NDC 70518-2400 Vandazole


NDC Product Code 70518-2400

NDC CODE: 70518-2400

Proprietary Name: Vandazole What is the Proprietary Name?
The proprietary name also known as the trade name is the name of the product chosen by the medication labeler for marketing purposes.

Non-Proprietary Name: Metronidazole What is the Non-Proprietary Name?
The non-proprietary name is sometimes called the generic name. The generic name usually includes the active ingredient(s) of the product.

Drug Use Information

Drug Use Information
The drug use information is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate. This information is not individual medical advice and does not substitute for the advice of a health care professional. Always ask a health care professional for complete information about this product and your specific health needs.

  • Metronidazole is an antibiotic that is used to treat a wide variety of infections. It works by stopping the growth of certain bacteria and parasites. This antibiotic treats only certain bacterial and parasitic infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections. Metronidazole may also be used with other medications to treat certain stomach/intestinal ulcers caused by a bacteria (H. pylori).

NDC Code Structure

  • 70518 - Remedyrepack Inc.

NDC 70518-2400-0

Package Description: 1 TUBE, WITH APPLICATOR in 1 CARTON > 70 g in 1 TUBE, WITH APPLICATOR

NDC Product Information

Vandazole with NDC 70518-2400 is a a human prescription drug product labeled by Remedyrepack Inc.. The generic name of Vandazole is metronidazole. The product's dosage form is gel and is administered via vaginal form.

Labeler Name: Remedyrepack Inc.

Dosage Form: Gel - A semisolid3 dosage form that contains a gelling agent to provide stiffness to a solution or a colloidal dispersion.4 A gel may contain suspended particles.

Product Type: Human Prescription Drug What kind of product is this?
Indicates the type of product, such as Human Prescription Drug or Human Over the Counter Drug. This data element matches the “Document Type” field of the Structured Product Listing.

Vandazole Active Ingredient(s)

What is the Active Ingredient(s) List?
This is the active ingredient list. Each ingredient name is the preferred term of the UNII code submitted.

  • METRONIDAZOLE 7.5 mg/g

Inactive Ingredient(s)

About the Inactive Ingredient(s)
The inactive ingredients are all the component of a medicinal product OTHER than the active ingredient(s). The acronym "UNII" stands for “Unique Ingredient Identifier” and is used to identify each inactive ingredient present in a product.

  • WATER (UNII: 059QF0KO0R)

Administration Route(s)

What are the Administration Route(s)?
The translation of the route code submitted by the firm, indicating route of administration.

  • Vaginal - Administration into the vagina.
  • Vaginal - Administration into the vagina.

Pharmacological Class(es)

What is a Pharmacological Class?
These are the reported pharmacological class categories corresponding to the SubstanceNames listed above.

  • Nitroimidazole Antimicrobial - [EPC] (Established Pharmacologic Class)
  • Nitroimidazoles - [CS]

Product Labeler Information

What is the Labeler Name?
Name of Company corresponding to the labeler code segment of the Product NDC.

Labeler Name: Remedyrepack Inc.
Labeler Code: 70518
FDA Application Number: NDA021806 What is the FDA Application Number?
This corresponds to the NDA, ANDA, or BLA number reported by the labeler for products which have the corresponding Marketing Category designated. If the designated Marketing Category is OTC Monograph Final or OTC Monograph Not Final, then the Application number will be the CFR citation corresponding to the appropriate Monograph (e.g. “part 341”). For unapproved drugs, this field will be null.

Marketing Category: NDA - A product marketed under an approved New Drug Application. What is the Marketing Category?
Product types are broken down into several potential Marketing Categories, such as NDA/ANDA/BLA, OTC Monograph, or Unapproved Drug. One and only one Marketing Category may be chosen for a product, not all marketing categories are available to all product types. Currently, only final marketed product categories are included. The complete list of codes and translations can be found at www.fda.gov/edrls under Structured Product Labeling Resources.

Start Marketing Date: 11-01-2019 What is the Start Marketing Date?
This is the date that the labeler indicates was the start of its marketing of the drug product.

Listing Expiration Date: 12-31-2020 What is the Listing Expiration Date?
This is the date when the listing record will expire if not updated or certified by the product labeler.

Exclude Flag: N What is the NDC Exclude Flag?
This field indicates whether the product has been removed/excluded from the NDC Directory for failure to respond to FDA’s requests for correction to deficient or non-compliant submissions. Values = ‘Y’ or ‘N’.

