1. Montgomery C, Gafos M, Lees S, Morar N, Mweemba O, Ssali A, et al. Re-framing microbicide acceptability: findings from the MDP301 trial. Cult Health Sex. 2010;12:649-62 pubmed publisher
    ..We now need to move beyond limited notions of acceptability and consider how microbicides fit into a more holistic picture of women's and men's sexuality and sexual health. ..
  2. Oppegaard K, Nesheim B, Istre O, Qvigstad E. Comparison of self-administered vaginal misoprostol versus placebo for cervical ripening prior to operative hysteroscopy using a sequential trial design. BJOG. 2008;115:663, e1-9 pubmed publisher
    ..There is a risk of lower abdominal pain and light preoperative bleeding with this regimen, which is very cheap and easy to use. ..
  3. Saethre E, Stadler J. Gelling medical knowledge: innovative pharmaceuticals, experience, and perceptions of efficacy. Anthropol Med. 2010;17:99-111 pubmed publisher
    ..Examining participant responses to the gel provides insight into the relationship between knowledge and experience when utilizing previously unfamiliar biotechnologies. ..
  4. Vallely A, Shagi C, Lees S, Shapiro K, Masanja J, Nikolau L, et al. Microbicides development programme: engaging the community in the standard of care debate in a vaginal microbicide trial in Mwanza, Tanzania. BMC Med Ethics. 2009;10:17 pubmed publisher
    ..Current Controlled Trials ISRCTN64716212. ..
  5. Zhang X, Chentoufi A, Dasgupta G, Nesburn A, Wu M, Zhu X, et al. A genital tract peptide epitope vaccine targeting TLR-2 efficiently induces local and systemic CD8+ T cells and protects against herpes simplex virus type 2 challenge. Mucosal Immunol. 2009;2:129-143 pubmed publisher
    ..IVAG immunization with self-adjuvanting lipid-tailed peptides appears to be a novel mucosal vaccine approach, which has attractive practical and immunological features...
  6. Turner A, De Kock A, Meehan Ritter A, Blanchard K, Sebola M, Hoosen A, et al. Many vaginal microbicide trial participants acknowledged they had misreported sensitive sexual behavior in face-to-face interviews. J Clin Epidemiol. 2009;62:759-65 pubmed publisher
    ..Women overwhelmingly found the computer survey easy. Researchers cannot assume that participants always tell the truth about sensitive behaviors in face-to-face interviews. ACASI was efficient and acceptable in this population. ..
  7. Prager M, Eneroth Grimfors E, Edlund M, Marions L. A randomised controlled trial of intravaginal dinoprostone, intravaginal misoprostol and transcervical balloon catheter for labour induction. BJOG. 2008;115:1443-50 pubmed publisher
    ..The two prostaglandins, dinoprostone and misoprostol, were shown to be equally effective and safe, while misoprostol costs significantly less and is easier to store. ..
  8. Van Damme L, Govinden R, Mirembe F, Gu├ędou F, Solomon S, Becker M, et al. Lack of effectiveness of cellulose sulfate gel for the prevention of vaginal HIV transmission. N Engl J Med. 2008;359:463-72 pubmed publisher
    ..71; 95% CI, 0.47 to 1.08). Cellulose sulfate did not prevent HIV infection and may have increased the risk of HIV acquisition. ( number, NCT00153777; and Current Controlled Trials number, ISRCTN95638385.) ..
  9. Salter M, Go V, Celentano D, Diener West M, Nkhoma C, Kumwenda N, et al. The role of men in women's acceptance of an intravaginal gel in a randomized clinical trial in Blantyre, Malawi: a qualitative and quantitative analysis. AIDS Care. 2008;20:853-62 pubmed publisher
    ..These results indicate that female perceptions of male partner acceptability and actual male partner acceptability need to be considered when addressing female-controlled product acceptability and use. ..

More Information


  1. Montgomery C, Lees S, Stadler J, Morar N, Ssali A, Mwanza B, et al. The role of partnership dynamics in determining the acceptability of condoms and microbicides. AIDS Care. 2008;20:733-40 pubmed publisher
    ..Whilst preferences relating to product characteristics are largely individual, use itself is dependent on partnership dynamics and the broader social context in which sexual risk management occurs. ..
  2. Oppegaard K, Lieng M, Berg A, Istre O, Qvigstad E, Nesheim B. Does self-administered vaginal misoprostol result in cervical ripening in postmenopausal women after 14 days of pre-treatment with estradiol? Trial protocol for a randomised, placebo-controlled sequential trial. BJOG. 2008;115:917-e10 pubmed publisher
    ..Prof B.I.N.'s research grant also funded insurance for the study participants. Estimated completion date 31 December 2008. ..
