Can I take Kesimpta (ofatumumab) with an active vaginal infection?

Taking Kesimpta with a Vaginal Infection

Yes, you can take Kesimpta (ofatumumab) while having a vaginal infection, as there are no specific contraindications between Kesimpta and vaginal infections. The vaginal infection should be properly diagnosed and treated according to established guidelines while continuing your Kesimpta therapy.

Diagnosis of Vaginal Infection

Before continuing with Kesimpta while managing a vaginal infection, proper diagnosis is essential:

• Vaginal infections are typically characterized by discharge, odor, irritation, or itching 1, 2

• Common vaginal infections include:

  • Bacterial vaginosis (BV): characterized by malodorous discharge with minimal irritation 2
  • Trichomoniasis: presents with malodorous yellow-green discharge, dysuria, and vulvar irritation 1, 2
  • Vulvovaginal candidiasis (VVC): presents with pruritus, external dysuria, and thick white discharge 1

• Diagnostic testing should include:

  • Vaginal pH testing (BV and trichomoniasis pH >4.5; candidiasis pH ≤4.5) 2
  • Microscopic examination with saline and 10% KOH to identify pathogens 1, 2

Treatment of Vaginal Infections While on Kesimpta

For Bacterial Vaginosis:

• Recommended treatment: Metronidazole 500 mg orally twice daily for 7 days 1, 2
• Alternative options:
  • Clindamycin cream 2% intravaginally at bedtime for 7 days 1
  • Metronidazole gel 0.75% intravaginally once daily for 5 days 1

For Trichomoniasis:

• Recommended treatment: Metronidazole 2 g orally in a single dose 1, 2
• Alternative option: Metronidazole 500 mg orally twice daily for 7 days 1
• Sexual partners should also be treated to prevent reinfection 1

For Vulvovaginal Candidiasis:

• Recommended treatments:
  • Fluconazole 150 mg oral tablet as a single dose 1, 2
  • Various intravaginal azole preparations (clotrimazole, miconazole, etc.) for 1-7 days depending on formulation 1

Important Considerations

• Topical treatments for vaginal infections are generally preferred as they allow direct therapeutic action with reduced systemic effects 3, 4
• For recurrent vulvovaginal candidiasis, prophylactic treatment may be necessary 5
• Mixed infections are common and may require combination therapy 2
• Follow-up is generally unnecessary if symptoms resolve for bacterial vaginosis or trichomoniasis 2
• For vulvovaginal candidiasis, return only if symptoms persist or recur within 2 months 2

Pitfalls to Avoid

• Do not treat empirically without proper diagnosis 2
• Avoid douching as it lacks well-documented clinical benefits and may be associated with risks 6
• Do not discontinue Kesimpta without consulting your healthcare provider, as vaginal infections are not a contraindication for continuing treatment
• For trichomoniasis, ensure sexual partners are treated to prevent reinfection 1, 2