Label Review

July 1999; Volume 1: 64

YEAST ARRESTTM

Package Insert Information
"Relief of itching, burning, and minor irritations associated with vaginal yeast infections. Yeast Arrest suppositories aid in the normalization of vaginal health while eliminating yeast overgrowth."
Suggested Use
Use finger to push the suppository deeply into the vagina. Use with a light mini panty liner due to leakage from dissolving herbs.

Acute yeast vaginitis
Mild cases: insert 1 suppository twice per day for 3 to 7 days.
Resistant cases: insert 1 suppository twice per day for 10 to 14 days.

Chronic yeast vaginitis
Insert 1 suppository twice per day for two weeks. If a response occurs but not a complete resolution, repeat for an additional two weeks at 1 capsule per day.

Prevention of recurrence
Insert 1 suppository once per day at bedtime, during menstruation for four months.

Additional naturopathic care
Avoid fermented foods such as cheese, vinegar, beer, and wine. Avoid simple carbohydrates such as sugar, fruit, white and flour products(sic). Avoid foods with baker’s yeast. Increase dietary intake of active yogurt and garlic.

Do not use this product if pregnant without consulting a health care practitioner.

Keep this product out of reach of children.

Store in a cool, dry place.

Supplement Facts
One suppository contains:
Boric acid
Hydrastis canadensis—goldenseal root 
Calendula officinalis—calendula flowers 
Berberis aquifolium—Oregon grape root 
600 mg
100 mg
50 mg
50 mg

Suggested use: insert one suppository in vagina morning and evening.

"Formulated by Dr. Tori Hudson, a naturopathic physician specializing in women's natural health care"

Yeast Arrest™ is a trademark of Vitanica™, P.O. Box 1285, Sherwood, OR 97140.

Price: $11.49, 14 suppositories

Comments from Adriane Fugh-Berman, MD

The suppositories (actually large clear capsules filled with powdered light-brown material) could easily be mistaken for oral medication; however, the lid of the plastic container is clearly marked "Suppositories: Do Not Ingest."

Boric acid clearly has antifungal properties, has been tested as a treatment for both acute1 and chronic2 vulvovaginal candidiasis, and is quite safe (occasional burning at the introitus has been noted in those using boric acid for more than two weeks1). Although not widely used, boric acid is an inexpensive and apparently effective therapy for treating Candida infections. Doses used in studies were usually 600 mg bid, which this formula provides.

Although there are no published clinical trials for the use of the herbs in this formula for vaginitis, there is some evidence for anti-inflammatory and antifungal activity. Calendula reduces inflammation, and antifungal activity of a 10% methanol extract of calendula has been demonstrated.3 Goldenseal contains alkaloids (including hydrastine and berberine) and has been used in Native American Indian medicine for oral sores and irritation. Oregon grape root also contains berberine, but in lesser amounts than other Berberis species, especially B. vulgaris. Berberine has broad-spectrum antibacterial and antifungal activity.

The package insert is referenced, which is unusual and commendable for an OTC product. Most women are quite familiar with symptoms of Candida overgrowth and self-treatment is fine. However, OTC products that include directions for chronic use are worrisome. Dosing instructions for "mild cases," "resistant cases," and "chronic yeast vaginitis" could encourage consumers to continue using this product when they should consult a health care provider. Triggers for recurrent yeast infections should be identified: possibilities include irritant exposure (soap, bath oil); labial occlusion/irritation (swimsuits, bicycle pants); or immunosuppression. And of course another diagnosis may be in order. The insert does state "…for symptoms other than those related to yeast infections, or persistent or recurring symptoms, consult a health care practitioner." However, it would be more useful to specify a time frame of one or two weeks.

In summary, this product should be effective in treating a yeast infection, although boric acid alone may work as well and would be a less expensive option. It does not appear to be more convenient or less expensive than generic antifungal suppositories.

References

    1. Van Slyke KK, et al. Treatment of vulvovaginal candidiasis with boric acid powder. Am J Obstet Gynecol 1981;141:145-148.

    2. Jovanovic R, et al. Antifungal agents vs. boric acid for treating chronic mycotic vulvovaginitis. J Reprod Med 1991;36:593-597.

    3. European Scientific Cooperative on Phytotherapy. Calendula monograph. Exeter, UK; 1997.