Boric acid has a long and well-established history in compounding pharmacy, particularly for addressing persistent or recurrent vaginal health issues. When standard antifungal or antibacterial treatments fail to resolve a vaginal infection, boric acid pessaries (vaginal suppositories or capsules) are often prescribed as a targeted, localised solution.
It is important to understand what boric acid is, how it works, and why it’s a go-to option for doctors seeking to restore the body’s natural vaginal balance.
In this blog post, we’ll explore:
- What is Boric Acid in Compounding Pharmacy?
- How Boric Acid Vaginal Pessaries Work
- Conditions Treated with Boric Acid
- Key Benefits of Localised Application
- Usage and Safety Considerations
- Video Transcript
What is Boric Acid?
Boric acid used in compounded pessaries is a specific, pharmaceutical-grade ingredient. It must not be confused with household products like borax, as they are chemically different and used for completely different purposes.
Compounding pharmacies prepare boric acid into a specific dosage form, usually a vaginal capsule or pessary (a suppository), designed to be inserted vaginally. This delivery method is essential for ensuring the ingredient works in the targeted area.
How Boric Acid Vaginal Pessaries Work
The primary mechanism of boric acid is its ability to create a vaginal environment that is inhospitable to the organisms that cause infection.
It functions by:
- Acidifying the Vagina: Boric acid helps restore the vagina’s natural acidic pH level. Most harmful bacteria and yeast (like Candida albicans) thrive in less acidic, more humid conditions.
- Creating an Unsuitable Environment: By lowering the pH, boric acid essentially makes the vaginal environment unsuitable for the yeast or bacteria to grow and thrive.
- Supporting Natural Balance: This temporary alteration gives the body’s own protective mechanisms time to recover, allowing the normal, healthy flora (lactobacilli) to re-establish and restore homeostasis (natural balance).
Conditions Treated with Boric Acid
Boric acid is often prescribed by doctors for conditions that are chronic or resistant to standard treatment.
The most common uses include:
- Recurrent or Chronic Vulvovaginal Candidiasis (Thrush): This refers to yeast infections that keep coming back, often caused by non-albicans species of Candida that are resistant to typical antifungal creams.
- Bacterial Vaginosis (BV): Boric acid may be used as a second-line or adjunctive therapy for persistent or recurrent BV that has not been successfully treated with primary prescription medications.
Key Benefits of Localised Application
One of the most significant benefits of using a vaginal pessary is the localised application.
- The boric acid is absorbed only into the surrounding tissues of the vaginal area.
- It is not absorbed systemically into the bloodstream, which is why the risk of systemic (whole-body) side effects is minimal.
This allows for a targeted, high concentration of the active ingredient exactly where the infection is located, without affecting the rest of the body.
Usage and Safety Considerations
Boric acid is a prescription-only product in Australia, meaning it must be prescribed by a doctor who will provide specific usage instructions.
General guidelines for use include:
- Dosage and Duration: It is typically used once daily, usually at nighttime, for a treatment course that can range from 7 days up to 28 days, depending on the severity and recurrence of the condition.
- Vaginal Use Only: It is critically important that the capsule is never swallowed. Swallowing the capsule can cause severe discomfort and will not treat the vaginal condition.
- Pregnancy and Breastfeeding: If you are pregnant or breastfeeding, you must consult your doctor or specialist before using boric acid.
- Potential Irritation: As it is a sensitive area, some minor local irritation may occur. If you experience significant discomfort, contact your prescribing doctor or pharmacist immediately.
If you have a chronic or recurrent vaginal infection, speak to your doctor about whether compounded boric acid pessaries are a suitable treatment option for you.
Video Transcript
Boric acid is a really well established product that has been around in compounding pharmacy world for a long, long time. It’s generally made into pessary or capsule dosage form, and generally boric acid is used in situations where there’s a fungal or vaginal infection which can’t be treated with things like topical creams. Um, it’s not to be confused or mixed up with borax or household products. They’re very, very different. So boric acid is a specific ingredient that compounding pharmacies use. And they make them into a form that that females and ladies can use to help these, um, challenges, which they might be experiencing. So it’s applied vaginally, which is really important because it actually doesn’t get absorbed into the body. It’s only absorbed into the local area, which is a really good situation for that type of problem to be resolved. So you can be sure that there’s sort of minimal side effects systemically. Um, it’s generally used in situations where there’s been a recurrent, um, thrush, uh, problem. And it can be used in situations with bacterial vaginosis if that’s not treated using other prescription therapies. Um, the product is safe. It’s used normally at nighttime, somewhere between 14 and 28 days. But because it’s a prescription only product, your doctor will give you directions on how to use it. Um, and the strength of the capsule, uh, is on your prescription, but will generally make, um, a common one that the doctor requires. So how it works? It basically creates an environment, um, in the vagina that is not suitable for bacteria and yeast to thrive. Obviously, they prefer conditions which are moist, humid, that type of thing. So it will work there. Um, and then it will support the body doing its own natural processes to resolve the issue. Um, so really it gives 14 to 28 days for the body to come back into that homeostasis, which is the body’s balance, and the conditions will return to normal and hopefully the problem is solved. Um, like I said, it’s normally used for, um, 7 to 14 up to 28 days sometimes. If you’re pregnant or breastfeeding, double check with your specialist or your doctor before using it. They’ll obviously put you through a process before prescribing it. Um, and if you’ve got any questions, don’t be afraid to talk to our compounding pharmacists about them. Um, it might cause a little bit of irritation. It is a sensitive area, so we do just recommend you take it slow and steady. Again. If you’ve got any concerns, call us at any time. Um, and obviously it makes sense, but the capsule is never to be swallowed. It won’t work. If it’s swallowed, it’ll make you feel quite uncomfortable. But it’s a vaginal capsule only. So if you’ve got any questions, we’re more than happy to help. Um, compounding pharmacies have been doing, uh, boric acid, vaginal capsules or suppositories for a long time, so we’ve got plenty of experience. Um, it is a challenging topic, and we understand, um, the importance of privacy and discretion in these type of situations. So we’re here to help reach you at any time and see you soon.