  3. Nuttall J, Thake D, Lewis M, Ferkany J, Romano J, Mitchnick M. Concentrations of dapivirine in the rhesus macaque and rabbit following once daily intravaginal administration of a gel formulation of [14C]dapivirine for 7 days. Antimicrob Agents Chemother. 2008;52:909-14 pubmed
    ..This was preceded by a preliminary study with rabbits. Following the intravaginal administration of [14C]dapivirine ( approximately 0.1 mg/ml [15 microCi/ml]) to rabbits (0...
  4. Weeks A, Faundes A. Misoprostol in obstetrics and gynecology. Int J Gynaecol Obstet. 2007;99 Suppl 2:S156-9 pubmed
  5. Fiala C, Gemzell Danielsson K, Tang O, von Hertzen H. Cervical priming with misoprostol prior to transcervical procedures. Int J Gynaecol Obstet. 2007;99 Suppl 2:S168-71 pubmed
    ..Higher doses or longer intervals do not improve the effect on the cervix. Pain is a frequent side effect, but usually responds well to NSAIDs. Other side effects are rare. ..
  6. Shattock R, Moore J. Inhibiting sexual transmission of HIV-1 infection. Nat Rev Microbiol. 2003;1:25-34 pubmed
  7. Lamont R, Jones B, Mandal D, Hay P, Sheehan M. The efficacy of vaginal clindamycin for the treatment of abnormal genital tract flora in pregnancy. Infect Dis Obstet Gynecol. 2003;11:181-9 pubmed
    ..A 3-day course of CVC appears to be well tolerated by the mother and statistically significantly more efficacious than placebo in the treatment of BV during the second trimester of pregnancy. ..
  8. Stone A, Jiang S. Microbicides: stopping HIV at the gate. Lancet. 2006;368:431-3 pubmed
  9. Tolley E, Eng E, Kohli R, Bentley M, Mehendale S, Bunce A, et al. Examining the context of microbicide acceptability among married women and men in India. Cult Health Sex. 2006;8:351-69 pubmed
  10. Wallace A, Teitelbaum A, Wan L, Mulima M, Guichard L, Skoler S, et al. Determining the feasibility of utilizing the microbicide applicator compliance assay for use in clinical trials. Contraception. 2007;76:53-6 pubmed
    ..In South Africa, the assay was validated with an accuracy of over 95%. Applicator assay modifications render the test safe and suitable for use in clinical trials. ..
  11. Wallace A, Thorn M, Maguire R, Sudol K, Phillips D. Assay for establishing whether microbicide applicators have been exposed to the vagina. Sex Transm Dis. 2004;31:465-8 pubmed
    ..This method could be be used in clinical settings in the developing world. Dying applicator tips could prove useful in excluding non-compliant subjects, analyzing data, or developing social intervention strategies to improve compliance. ..
  12. Boadi T, Schneider E, Chung S, Tsai L, Gettie A, Ratterree M, et al. Cellulose acetate 1,2-benzenedicarboxylate protects against challenge with pathogenic X4 and R5 simian/human immunodeficiency virus. AIDS. 2005;19:1587-94 pubmed
    ..Research on further development of this promising compound as a candidate microbicide for the prevention of sexual HIV-1 transmission is therefore warranted. ..
  13. Dhawan D, Mayer K. Microbicides to prevent HIV transmission: overcoming obstacles to chemical barrier protection. J Infect Dis. 2006;193:36-44 pubmed
    ..Safe and effective topical microbicides are biologically plausible. Several trials that are under way may demonstrate the ability of microbicides to protect against transmission of HIV, but multiple challenges remain. ..
  14. Connor R. Sensitivity of non-clade B primary HIV-1 isolates to mildly acidic pH. J Acquir Immune Defic Syndr. 2006;43:499-501 pubmed
  15. Preutthipan S, Herabutya Y. A randomized comparison of vaginal misoprostol and dinoprostone for cervical priming in nulliparous women before operative hysteroscopy. Fertil Steril. 2006;86:990-4 pubmed
    ..Although more side effects occurred in the misoprostol-treated patients, they were mild. We suggest using vagina misoprostol for cervical priming instead of dinoprostone. ..
  16. Bentley M, Fullem A, Tolley E, Kelly C, Jogelkar N, Srirak N, et al. Acceptability of a microbicide among women and their partners in a 4-country phase I trial. Am J Public Health. 2004;94:1159-64 pubmed
    ..Acceptability research across diverse settings through all stages of microbicide research, development, and post-licensure dissemination can help maximize acceptability and use. ..
