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Alagin Duo is a fixed-dose combination of clindamycin phosphate (an antibiotic) and ketoconazole (an antifungal) formulated as vaginal suppositories (ovules). Developed and marketed by Laboratorios Casasco in Argentina, it is indicated for the treatment of bacterial vaginosis (caused by organisms such as Gardnerella vaginalis, Mobiluncus spp., and other anaerobes), vaginal candidiasis, and mixed vaginal infections. Clindamycin acts by binding to the 50S ribosomal subunit of susceptible bacteria, thereby inhibiting protein synthesis. Ketoconazole is an imidazole antifungal that inhibits the fungal enzyme lanosterol 14-alpha-demethylase, preventing the conversion of lanosterol to ergosterol and disrupting fungal cell membrane integrity.
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