Antifungal Drugs

• Oral agents: Fluconazole (Diflucan), ketoconazole (Nizoral), itraconazole (Sporanox)
  
  
• Vaginal agents: Butoconazole (Femstat), clotrimazole (Mycelex, Gyne-Lotrimin, FemCare), miconazole (Monistat-7, Femizol-M), nystatin (Mycostatin), terconazole (Terazol), tioconazole (Vagistat-1)
  
  
• How antifungal drugs work: Antifungal drugs inhibit the ability of fungus to multiply and form new cell membranes.
  
  
• Who should not use these medications: Individuals with allergy to any ingredients contained within these products should not take them.
  
  
• Use: The choice of oral or vaginal dosage forms depends on the severity of the yeast infection, whether infection is recurrent, and the individual’s personal history (for example, immune system status, pregnancy, diabetes). Some drug regimens may include a combination treatment of an oral agent followed by vaginal application of a cream or vaginal suppository. Severe or recurrent infections may require maintenance treatment prescribed by a doctor. Maintenance treatments are taken periodically (for example, once per week).
  
  
  • Oral agents: These prescription drugs are available as tablets or capsules. Various treatment regimens are used. Patients with mild infections may require only a single dose or daily doses for a short duration.
    
    
  • Vaginal agents: Some vaginal preparations are available without a prescription. Vaginal dosage forms include vaginal suppositories or creams that come with special applicators for proper administration.
  
  
• Drug or food interactions: Clinically important drug interactions may occur with orally administered ketoconazole, fluconazole, or itraconazole. Patients should check with their doctor or pharmacist if they are currently taking other medications. Antacids or other drugs that decrease stomach acidity (for example, Pepcid, Tagamet, Zantac) may decrease the effectiveness of oral antifungal drugs. Common side effects with oral treatment include dizziness, fever, mild itching, nausea, bad taste, or diarrhea.
  
  
• Side effects: The most common side effect experienced with vaginally applied treatments is vaginal burning and itching. Less common effects of vaginally applied treatments include contact dermatitis, irritation, inflammation, and pain with urination or intercourse. Creams and suppositories may contain oil and weaken latex condoms.