What pill do doctors prescribe for yeast infections

Yeast Infection

There are dozens of options — which one is right for you?

By Joseph Bennington-CastroMedically Reviewed by Jennifer Payne, MD

Reviewed: September 27, 2022

Yeast infections are caused by the Candida genus of yeasts (a single-cell fungus), most often Candida albicans.

Research shows that C. albicans colonizes the vaginas of about 20 percent of women and 30 percent of pregnant women. (1)

Though this colonization doesn’t cause symptoms, symptomatic yeast infections can develop when the balance of microbial communities within the body gets thrown off by things like medication (antibiotics, in particular), hormonal changes, and the overuse of feminine hygiene products.

There are numerous drugs that can be used to treat vaginal yeast infections.

They can be purchased over-the-counter (OTC) or with a prescription, and take the form of an antifungal cream, ointment, suppository, or medicated tampon. An oral tablet is also available.

It’s important to get diagnosed by your doctor before trying OTC drugs — especially if you’ve never had a yeast infection before — because the symptoms of yeast infections are similar to other types of vaginal infections, including bacterial vaginosis (a bacterial infection of the vagina) and trichomoniasis (a sexually transmitted infection). (2)

Medication for Treating Yeast Infections

Standard medicines for yeast infections are all part of the class of antifungal drugs called azoles. They include:

• miconazole (Monistat)
• clotrimazole (Gyne-Lotrimin)
• tioconazole (Vagistat)
• butoconazole (Gynazole)
• terconazole (Terazol)

Prescribed medication may also come with additional prescription drugs to help treat your symptoms, such as steroids to relieve inflammation of the opening of the vagina.

Treatments last one, three, or seven days, all of which are equally effective. Unless you have an allergic reaction to the medication, side effects are generally mild.

You should not use tampons while using suppositories and creams. You should also avoid condoms and diaphragms because the yeast infection medicines contain oil, which can degrade the contraceptives. (3,4)

Having sex while being treated for a yeast infection is not generally recommended because it may worsen symptoms (by further irritating your vagina) and cause micro-tears in your skin that increase your risk of catching a sexually transmitted disease. (5)

Fluconazole (Diflucan) is a prescription pill for yeast infections. Most women only require a single dose of the medication to clear their yeast infection, but fluconazole is not recommended for pregnant women due to a potential risk of harming the developing baby.

Fluconazole may cause mild and infrequent side effects, such as headache, rash, and upset stomach. More rarely, severe side effects may develop, such as flu-like symptoms, swelling, and seizures. (2)

Lifestyle Changes That Support Medical Yeast Infection Treatment

While taking yeast infection medication, certain lifestyle changes can help relieve symptoms and prevent worsening symptoms. These include:

• Keeping your genital area clean and dry
• Avoiding douching and using scented feminine sprays, fragrances, or powders, which can affect the microbial balance of the vagina (and potentially promote yeast growth)
• Wearing loose-fitting underwear, pants, or shorts to prevent irritation and sweating, which can lead to the growth of more yeast
• Promptly changing out of wet bathing suits or exercise clothing, and washing sweat-covered or wet clothes after each use
• Keeping your blood sugar level under control if you have diabetes (4,6)

Some Candida Species Are Resistant to Drugs

Though azoles work well against C. albicans, some other Candida species are resistant to these first-line drugs.

For example, about half of C. glabrata strains isolated from recurrent yeast infections are far less susceptible to fluconazole than C. albicans, and C. krusei is completely resistant to it.

To treat non-albicans yeast infections, your doctor may prescribe nystatin (Mycostatin) vaginal cream or tablet, which you must apply or take daily for 14 days.

With treatment, a yeast infection will usually pass after one to seven days. The length of treatment will depend on which product you are using.

If a week is too long for you, you can also try a single dose of a powerful azole oral medication — fluconazole, if appropriate. (7)

Other antifungals, such as amphotericin B (Fungizone) and flucytosine (Ancobon), are also available for the treatment of non-albicans yeast infections.

Popular Home Remedies for Vaginal Yeast Infections

Despite the effectiveness of prescription and OTC treatments, some people may choose to try home remedies for yeast infections, including:

• Probiotic yogurt and supplements
• Boric acid suppositories
• Tea tree oil
• Garlic
• Douching (especially with vinegar)

But not all home remedies are backed up by clinical trials, and thus have not been proven effective against yeast infections.

Boric acid suppositories, at the very least, might be effective against yeast infections, in particular those caused by nonalbicans Candida species. (8,9)

Yogurt and supplements containing Lactobacillus — “good” bacteria common in the vagina and elsewhere — are thought to help treat and prevent yeast infections. But evidence for the bacteria’s helpfulness is inconsistent. (10)

The same is true for capsules of garlic, which is a natural fungicide. (11)

What Causes Recurring Yeast Infections?

About 5 to 8 percent of women experience four or more yeast infections in a single year, a condition known as recurrent or chronic yeast infections. (12)

It’s not clear why some women get chronic or recurring yeast infections, but there are several risk factors that can predispose you to it, such as pregnancy, birth control pills, estrogen therapy, regular antibiotic use, diabetes, and conditions that affect your immune system, particularly HIV.

Treatments used for normal yeast infections are effective if your recurring yeast infections are caused by C. albicans.

But some infections are caused by other Candida species, such as C. glabrata, which may require treatment with a nystatin vaginal cream or tablet, a vaginal gel containing the antifungals amphotericin B and flucytosine, or another treatment.

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Editorial Sources and Fact-Checking

1. Aguin TJ, Sobel JD. Vulvovaginal Candidiasis in Pregnancy. Current Infectious Disease Reports. April 28, 2015.
2. Patient Education: Vaginal Yeast Infection (Beyond the Basics). UpToDate. August 2022.
3. Yeast Infection (Vaginal). Mayo Clinic. March 17, 2021.
4. Vaginal Yeast Infection. MedlinePlus. July 13, 2021.
5. Can You Have Sex With a Yeast Infection? Self. February 12, 2022.
6. Vaginal Yeast Infections — Women’s Health Guide. U.S. Department of Veterans Affairs. June 3, 2015.
7. Ramsay S, Astill N, Shankland G, et al. Practical Management of Recurrent Vulvovaginal Candidiasis. Trends in Urology Gynaecology & Sexual Health. November–December 2009.
8. Pappas PG, Kauffman CA, Andes DR, et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases. February 15, 2016.
9. Iavazzo C, Gkegkes ID, Zarkada IM, et al. Boric Acid for Recurrent Vulvovaginal Candidiasis: the Clinical Evidence. Journal of Women’s Health. August 2011.
10. Xie H, Feng D, Wei D, et al. Probiotics for Vulvovaginal Candidiasis in Non-Pregnant Women. Cochrane Database of Systematic Reviews. November 23, 2017.
11. Watson CJ, Grando D, Fairley CK, et al. The Effects of Oral Garlic on Vaginal Candida Colony Counts: A Randomised Placebo Controlled Double-Blind Trial. BJOG. March 2014.
12. Rosa MI, Silva BR, Pires PS, et al. Weekly Fluconazole Therapy for Recurrent Vulvovaginal Candidiasis: A Systematic Review and Meta-Analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology. April 2013.

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