* Please review the disclaimer below.

Vandazole Product Labeling Information

The product labeling information includes all published material associated to a drug. Product labeling documents include information like generic names, active ingredients, ingredient strength dosage, routes of administration, appearance, usage, warnings, inactive ingredients, etc.

Product Labeling Index

1 Indications And Usage

VANDAZOLE is indicated in the treatment of bacterial vaginosis (formerly referred to as

Haemophilus vaginitis,

Gardnerella vaginitis, nonspecific vaginitis,

Corynebacterium vaginitis, or anaerobic vaginosis) in non-pregnant women.

2 Dosage And Administration

The recommended dose is one applicator full of VANDAZOLE, (approximately 5 grams of gel containing approximately 37.5 mg of metronidazole) administered intravaginally once a day for 5 days. For once a day dosing, VANDAZOLE should be administered at bedtime [

see Patient Counseling Information (



Not for ophthalmic, dermal, or oral use.

3 Dosage Forms And Strengths

VANDAZOLE is a vaginal gel 0.75% in a 70 g tube with 5 vaginal applicators (each applicator delivers approximately 5 g of gel containing 37.5 mg of metronidazole, USP).

4.1 Hypersensitivity

The use of VANDAZOLE is contraindicated in patients with a history of hypersensitivity to metronidazole, other nitroimidazole derivatives, or parabens. Reported reactions include urticaria; erythematous rash; Stevens-Johnson Syndrome, toxic epidermal necrolysis, flushing; nasal congestion; dryness of the mouth, vagina, or vulva; fever; pruritus; fleeting joint pains [

see Adverse Reactions (



4.2 Psychotic Reaction With Disulfiram

Use of oral metronidazole is associated with psychotic reactions in alcoholic patients who were using disulfiram concurrently. Do not administer VANDAZOLE to patients who have taken disulfiram within the last two weeks [

see Adverse Reactions (



4.3 Interaction With Alcohol

Use of oral metronidazole is associated with a disulfiram-like reaction to alcohol, including abdominal cramps, nausea, vomiting, headaches, and flushing [

see Adverse Reactions (


]. Discontinue alcohol consumption during and for at least three days after therapy with VANDAZOLE.

5.1 Central And Peripheral Nervous System Effects

Use of oral or intravenous metronidazole is associated with convulsive seizures, encephalopathy, aseptic meningitis, optic and peripheral neuropathy, the latter characterized mainly by numbness or parethesia of an extremity [

see Adverse Reactions (


]. VANDAZOLE should be administered with caution to patients with central nervous system diseases. Discontinue VANDAZOLE promptly if a patient develops abnormal neurologic signs.

5.2 Carcinogenicity In Animals

Metronidazole has been shown to be carcinogenic in mice and rats [

see Carcinogenesis, Mutagenesis, Impairment of Fertility (


]. Unnecessary use of metronidazole should be avoided. Use of VANDAZOLE should be reserved for the treatment of bacterial vaginosis [

see Indications and Usage (



5.3 Interference With Laboratory Tests

Metronidazole may interfere with certain types of determinations of serum chemistry values, such as aspartate aminotransferase (AST, SGOT), alanine aminostransferase (ALT, SGPT), lactate dehydrogenase (LDH), triglycerides, and glucose hexokinase. Values of zero may be observed. All of the assays in which interference has been reported involve enzymatic coupling of the assay to oxidation-reduction of nicotinamide-adenine dinucleotides (NAD + NADH). Interference is due to the similarity in absorbance peaks of NADH (340 nm) and metronidazole (322 nm) at pH 7. Consider postponing chemistry laboratory tests to after treatment with VANDAZOLE.

6.1 Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.The data described below reflect exposure to VANDAZOLE compared to another formulation of vaginal metronidazole in 220 women in a single trial. The population was non-pregnant females (age range 18 to 72 years, the mean was 33 years +/- 11 years) with bacterial vaginosis. The racial demographic of those enrolled was 71 (32%) of White, 143 (65%) of Black, 3 (1%) of Hispanic, 2 (1%) of Asian, and 1 (0%) of other. Patients administered an applicator full of VANDAZOLE intravaginally once daily at bedtime for 5 days.There were no deaths or serious adverse reactions related to drug therapy in the clinical trial. VANDAZOLE was discontinued in 5 patients (2.3%) due to adverse reactions. The incidence of all adverse reactions in VANDAZOLE-treated patients was 42% (92/220). Adverse reactions occurring in ≥ 1% of patients were: fungal infection* (12%), headache (7%), pruritus (6%), abdominal pain (5%), nausea (3%), dysmenorrhea (3%), pharyngitis (2%), rash (1%), infection (1%), diarrhea (1%), breast pain (1%), and metrorrhagia (1%).* Known or previously unrecognized vaginal candidiasis may present more prominent symptoms during therapy with VANDAZOLE. Approximately 10% of patients treated with VANDAZOLE developed

Candida vaginitis during or immediately after therapy.

