Generic Name Brand Name butoconazole Femstat clotrimazole Gyne-Lotrimin, Mycelex miconazole Monistat terconazole Terazol tioconazole Vagistat
Vaginal antifungal medicines are:
- Often available without a prescription.
- Inserted into the vagina at bedtime, and some may also be applied to the genital area (vulva).
- Used with an applicator that supplies the correct amount of medicine. Vaginal tablets and suppositories are also sold with an applicator to help insert the medicine into the vagina.
- Able to be used externally. Yeast organisms can grow on the genital skin. Small amounts of some vaginal creams may reduce symptoms.
Treatment length varies depending on which vaginal medicine you use. Single-day treatments are stronger and more convenient. But you may need longer treatment for a severe infection.
In general, symptoms will diminish before the medicine has completely eliminated the yeast infection. If treatment is discontinued before it is completed, the yeast infection may return. So it is important to complete the full medicine treatment.
Vaginal antifungal medicine kills yeast cells by destroying their cell membranes.
Vaginal antifungal treatment is recommended for:
- Occasional yeast infections.
- Yeast infection during pregnancy.
- Recurrent vaginal yeast infection. An initial treatment using oral and/or vaginal medicine is followed by 6 months to 1 year of less frequent maintenance treatment.1
Vaginal medicine treatment in pregnancy
Vaginal yeast infections commonly occur during pregnancy, probably related to the high estrogen levels. Consistently high estrogen is the most likely reason that treatment takes longer to cure a yeast infection during pregnancy.
Vaginal medicines, such as cream or vaginal suppositories, are recommended for yeast infection treatment during pregnancy.1
If you are pregnant, do not use these nonprescription medicines without first discussing your condition with your doctor.
All antifungal treatments have an 80% to 90% yeast infection cure rate.1
About 30 to 40 out of 100 women with recurrent vaginal yeast infection develop another yeast infection after they stop their maintenance therapy with antifungal medicine.
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call 911 or other emergency services right away if you have:
- Trouble breathing.
- Swelling of your face, lips, tongue, or throat.
Call your doctor if you have:
- Vaginal burning, itching, discharge, or other irritation you did not have before using this medicine.
Common side effects of this medicine include:
- Belly pain or cramping.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
Talk to your doctor if your symptoms continue or recur within 2 months of using a vaginal over-the-counter medicine.
Treatment of sex partners does not typically prevent a yeast infection from reoccurring. But sex partners with red, itchy, or painful skin in the genital area should be seen by a doctor and treated if needed.
Women who have a vaginal yeast infection and who have HIV should follow the same treatment regimens as women who have a vaginal yeast infection and do not have HIV.1
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
If you are pregnant, breast-feeding, or trying to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF) to help you understand this medication.
Centers for Disease Control and Prevention (2010). Vulvovaginal candidiasis section of Sexually transmitted diseases treatment guidelines 2010. MMWR, 59(RR-12): 61–63. Also available online: http://www.cdc.gov/std/treatment/2010/default.htm.
By Healthwise Staff Primary Medical Reviewer Kathleen Romito, MD - Family Medicine Specialist Medical Reviewer Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology Last Revised August 18, 2013