  17. D Cruz O, Waurzyniak B, Uckun F. Mucosal toxicity studies of a gel formulation of native pokeweed antiviral protein. Toxicol Pathol. 2004;32:212-21 pubmed
    ..These findings indicate careful monitoring of vaginal irritation will be required in the clinical development of PAP as a nonspermicidal microbicide...
  18. Atmaca R, Kafkasli A, Burak F, Germen A. Priming effect of misoprostol on estrogen pretreated cervix in postmenopausal women. Tohoku J Exp Med. 2005;206:237-41 pubmed
    ..To get a beneficial effect of misoprostol on cervical ripening, estrogenic activity is necessary and when pretreated with local estrogen, misoprostol ameliorates cervical priming in postmenopausal women. ..
  19. Oppegaard K, Qvigstad E, Nesheim B. Oral versus self-administered vaginal misoprostol at home before surgical termination of pregnancy: a randomised controlled trial. BJOG. 2006;113:58-64 pubmed
    ..The oral route does not lead to satisfactory dilatation in either group and is associated with a higher occurrence of pre-operative bleeding. Self-administered vaginal misoprostol at home is highly acceptable. ..
  20. Han I, Kim Y, Kang H, Sul D, Jung W, Cho H, et al. Thermosensitive and mucoadhesive delivery systems of mucosal vaccines. Methods. 2006;38:106-11 pubmed
    ..Here, we describe the formulation and delivery methods of mucosal vaccines using thermosensitive and mucoadhesive polymers...
  21. Kwant A, Rosenthal K. Intravaginal immunization with viral subunit protein plus CpG oligodeoxynucleotides induces protective immunity against HSV-2. Vaccine. 2004;22:3098-104 pubmed
  22. Wang Y, Lee C. Effects of intrinsic variables on release of sodium dodecyl sulfate from a female controlled drug delivery system. Int J Pharm. 2004;282:173-81 pubmed
    ..It can be concluded that FcDDS can be exploited as a controlled delivery device for prevention against sexually transmitted diseases. ..
  23. Barcaite E, Bartusevicius A, Railaite D, Nadisauskiene R. Vaginal misoprostol for cervical priming before hysteroscopy in perimenopausal and postmenopausal women. Int J Gynaecol Obstet. 2005;91:141-5 pubmed
    ..Vaginal misoprostol applied before hysteroscopy reduced cervical resistance and the need for cervical dilation in perimenopausal and postmenopausal women, with only mild adverse effects. ..
  24. Camero M, Bellacicco A, Tarsitano E, Decaro N, Martella V, Tempesta M, et al. Intravaginal administration of an inactivated vaccine prevents lesions induced by caprine herpesvirus-1 in goats. Vaccine. 2007;25:1658-61 pubmed
    ..Even without adjuvants, prolonged mucosal vaccination induced production of secretory IgA and provided significant clinical protection...
  25. Keller M, Tuyama A, Carlucci M, Herold B. Topical microbicides for the prevention of genital herpes infection. J Antimicrob Chemother. 2005;55:420-3 pubmed
    ..A more vigorous evaluation of the safety of these and other candidate topical microbicides in development should include assessment of the impact of repeated application on innate host defences in the genital tract. ..
  26. Bunnasathiansri S, Herabutya Y, O Prasertsawat P. Vaginal misoprostol for cervical priming before dilatation and curettage in postmenopausal women: a randomized controlled trial. J Obstet Gynaecol Res. 2004;30:221-5 pubmed
    ..There were two uterine perforations in the misoprostol group (2 vs 0). There was no significant benefit from applying 400 micro g vaginal misoprostol 6 h prior to dilatation and curettage in postmenopausal women. ..
  27. Owen D, Peters J, Kieweg S, Geonnotti A, Schnaare R, Katz D. Biophysical analysis of prototype microbicidal gels. J Pharm Sci. 2007;96:661-9 pubmed
    ..The relationships between gel rheological properties, coating flow and erosion of coating were not always anticipated from differences in gel molecular composition. ..
  28. Fernandez H, Alby J, Tournoux C, Chauveaud Lambling A, DeTayrac R, Frydman R, et al. Vaginal misoprostol for cervical ripening before operative hysteroscopy in pre-menopausal women: a double-blind, placebo-controlled trial with three dose regimens. Hum Reprod. 2004;19:1618-21 pubmed
    ..Vaginal misoprostol applied 4 h before operative hysteroscopy at three different doses did not reduce the need for cervical dilatation, did not facilitate hysteroscopic surgery, and increased pre-operative pain. ..