Additional uncommon events, reported by < 1% of those women treated with VANDAZOLE included:General: allergic reaction, back pain, flu syndrome, mucous membrane disorder, pain Gastrointestinal:anorexia, constipation, dyspepsia, flatulence, gingivitis, vomiting Nervous System:depression, dizziness, insomnia Respiratory System:asthma, rhinitis Skin and Appendages:acne, sweating, urticaria Urogenital System:  

 breast enlargement, dysuria, female lactation, labial edema, leucorrhea, menorrhagia, pyleonephritis, salpingitis, urinary frequency, urinary tract infection, vaginitis, vulvovaginal disorder

6.2 Other Metronidazole Formulations

Other Vaginal FormulationsOther reactions that have been reported in association with the use of other formulations of metronidazole vaginal gel include: unusual taste and decreased appetite.Topical (Dermal) FormulationsOther reactions that have been reported in association with the use of topical (dermal) formulations of metronidazole include skin irritation, transient skin erythema, and mild skin dryness and burning. None of these adverse reactions exceeded an incidence of 2% of patients.Oral and Parenteral FormulationsThe following adverse reactions and altered laboratory tests have been reported with the oral or parenteral use of metronidazole:Cardiovascular: Flattening of the T-wave may be seen in electrocardiographic tracings.

Nervous System: The most serious adverse reactions reported in patients treated with metronidazole have been convulsive seizures, encephalopathy, aseptic meningitis, optic and peripheral neuropathy, the latter characterized mainly by numbness or paresthesia of an extremity. In addition, patients have reported syncope, vertigo, incoordination, ataxia, confusion, dysarthria, irritability, depression, weakness, and insomnia. [

see Warnings and Precautions (5.1)]

Gastrointestinal: Abdominal discomfort, nausea, vomiting, diarrhea, an unpleasant metallic taste, anorexia, epigastric distress, abdominal cramping, constipation, “furry” tongue, glossitis, stomatitis, pancreatitis, and modification of taste of alcoholic beverages.

Genitourinary: Overgrowth of

Candida in the vagina, dyspareunia, decreased libido, proctitis.

Hematopoietic: Reversible neutropenia, reversible thrombocytopenia.

Hypersensitivity Reactions: Urticaria; erythematous rash; Stevens-Johnson Syndrome, toxic epidermal necrolysis, flushing; nasal congestion; dryness of the mouth, vagina, or vulva; fever; pruritus; fleeting joint pains [

see Contraindications (



Renal: Dysuria, cystitis, polyuria, incontinence, a sense of pelvic pressure, darkened urine.

7 Drug Interactions

The intravaginal administration of a single 5 gram dose of VANDAZOLE results in relatively lower mean systemic exposure to metronidazole that is approximately 2% to 5% of that achieved following a 500 mg oral dose of metronidazole [

see Clinical Pharmacology (


]. The following drug interactions were reported for oral metronidazole.

7.1 Disulfiram

Use of oral metronidazole has been associated with psychotic reactions in alcoholic patients who are using disulfiram concurrently. VANDAZOLE should not be used by patients who have taken disulfiram within the last two weeks [

see Contraindications (



7.2 Alcoholic Beverages

Use of oral metronidazole has been associated with a disulfiram-like reaction (abdominal cramps, nausea, vomiting, headaches, and flushing) to alcohol. Alcoholic beverages and preparations containing ethanol or propylene glycol should not be consumed during and for at least three days after VANDAZOLE therapy [

see Contraindications (



7.3 Coumarin And Other Oral Anticoagulants

Use of oral metronidazole has been reported to potentiate the anticoagulant effect of warfarin and other coumarin anticoagulants, resulting in a prolongation of prothrombin time. This possible drug interaction should be considered when VANDAZOLE is prescribed for patients on this type of anticoagulant therapy. In patients on oral anticoagulants, consider monitoring prothrombin time, international normalized ratio (INR), and other coagulation parameters while on VANDAZOLE.

