ABSTRACT

Objective: Candida albicans is the predominant yeast isolated from clinical specimens, frequently associated with vaginal thrush or vulvovaginal candidiasis (VVC) as a result of its overgrowth in the vaginal cavity. The ability of C. albicans to form biofilms complicates the treatment of candidiasis, rendering it resistant to standard antifungal therapies. The emergence of fluconazole (FCZ)-resistant C. albicans necessitates the development of innovative therapeutic approaches, either as standalone treatments or in conjunction with other agents. This study explores the synergistic effects of fluconazole and quercetin in the formulation of a mucoadhesive in-situ vaginal tablet aimed at targeting resistant strains of C. albicans. The mucoadhesive vaginal tablet formulation was developed and optimized through a 3² full factorial design (FFD), focusing on enhancing the properties of mucoadhesive and swelling polymers. Carbopol 934P (61.24% w/w) served as the swelling polymer, while HPMCK4M (63.15% w/w) was utilized as the mucoadhesive polymer. Comprehensive evaluations of the developed tablet were conducted, encompassing both pre-compression and post-compression assessments. In vitro studies included drug diffusion analyses, kinetic evaluations, product assays, and antifungal efficacy tests against resistant strains of Candida albicans. The optimized formulationdemonstrated satisfactory pre- and post-compression parameters of formulation. FCZ exhibited complete release within 90 minutes, whereas QCT released 99.55% within 150 minutes. The tablet maintained adhesion to the vaginal membrane for 273 minutes, ensuring the complete release of both FCZ and QCT. Kinetic analysis indicated that FCZ release adhered to the Korsmeyer-Peppas model, while QCT release conformed to the Higuchi model. The mucoadhesive vaginal formulation exhibited a synergistic effect against itraconazole-resistant Candida albicans. This mucoadhesive in-situ vaginal tablet formulation presents several advantages over oral dosage forms, including reduced metabolic degradation, enhanced bioavailability of quercetin, improved cosmetic acceptability, and increased patient adherence. Furthermore, the formulation is scalable and effectively targets drug-resistant strains of Candida albicans, making it particularly valuable in instances where fluconazole monotherapy proves ineffective. Keywords: Mucoadhesive Vaginal Tablet, Fluconazole (FCZ), Quercetin (QCT), 32 Full Factorial Design (FFD), Antifungal activity
Publication date: 01/02/2026

https://ijbpas.com/pdf/2026/February/MS_IJBPAS_2026_9887.pdf

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https://doi.org/10.31032/IJBPAS/2026/15.2.9887