acetic acid vaginal

Action and Spectrum

Actions and Spectrum: 

acetic acid, when used vaginally, is often in the form of a diluted solution and is commonly known as vinegar. The mechanism of action and spectrum of activity for acetic acid in the vaginal setting is associated with its properties as a mild acid.  

• Acidification of Vaginal Environment: acetic acid acts as an acidifier when applied to the vagina. The normal pH of the healthy vaginal environment is slightly acidic, typically ranging from 3.5 to 4.5. This acidity helps to maintain a balance of microorganisms in the vagina, promoting the growth of beneficial bacteria (Lactobacillus species) and preventing the overgrowth of harmful bacteria. 
• Bacterial Vaginosis : There is an imbalance in the normal vaginal flora; acetic acid may be used to restore the acidic environment and promote the growth of beneficial bacteria. Bacterial vaginosis is often associated with a decrease in Lactobacillus species and an increase in other bacteria. By promoting a more acidic environment, acetic acid may help restore the balance of the vaginal microbiota. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Local stinging and burning 

Black Box Warning

Black box warning: 

None 

Contraindication / Caution

Contraindications/caution: 

Contraindications: 

None 

Caution: 

• Irritation and Discomfort: acetic acid is acidic and applying it to the sensitive mucosal tissues of the vagina may cause irritation and discomfort. It can disrupt the natural pH balance and lead to inflammation. 
• Allergic Reactions: Individuals may be allergic or sensitive to acetic acid. Before using it vaginally, perform a patch test on a small area of skin to check for any adverse reactions. 
• Open Wounds or Lesions: Applying acetic acid to open wounds, lesions, or irritated skin in the vaginal area can cause pain and may hinder the healing process. 
• Pregnancy: The safety of using acetic acid vaginally during pregnancy is not well-established.

Pregnancy / Lactation

Pregnancy consideration: Use with caution 

Lactation: Excretion of the drug in human breast milk is unknown 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

The pharmacology of acetic acid in the vaginal context involves its use for maintaining vaginal health and treating certain conditions.  

• pH Regulation: acetic acid helps regulate the pH of the vagina, maintaining its natural acidity (pH 3.8 to 4.5). This acidic environment is essential for a healthy balance of vaginal flora and inhibiting the growth of harmful microorganisms. 
• Microbial Activity: acetic acid possesses antimicrobial properties that can inhibit the growth of pathogenic bacteria and fungi in the vagina, particularly beneficial in conditions like bacterial vaginosis. 
• Bacterial Vaginosis (BV) Treatment: acetic acid is used as part of the treatment for bacterial vaginosis to restore the average balance of bacteria in the vagina. 
• Vaginal Health Maintenance: Regular use of acetic acid solutions, often in the form of diluted vinegar, helps maintain a healthy vaginal pH and supports the natural acidic environment. 
• Prevention of Recurrent Infections: acetic acid may be recommended for individuals prone to recurrent vaginal infections as a preventive measure to maintain a healthy pH and prevent microbial overgrowth. 

Pharmacokinetics: 

Absorption 

acetic acid is typically applied topically in the form of vaginal solutions or douches. The absorption of acetic acid in the vagina primarily occurs through the vaginal mucosa. While some absorption may occur, systemic absorption is generally limited because the primary therapeutic effect is localized to the vaginal environment. 

Distribution 

acetic acid remains primarily localized to the vaginal tissues. Since the application is topical, the systemic distribution of acetic acid is limited. 

Metabolism: 

acetic acid is a simple compound, and its metabolism is minimal. It can be metabolized through normal cellular processes, but significant metabolic transformations are not typically associated with topical application. 

Elimination and Excretion 

acetic acid, if systemically absorbed, can be eliminated through normal metabolic processes. However, since the primary use is topical, the majority is likely eliminated locally or may be excreted in urine if absorbed systemically. 

Adminstartion

Administration: 

Vaginal administration 

• Vaginal Douche: acetic acid solutions may be used as part of a vaginal douche. A douche is a method of cleansing the vagina by washing or flushing it with a liquid solution.  
• Vaginal Rinse or Soak: Some formulations of acetic acid may be used as a rinse or as part of a vaginal soak. This involves applying the solution to the vaginal area for a specified period, allowing it to have a localized effect. 
• Vaginal Suppositories: In some cases, acetic acid may be formulated into suppositories designed for vaginal insertion. These suppositories can provide a controlled release of acetic acid over time. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: acetic acid vaginal 

Why do we use acetic acid vaginal? 

acetic acid is primarily employed for maintaining vaginal health and treating certain conditions. Here are common uses of acetic acid in the vaginal area: 

• Maintaining Vaginal pH: acetic acid is used to help regulate and maintain the natural acidic pH of the vagina (typically between 3.8 and 4.5). This acidic environment is essential for the health of the vaginal microbiota and helps prevent the overgrowth of harmful microorganisms. 
• Bacterial Vaginosis (BV) Treatment: acetic acid solutions are sometimes used as part of the treatment for bacterial vaginosis, a common vaginal infection characterized by an imbalance of bacteria. The acidity of acetic acid may help restore the normal balance of the vaginal flora. 
• Prevention of Recurrent Infections: In some cases, acetic acid may be recommended to individuals prone to recurrent vaginal infections as a preventive measure. Regular use can help maintain a healthy pH and prevent the overgrowth of harmful microorganisms. 
• Vaginal Health Maintenance: Regular use of acetic acid solutions, often in the form of diluted vinegar, may be recommended for general vaginal health. This is done to support the natural acidic environment of the vagina and promote overall well-being.