7.4 Lithium

Short-term use of oral metronidazole has been associated with elevation of serum lithium concentrations and, in a few cases signs of lithium toxicity, in patients stabilized on relatively high doses of lithium. Use VANDAZOLE with caution in patients treated with lithium and consider monitoring lithium serum concentrations while on VANDAZOLE.

7.5 Cimetidine

Use of oral metronidazole with cimetidine may prolong the half-life and decrease plasma clearance of metronidazole. No dose adjustment of VANDAZOLE is necessary.

8.3 Nursing Mothers

Caution should be exercised when VANDAZOLE is administered to a nursing woman. Following oral metronidazole administration, concentrations of metronidazole in human milk are similar to concentrations in plasma. Since some metronidazole is systemically absorbed following vaginal administration of metronidazole, excretion in human milk is possible.Because of the potential for tumorigenicity shown for metronidazole in animal studies, a decision should be made whether to discontinue nursing or to discontinue VANDAZOLE, taking into account the importance of the therapy to the mother. A nursing mother may choose to pump and discard her milk for the duration of VANDAZOLE therapy, and for 24 hours after therapy ends and feed her infant stored human milk or formula.

8.4 Pediatric Use

The safety and efficacy of VANDAZOLE in the treatment of bacterial vaginosis in post-menarchal females have been established on the extrapolation of clinical trial data from adult women. The safety and efficacy of VANDAZOLE in pre-menarchal females have not been established.

8.5 Geriatric Use

Clinical studies with VANDAZOLE did not include sufficient numbers of subjects 65 years of age or older to determine whether they respond differently than younger subjects. Other reported clinical experience in using metronidazole gel, 1% has not identified differences in responses between elderly and younger patients.

10 Overdosage

There is no human experience with overdosage of metronidazole vaginal gel. Vaginally applied metronidazole gel, 0.75% could be absorbed in sufficient amounts to produce systemic effects [

see Warnings and Precautions (

5) and Adverse Reactions (



11 Description

VANDAZOLE (metronidazole gel USP, 0.75% (vaginal)) is the vaginal dosage form of the nitroimidazole antimicrobial metronidazole at a concentration of 0.75%. Chemically, metronidazole is a 2-methyl-5-nitroimidazole-1-ethanol. C




3 M.W. 171.16

VANDAZOLE is a colorless to yellow gel, containing metronidazole, USP at a concentration of 7.5 mg/g (0.75%). The gel also contains edetate disodium, hypromellose, methylparaben, propylene glycol, propylparaben, purified water, and sodium hydroxide (to adjust pH).Each applicator full of 5 grams of vaginal gel contains approximately 37.5 mg of metronidazole, USP.

12.1 Mechanism Of Action

Metronidazole is an antibacterial drug [

see Clinical Pharmacology, Microbiology (



12.3 Pharmacokinetics

Healthy SubjectsFollowing a single, intravaginal 5 gram dose of metronidazole vaginal gel (equivalent to 37.5 mg of metronidazole) to 38 healthy female subjects, a mean maximum serum metronidazole concentration of 281 ng/mL was reported (range: 134 to 464 ng/mL). The average time to achieve this C

max was 9.5 hours (range: 4 to 17 hours) after dosing with metronidazole vaginal gel. This C

max is approximately 2% of the mean maximum serum concentration reported in healthy subjects administered a single, oral 500 mg dose of metronidazole (mean C

max = 12,785 ng/mL).

The extent of exposure [area under the curve (AUC)] of metronidazole, when administered as a single intravaginal 5 gram dose of metronidazole vaginal gel (equivalent to 37.5 mg of metronidazole), was 5,989 ng•hr/mL (range: 2,797 to 10,515 ng•hr/mL). This AUC

0-∞ is approximately 5% of the reported AUC of metronidazole following a single oral 500 mg dose of metronidazole approximately 125,000 ng•hr/mL.

Patients with Bacterial VaginosisFollowing single and multiple 5 gram doses of a similar metronidazole vaginal gel product to 4 patients with bacterial vaginosis, a mean maximum serum metronidazole concentration of 214 ng/mL on day one and 294 ng/mL (range: 228 to 349 ng/mL) on day five were reported. Steady state metronidazole serum concentrations following oral dosages of 400 to 500 mg BID have been reported to range from 6,000 to 20,000 ng/mL.