  29. Aranha C, Gupta S, Reddy K. Contraceptive efficacy of antimicrobial peptide Nisin: in vitro and in vivo studies. Contraception. 2004;69:333-8 pubmed
    ..The effect on sperm motility was observed to be dose- and time-dependent. Intravaginal administration of Nisin (200 microg) before mating during proestrus-estrous transition phase caused complete arrest of ..
  30. Sobel J, Ferris D, Schwebke J, Nyirjesy P, Wiesenfeld H, Peipert J, et al. Suppressive antibacterial therapy with 0.75% metronidazole vaginal gel to prevent recurrent bacterial vaginosis. Am J Obstet Gynecol. 2006;194:1283-9 pubmed
    ..02). Suppressive therapy with twice-weekly metronidazole gel achieves a significant reduction in the recurrence rate of bacterial vaginosis; however, secondary vaginal candidiasis is common. ..
  31. Veazey R, Klasse P, Schader S, Hu Q, Ketas T, Lu M, et al. Protection of macaques from vaginal SHIV challenge by vaginally delivered inhibitors of virus-cell fusion. Nature. 2005;438:99-102 pubmed
    ..In vivo, significant protection was achieved using each compound alone and in combinations. CMPD167 and BMS-378806 were protective even when applied 6 h before challenge. ..
  32. Oppegaard K, Nesheim B, Istre O, Qvigstad E. Comparison of self-administered vaginal misoprostol versus placebo for cervical ripening prior to operative hysteroscopy using a sequential trial design. BJOG. 2007;114:769, e1-12 pubmed
    ..Values are given as median (range). (d) Occurrence of adverse effects in the two treatment groups. Values are given as n (%). (e) Complications, given as n (%). ..
  33. Hemmerling A, Potts M, Walsh J, Young Holt B, Whaley K, Stefanski D. Lime juice as a candidate microbicide? An open-label safety trial of 10% and 20% lime juice used vaginally. J Womens Health (Larchmt). 2007;16:1041-51 pubmed
    ..Lime has a long history as a contraceptive and vaginal hygiene douche, and ongoing use in Africa is documented. We report on the first safety study on diluted lime juice to assess its potential as a candidate microbicide...
  34. Hoffman I, Taha T, Padian N, Kelly C, Welch J, Martinson F, et al. Nonoxynol-9 100 mg gel: multi-site safety study from sub-Saharan Africa. AIDS. 2004;18:2191-5 pubmed
    ..To evaluate the safety of 100 mg nonoxynol-9 (N-9) gel, a vaginal microbicide, on the genital mucosa of women from Malawi and Zimbabwe in preparation for a phase III efficacy study...
  35. Amaral E, Perdigao A, Souza M, Mauck C, Waller D, Zaneveld L, et al. Postcoital testing after the use of a bio-adhesive acid buffering gel (ACIDFORM) and a 2% nonoxynol-9 product. Contraception. 2004;70:492-7 pubmed
    ..05, Wilcoxon test). All treated cycles had five or fewer progressively motile sperm in midcycle cervical mucus, confirming in vivo the spermicidal effect of ACIDFORM previously observed in vitro and in animal models...
  36. Dhondt M, Adriaens E, Roey J, Remon J. The evaluation of the local tolerance of vaginal formulations containing dapivirine using the Slug Mucosal Irritation test and the rabbit vaginal irritation test. Eur J Pharm Biopharm. 2005;60:419-25 pubmed
    ..The results obtained with the Slug Mucosal Irritation test were comparable to those of the rabbit vaginal irritation test. ..
  37. Lederman M, Veazey R, Offord R, Mosier D, Dufour J, Mefford M, et al. Prevention of vaginal SHIV transmission in rhesus macaques through inhibition of CCR5. Science. 2004;306:485-7 pubmed
    ..These experimental findings have potentially important implications for understanding vaginal transmission of HIV and the design of strategies for its prevention. ..
  38. Lyons J, Ito J, Morre S. The influence of vaginally applied imiquimod on the course of Chlamydia trachomatis serovar D infection in a murine model. Infect Dis Obstet Gynecol. 2005;13:1-3 pubmed
  39. das Neves J, Bahia M. Gels as vaginal drug delivery systems. Int J Pharm. 2006;318:1-14 pubmed
    ..Therefore, this paper discusses and summarizes current use and research of vaginal drug delivery systems based in gels. ..
  40. Eriksson K, Carlsson B, Forsum U, Larsson P. A double-blind treatment study of bacterial vaginosis with normal vaginal lactobacilli after an open treatment with vaginal clindamycin ovules. Acta Derm Venereol. 2005;85:42-6 pubmed
    ..The cure rate of treatment of bacterial vaginosis was not improved by using lactobacilli-prepared tampons for one menstruation. ..
