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Venus 20 is a vaginal cream formulation developed by the Brazilian pharmaceutical company EMS, consisting of a combination of the antifungal agent tioconazole and the antiprotozoal/antibacterial agent tinidazole. This combination, referred to as the "Venus association," is being investigated for the treatment of vulvovaginal candidiasis (VVC), with a focus on providing an effective single-dose therapeutic option. The "20" in the name designates a specific dose strength or concentration (likely 20 mg/g of tioconazole) evaluated in clinical trials. In a Phase II randomized, double-blind study (NCT05031481), Venus 20 was compared against butoconazole nitrate 2% cream to assess its efficacy and safety in patients with VVC. Tioconazole exerts its antifungal activity by inhibiting the enzyme lanosterol 14-alpha demethylase, which is essential for ergosterol synthesis and fungal cell membrane integrity. Tinidazole, a nitroimidazole derivative, acts by being reduced to reactive intermediates that cause DNA strand breakage and inhibit DNA synthesis in susceptible anaerobic organisms and protozoa, providing broad-spectrum coverage for potential mixed infections.
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