12.4 Microbiology

Mechanism of ActionThe intracellular targets of action of metronidazole on anaerobes are largely unknown. The 5-nitro group of metronidazole is reduced by metabolically active anaerobes, and studies have demonstrated that the reduced form of the drug interacts with bacterial DNA. However, it is not clear whether interaction with DNA alone is an important component in the bactericidal action of metronidazole on anaerobic organisms. Activity

In VitroMetronidazole is an antibacterial agent active

in vitro against most strains of the following organisms that have been reported to be associated with bacterial vaginosis:

Bacteroides spp.

Gardnerella vaginalisMobiluncus spp.

Peptostreptococcus spp.

Standard methodology for the susceptibility testing of the potential bacterial vaginosis pathogens,

Gardnerella vaginalis and

Mobiluncus spp., has not been defined. Culture and sensitivity testing of bacteria are not routinely performed to establish the diagnosis of bacterial vaginosis [

see Clinical Studies (



13.1 Carcinogenesis, Mutagenesis, Impairment Of Fertility

Metronidazole has shown evidence of carcinogenic activity after chronic oral administration in mice and rats. Pulmonary tumors and lymphomas were reported in several oral mouse studies in which mice were dosed at 75 mg/kg and above (about 5 times the clinical human dose based on body surface area comparison). Malignant liver tumors were reported in male mice dosed at doses equivalent to a human dose of 41 mg/kg/day (33 times the recommended clinical dose based on body surface area comparisons). Chronic oral dosing of metronidazole in rats at doses above 150 mg/kg (about 20 times the clinical human dose based on body surface area comparison) has resulted in mammary and hepatic tumors. Two lifetime tumorigenicity studies in hamsters have been performed and reported to be negative. Although no life-time studies were performed to evaluate the carcinogenic potential of VANDAZOLE (metronidazole vaginal gel, 0.75%), published data have shown that intravaginal administration of metronidazole to Wistar rats for 5 days, at doses 26 times the recommended human dose based on body surface area comparisons, has resulted in an increased frequency of micronuclei in rat vaginal mucosal cells. Metronidazole has shown mutagenic activity in a number of

in vitro assay systems. In addition, a dose dependent increase in the frequency of micronuclei was observed in mice after intraperitoneal injections. An increase in chromosome aberrations has been reported in one study of patients with Crohn’s disease who were treated with 200 to 1200 mg/day of metronidazole for 1 to 24 months. However, in a second study, no increase in chromosome aberrations was reported in patients with Crohn’s disease who were treated with metronidazole for 8 months.

Fertility studies have been performed in mice up to six times the recommended human oral dose (based on mg/m

2) and have revealed no evidence of impaired fertility.

14 Clinical Studies

A single, randomized, double-blind, active-controlled clinical trial was conducted to evaluate the efficacy of VANDAZOLE for the treatment of bacterial vaginosis. A clinical diagnosis of bacterial vaginosis was defined by the presence of a homogeneous vaginal discharge that (a) has a pH of greater than 4.5, (b) emits a "fishy" amine odor when mixed with a 10% KOH solution, and (c) contains clue cells on microscopic examination. Gram's stain results consistent with a diagnosis of bacterial vaginosis include (a) markedly reduced or absent

Lactobacillus morphology, (b) predominance of

Gardnerella morphotype, and (c) absent or few white blood cells. Non-pregnant females at least 18 years of age were randomized to receive treatment with either VANDAZOLE or another formulation of metronidazole vaginal gel 0.75% once daily at bedtime for 5 days. The modified intent-to treat population (patients who received study medication and had a Nugent score ≥ 4) consisted of 229 VANDAZOLE patients and 243 patients treated with another vaginal formulation of metronidazole. Therapeutic Cure defined as a clinical cure and Nugent score < 4 was assessed Day 22-31. Table 1 shows the therapeutic, clinical and Nugent score cure rates in this trial. The therapeutic cure rate was 42.8% for the VANDAZOLE group and 30.9% for the comparator group (95% confidence interval about the 11.9% difference in therapeutic cure rate: 2.8% to 21.0%).

Table 1 Efficacy of Vandazole for the Treatment of Bacterial Vaginosis in a Randomized, Double-Blind Active Controlled Study

Modified intent-to-treat populationOutcomeVandazole

n = 229

Active Control

n = 243

Treatment Difference (%)

[95% Confidence Interval]

% Cure% CureTherapeutic Cure42.830.911.9 [2.8, 21.0]Clinical Cure52.445.37.1 [-2.3, 16.5]Nugent Score Cure52.041.110.9 [1.5, 20.3]

16 How Supplied/Storage And Handling

VANDAZOLE (metronidazole gel USP, 0.75% (vaginal)) is supplied in a 70 gram tube and packaged with 5 vaginal applicators. (NDC 0245-0860-70)Store at 20

o to 25

oC (68

o to 77

oF) [See USP Controlled Room Temperature]. Avoid exposure to extreme heat or cold. Protect from freezing.

