Boric acid suppositories: indications and side effects

Boric acid is an inorganic acid with antibacterial and antifungal properties and is used to treat vulvovaginal and otitis. Boric acid suppositories are solid capsules containing boric acid that can be inserted directly into the vagina. Helps restore natural pH balance and relieve recurring fungal infections or odor problems. Additionally, the antifungal effects of boric acid may be enhanced by the acidic environment of the vagina, and some studies suggest that boric acid vaginal suppositories may be effective as a short-term treatment for vaginal yeast infections.

Indications

Boric acid suppositories (also known as boric acid vaginal suppositories) are mainly used for the acute treatment of symptomatic vulvovaginal candidiasis in diabetic women. Because non-albicans Candida infections such as C. glabrata have a higher proportion in diabetic patients, such fungi are inherently resistant to azole drugs (such as fluconazole). Boric acid, as a topical treatment option, is particularly useful for the short-term treatment of C. glabrata infections. The long-term (3 months) cure rate is poor, and most patients will relapse [1].

How to use boric acid suppositories?

Boric acid vaginal suppositories are often used as short-term treatment. But because these products are not approved by the U.S. Food and Drug Administration (FDA), there are no standard recommended dosages. In some studies, 600 mg was administered once daily for 14 consecutive days. Boric acid vaginal suppositories are not intended for oral administration and should be inserted directly into the vagina.

Side Effects

When used as a suppository, boric acid is not significantly absorbed into the bloodstream, so significant toxicity is unlikely to occur. However, it usually causes minor temporary local side effects, such as vaginal burning, redness, and increased discharge. Sometimes, male sexual partners may experience pain during sex with women who use boric acid suppositories. There is little information on the safety of long-term use of boric acid vaginal suppositories. Therefore long-term use is not recommended.

References

[1] Ray, D., Goswami, R., Dadhwal, V., Goswami, D., Banerjee, U., Kochupillai, N. (2007). Prolonged (3-month) mycological cure rate after boric acid suppositories in diabetic women with vulvovaginal candidiasis. Journal of Infection, 55 4, Pages 374-377. https://doi.org/10.1016/j.jinf.2007.06.008