Oral Medicines for Vaginal Yeast Infections
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Fluconazole is the first-choice oral antifungal medicine for vaginal yeast infection. Itraconazole is also commonly used.
Why It Is Used
Oral medicines can be used:
- To treat the occasional vaginal yeast infection in women who have a preference for oral treatment.
- To treat a vaginal yeast infection that has not responded to vaginal medicine.
- As a weekly or monthly maintenance or suppressive treatment for 6 months to 1 year, to stop persistent, recurring vaginal yeast infection. All cases of recurring vaginal yeast infections should be confirmed by culture before preventive therapy begins.
How Well It Works
Antifungal treatments cure infections 80% to 90% of the time. (In some cases, the less common types of yeast infections may respond better to vaginal treatment or to boric acid suppositories).1 Oral medicines do not provide immediate relief of symptoms, so vaginal medicines may also be needed in the first 48 hours of treatment.
Recurring infections (four or more in 1 year)
If you have recurring yeast infections, you may want to ask your doctor about taking antifungal medicines as maintenance or suppressive treatment. This means taking the medicine weekly or monthly for 6 months to 1 year. This long-term use of antifungal medicine is likely to reduce the recurrence of vaginal yeast infections.2 But after women stop taking the medicines, 30 to 40 out of 100 of them get another vaginal infection that has symptoms.3
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 right away if you have:
- Fever and chills.
- Skin rash or itching.
Common side effects of this medicine include:
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Women who use several months of maintenance treatment for recurring vaginal yeast infections should have regular checkups to watch for side effects and to find out how well treatment is working.
Treatment of sex partners does not typically prevent a yeast infection from recurring. 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 planning 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.
- 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.
- Spence D (2010). Candidiasis (vulvovaginal), search date March 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
- Eschenbach DA (2008). Pelvic infections and sexually transmitted diseases. In RS Gibbs et al., eds., Danforth's Obstetrics and Gynecology, 10th ed., pp. 604–624. Philadelphia: Lippincott Williams and Wilkins.
Last Revised: August 18, 2013
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