17.1 Interaction With Alcohol

Instruct the patient not to consume alcoholic beverages and preparations containing ethanol or propylene glycol during and for at least 3 days after treatment with VANDAZOLE [

see Contraindications (

4.3) and Drug Interactions (



17.2 Drug Interactions

Instruct the patient not to use VANDAZOLE if disulfiram had been used within the last two weeks [

see Contraindications (


], and to inform their healthcare provider if they are taking oral anticoagulants, or lithium [

see Drug Interactions (




17.3 Vaginal Intercourse And Use With Vaginal Products

Instruct the patient not to engage in vaginal intercourse, or use other vaginal products (such as tampons or douches) during treatment with VANDAZOLE.

17.4 Fungal Vaginal Infections

Inform the patient that vaginal fungal infections can occur following use of VANDAZOLE and may require treatment with an antifungal drug [

see Adverse Reactions (



17.5 Human Milk Feeding

Advise women that they may consider discontinuing milk feeding or pump and discard their milk during treatment and for 24 hours after the last dose of VANDAZOLE [

see Use in Specific Populations (



17.6 Accidental Exposure To The Eye

Inform the patient that VANDAZOLE contains ingredients that may cause burning and irritation of the eye. In the event of accidental contact with the eye, rinse the eye with copious amounts of cool tap water and consult a healthcare provider.

17.7 Vaginal Irritation

Inform the patient to discontinue use and consult a healthcare provider if vaginal irritation occurs with use of VANDAZOLE.

17.8 Administration Of Drug

Instruct the patient that VANDAZOLE (metronidazole vaginal gel, 0.75%) is supplied with 5 vaginal applicators. For once daily dosing, one applicator should be used per dose. See

DIRECTIONS FOR USE for complete instructions on how to use the product and the vaginal applicator.

US Patent No. 7,456,207Manufactured In Croatia By: Pliva Hrvatska d.o.o. Zagreb, CroatiaManufactured forUPSHER-SMITH LABORATORIES, LLCMaple Grove, MN 55369Rev. G 6/2017

Patient Instructions For Use

  • ® (van-DA-zole)
  • (metronidazole gel USP, 0.75% (vaginal))For vaginal use only.Do not put VANDAZOLE in your eyes, mouth, or on your skin.Read this Patient Instructions for Use before you start using VANDAZOLE. This leaflet does not take the place of talking with your healthcare provider about your medical condition or your treatment.Instructions for use:1. Filling the applicatorRemove the cap and puncture the metal seal on the tube with the pointed tip of the cap. (See Figure A)Screw the end of applicator onto the tube. (See Figure B)Slowly squeeze the gel out of tube and into the applicator. The plunger will stop when the applicator is full. (See Figure C)Unscrew the applicator and replace the cap on the tube.2. Inserting the applicatorYou can insert the applicator into your vagina:
  • While you lie on your back with your knees bent orin any position that is comfortable for youHold the filled applicator by the barrel, and gently insert into your vagina as far as it will comfortably go. (See Figure D)Slowly push the plunger in until all of the gel goes into your vagina (See Figure D).Take the empty applicator out of your vagina.3. Care of the applicatorThis product comes with 5 vaginal applicators.After use, throw away the empty applicator in the trash.While you use VANDAZOLE you should not have vaginal intercourse or use other vaginal products (such as tampons or douches).If vaginal irritation develops when you use VANDAZOLE, discontinue use and consult your healthcare provider.If you get VANDAZOLE in your eye, rinse your eye with cool tap water and consult a healthcare provider.How should I store VANDAZOLE?Store VANDAZOLE at 68° to 77°F (20° to 25°C).Avoid exposure to extreme heat or cold. Avoid freezing VANDAZOLE.Keep this and all medicines out of reach of children. RX OnlyManufactured In Croatia By: Pliva Hrvatska d.o.o. Zagreb, CroatiaManufactured forUPSHER-SMITH LABORATORIES, LLCMaple Grove, MN 55369© 2017 Upsher-Smith Laboratories, LLCRev. D 6/2017

* Please review the disclaimer below.