  41. Liu X, Lagenaur L, Simpson D, Essenmacher K, Frazier Parker C, Liu Y, et al. Engineered vaginal lactobacillus strain for mucosal delivery of the human immunodeficiency virus inhibitor cyanovirin-N. Antimicrob Agents Chemother. 2006;50:3250-9 pubmed
    ..This work represents a major step towards the development of an inexpensive yet durable protein-based microbicide to block the heterosexual transmission of HIV in women. ..
  42. Shattock R, Solomon S. Microbicides--aids to safer sex. Lancet. 2004;363:1002-3 pubmed
  43. Joshi S, Katti U, Godbole S, Bharucha K, B K, Kulkarni S, et al. Phase I safety study of Praneem polyherbal vaginal tablet use among HIV-uninfected women in Pune, India. Trans R Soc Trop Med Hyg. 2005;99:769-74 pubmed
    ..There were no serious adverse events. Praneem polyherbal tablets were found to be safe for once daily intravaginal use for 14 consecutive days in sexually active HIV-uninfected women and a Phase II study may be taken up as a priority. ..
  44. Valenta C. The use of mucoadhesive polymers in vaginal delivery. Adv Drug Deliv Rev. 2005;57:1692-712 pubmed
  45. Bakobaki J, Lacey C, Bukenya M, Nunn A, McCormack S, Byaruhanga R, et al. A randomized controlled safety and acceptability trial of dextrin sulphate vaginal microbicide gel in sexually active women in Uganda. AIDS. 2005;19:2149-56 pubmed
    ..DS gel appeared to be acceptable to over 95% of the users. Results show a satisfactory safety and acceptability profile of dextrin sulphate gel. ..
  46. Choksuchat C, Cheewadhanaraks S, Getpook C, Wootipoom V, Dhanavoravibul K. Misoprostol for cervical ripening in non-pregnant women: a randomized double-blind controlled trial of oral versus vaginal regimens. Hum Reprod. 2006;21:2167-70 pubmed
    ..Oral misoprostol 400 microg had similar efficacy in cervical ripening to 200 microg of vaginal misoprostol. ..
  47. Kieweg S, Geonnotti A, Katz D. Gravity-induced coating flows of vaginal gel formulations: in vitro experimental analysis. J Pharm Sci. 2004;93:2941-52 pubmed
    ..This study introduces a simple methodology for comparing trial formulations and relating their flows to gel constituents and physical properties. It also suggests differences in coating by current commercial gels. ..
  48. Woolfson A, Malcolm R, Morrow R, Toner C, McCullagh S. Intravaginal ring delivery of the reverse transcriptase inhibitor TMC 120 as an HIV microbicide. Int J Pharm. 2006;325:82-9 pubmed
    ..TMC 120 release profiles and the mechanical properties of rings could be modified by the physicochemical nature of hydrophobic and hydrophilic excipients incorporated into the IVRs. ..
  49. Grant R, Hamer D, Hope T, Johnston R, Lange J, Lederman M, et al. Whither or wither microbicides?. Science. 2008;321:532-4 pubmed publisher
  50. Glaser R, Zava D, Wurtzbacher D. Pilot study: absorption and efficacy of multiple hormones delivered in a single cream applied to the mucous membranes of the labia and vagina. Gynecol Obstet Invest. 2008;66:111-8 pubmed publisher
    ..Additional studies in larger numbers of patients will provide better knowledge for clinicians wanting to provide similar therapy at the lowest effective dose. ..
  51. Agnew G, Turner M. Vaginal prostaglandin gel to induce labour in women with one previous caesarean section. J Obstet Gynaecol. 2009;29:209-11 pubmed publisher
    ..We report our results because they may be helpful in assessing the chances of a successful VBAC in the uncommon clinical circumstances where prostaglandin induction is being considered. ..
  52. Elkind Hirsch K, Darensbourg C, Ogden B, Ogden L, Hindelang P. Contraceptive vaginal ring use for women has less adverse metabolic effects than an oral contraceptive. Contraception. 2007;76:348-56 pubmed
    ..The lower-dose, nonoral hormonal RING had a lesser impact on carbohydrate metabolism and greater reduction of free androgen and dehydroepiandrosterone sulfate levels than PILL treatment. ..
  53. Shaw D. Misoprostol for reproductive health: Dosage recommendations. Int J Gynaecol Obstet. 2007;99 Suppl 2:S155 pubmed