Choosing the right treatment

Vaginal products and tablets (oral products) are equally effective. In general, both non-prescription and prescription medications are about 80% to 90% effective for most women, no matter which medication or length of treatment you choose. This is because the shorter treatments contain higher doses of medication per day. For some women, shorter treatment courses may also help avoid missed doses and make it easier to finish the treatment. Nystatin®, which is usually used for 14 days, is slightly less effective, but is still an alternative treatment.

Most yeast infections are caused by a type of yeast called Candida albicans, but some are caused by the yeast Candida glabrata, which can be harder to treat. Some medications are better than others at killing this tough-to-treat type of yeast.

Want to use a medication but not sure which one is best for you? Use our "Doctor Discussion Guide" to help you talk to your doctor about which treatment is best for you!

Vaginal products

Vaginal products come in a variety of different forms such as vaginal creams, tablets, suppositories, and ovules that get inserted high into the vagina, usually at bedtime, using an applicator. Some formulations will also include a topical cream that can be applied to the outside of the vagina, on the labia (lips of the vagina), and nearby skin to help relieve symptoms in this area. Vaginal products work directly on the vagina, treating the symptoms at their source.

Non-prescription vaginal products

Non-prescription medications include:

• clotrimazole (Canesten®,generics and store brands)
• miconazole (Monistat®, generics and store brands)

These products are available in 1-, 3-, 6-, and 7-day formulations and a variety of different dosage forms. Shorter treatments contain higher doses of the medication than the longer treatments. If you use a longer treatment, keep in mind that you must continue the treatment for the full course, even after your symptoms start to improve. The effectiveness of these medications is almost the same whether you choose the 1-, 3-, 6-, or 7-day treatment option, so the choice in length of treatment is up to you. But, if you're not sure which one is best for you, talk to your doctor or pharmacist. You can use these products whether or not you are menstruating.

Prescription vaginal products

• butoconazole (Gynazole-1®)
  • Butoconazole is a one-day treatment and is available as a ready-to-use vaginal cream in a pre-filled applicator.
  • Butoconazole is inserted high into the vagina as a single dose and can be used any time of the day.
• nystatin (Mycostatin®, Nyaderm®, and generics)
  • Nystatin is available as a vaginal cream and must be inserted into your vagina at bedtime for 14 days.
• terconazole (Terazol®, and generics)
  • Terconazole is available as a vaginal ovule and cream that is inserted into your vagina at bedtime for three or seven days in a row.
  • Prior to each use, the vaginal applicator is filled with the terconazole vaginal cream.

Things my doctor or pharmacist will tell me

Side effects associated with vaginal products are uncommon but mayinclude vaginal irritation, itching, or burning, abdominal pain orcramps. Since only a small amount of vaginal medication gets absorbedby your body, they don't usually interfere with other medications. Butthere are a few things you should keep in mind:

• Do not use other vaginal medications, tampons, deodorants, or douches, while using these medications.
• The medications may weaken latex condoms and diaphragms. Use a different method of birth control during your treatment and for three days afterwards. A weakened condom may not protect you from sexually transmitted infections either.
• Miconazole may interact with the blood thinner warfarin, increasing the risk of bleeding. If you're taking warfarin, talk to your pharmacist or doctor.

Oral products

Oral products used for vaginal yeast infections are absorbed by your body and travel through your bloodstream to the vagina, where they work to treat the infection. The oral product available in Canada has the active ingredient fluconazole is available as a single-dose tablet and capsule without a prescription. Depending on what province you live in, you may need to ask the pharmacist at the dispensary counter for the medication.

This one-dose treatment is considered as effective as the vaginal creams. Side effects include abdominal pain, diarrhea, headache, heartburn, or nausea. If you are taking medications for diabetes (glyburide or glicazide) you should talk to your doctor or pharmacist before taking oral fluconazole.

Written and reviewed by the MediResource Clinical Team