Medications

Topical antifungal agents in the form of creams, ointments, or vaginal creams or suppositories are usually initially used. Many are available as nonprescription medications.  

• Topical creams and ointments include clotrimazole (Lotrimin), econazole (Spectazole), ketoconazole (Nizoral cream), miconazole (Micatin, Monistat-Derm), and nystatin (Mycostatin Cream).



• Vaginal creams and suppositories include butoconazole (Femstat), clotrimazole (Femizole-7, Gyne-Lotrimin), miconazole (Monistat Vaginal products), terconazole (Terazol), tioconazole (Vagistat).
  
  
  • Follow manufacturer's instructions for 1-7 days depending on the formulation. If the irritation increases, immediately discontinue the medication. Some products contain topical antifungal cream to use on irritated external genital areas along with vaginal cream or suppositories.
  
  
  
  • Pregnant women should consult a doctor before using these treatments.
  
  
  
  • If symptoms continue for more than 1 week despite treatment, consult a doctor. These symptoms may be caused by something other than a fungal infection.
  
  
  
  • If you have abdominal pain, fever, or offensive-smelling vaginal discharge, consult your physician before using these products.
  
  
  
  • For more information, refer to Understanding Vaginal Yeast Infection Medications. 

• Nystatin (Nilstat, Mycostatin) is commonly prescribed for oral thrush. The oral liquid is administered with a dropper to adequately coat the inside of the mouth in infants and young children. Troches (lozenges) may be prescribed for older children and adults with oral thrush.



• Clotrimazole (Mycelex) troches are also available for treating oral thrush in older children and adults.



• Fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral) are prescription products administered as tablets or oral liquid. They may be used when topical agents are ineffective, large areas of skin is affected, or for individuals at a higher risk of fungal infection, such as patients with cancer or HIV.



• Fluconazole is approved by the US Food and Drug Administration for vaginal candida infections.



• These oral antifungal drugs interact with many medications. Your doctor and pharmacist should be aware of all medications that you are taking, including nonprescription drugs and herbal products.



• The most common side effects include nausea, vomiting, and abdominal pain.



• Your doctor will periodically draw blood samples to monitor for the rare toxicity of liver impairment.