Drug and trade name(s) | Requires a prescription in US | Preparation | Intravaginal* dose for adult |
Fluconazole oral administration¶ | |||
DiflucanΔ | Yes | 150 mg oral tablet | Single dose by mouth; patients with greater vulvovaginal involvement may require an additional dose of 150 mg given 72 hours after initial dose |
Clotrimazole | |||
Gyne-LotriminΔ | No | 1% vaginal cream | 1 applicatorful (approximately 5 g) once daily at bedtime for seven days |
Gyne-Lotrimin 3Δ | No | 2% vaginal cream | 1 applicatorful (approximately 5 g) once daily at bedtime for three days |
Gyne-Lotrimin◊ | Not applicable (not available in US) | 100 mg vaginal tablet◊ 200 mg vaginal tablet◊ 500 mg vaginal tablet◊ | Insert one 100 mg vaginal tablet once daily for seven days; or One 200 mg tablet once daily for three days; or One 500 mg tablet as a single dose |
Miconazole | |||
Monistat 7Δ | No | 2% vaginal cream (combination kit may include 2% miconazole cream for external use) | 1 applicatorful (approximately 5 g) once daily at bedtime for seven days |
Monistat 3Δ | No | 4% vaginal cream | 1 applicatorful (approximately 5 g) once daily at bedtime for three days |
Monistat 7Δ | No | 100 mg vaginal suppository | 1 suppository once daily at bedtime for seven days |
Monistat 3Δ, Vagistat-3Δ | No (combination kit) Yes (generic suppository) | 200 mg vaginal suppository (combination kit may include 2% miconazole cream for external use) | 1 suppository once daily at bedtime for three days |
Monistat 1Δ | No | 1200 mg vaginal suppository (combination kit may include 2% miconazole cream for external use) | 1 suppository for one day as a single dose |
Nystatin§ | |||
Nystatin vaginal◊ (former US brand Mycostatin) | Commercial vaginal tablet not available in US; vaginal suppositories can be prepared by a licensed compounding pharmacy (prescription required) | 100,000 unit vaginal tablet or suppository | Insert 1 vaginal tablet or suppository once daily for 7 days |
Terconazole¥ | |||
Generic only (former US brands Terazole 7, Zazole)Δ | Yes | 0.4% vaginal cream | 1 applicatorful (approximately 5 g) once daily at bedtime for seven days |
Generic only (former US brands Terazole 3, Zazole)Δ | Yes | 0.8% vaginal cream | 1 applicatorful (approximately 5 g) once daily at bedtime for three days |
Generic only (former US brands Terazole 3, Zazole)Δ | Yes | 80 mg vaginal suppository | 1 suppository once daily at bedtime for three days |
Tioconazole | |||
Vagistat-1, Monistat 1-DayΔ | No | 6.5% vaginal ointment | 1 applicatorful (approximately 5 g) at bedtime as a single dose |
Butoconazole | |||
Gynazole-1 | Yes | 2% vaginal cream | 1 applicatorful (approximately 5 g) as a single dose |
Ibrexafungerp | |||
Brexafemme | Yes | 150 mg oral tablet | Two 150 mg tablets (ie, 300 mg) by mouth twice a day for one day (4 tablets total). Limit use to non-pregnant patients who prefer oral dosing but cannot use oral fluconazole (eg, due to intolerance, allergy, or Candida infection resistant to fluconazole). Dose reduction required if taken with strong CYP3A inhibitors. |
Boric acid | |||
AZO Boric acid, others‡ | No | 600 mg vaginal suppository | 1 suppository once daily at bedtime for 7 days. Limit use to patients who are allergic to fluconazole and do not have access to other topical agents (ie, azoles and nystatin)‡. Warning: boric acid may cause death if taken orally. |
US: United States; VVC: vulvogaginal candidiasis.
* Except fluconazole and ibrexafungerp, which are given orally.
¶ Itraconazole is another oral antifungal that appears to be effective[1].
Δ Generic equivalent preparation(s) are available in US.
◊ Not commercially available in US.
§ Cure rate with nystatin is 70 to 80%.
¥ Rare cases of anaphylaxis and toxic epidermal necrolysis have been reported during terconazole therapy.
‡ Boric acid efficacy established with compounded intravaginal capsules which are not commercially available.Data from: UpToDate Lexidrug. More information available at https://online.lexi.com/.
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