What are the most effective antifungal medications for treating yeast infections. How do fluconazole, miconazole, and clotrimazole work to combat fungal infections. What are the potential side effects and precautions associated with these antifungal treatments.

Understanding Yeast Infections and Antifungal Treatments

Yeast infections are common fungal infections that can affect various parts of the body, including the skin, mouth, and vagina. These infections are typically caused by an overgrowth of Candida, a type of yeast that naturally exists in our bodies. When the balance of microorganisms in our system is disrupted, it can lead to a yeast infection.

To combat these infections, healthcare professionals often prescribe antifungal medications. Three of the most commonly used antifungal drugs are fluconazole, miconazole, and clotrimazole. Each of these medications has its unique properties and applications in treating fungal infections.

Fluconazole: A Powerful Oral Antifungal Medication

Fluconazole is a widely prescribed antifungal medication that belongs to the azole class of drugs. It is primarily used to treat various fungal infections, including vaginal yeast infections, thrush, and certain systemic fungal infections.

How Does Fluconazole Work?

Fluconazole works by inhibiting the growth of fungal cells. It does this by interfering with the production of ergosterol, a vital component of fungal cell membranes. Without ergosterol, the fungal cell membrane becomes weak and leaky, ultimately leading to the death of the fungal cells.

Administration and Dosage

Fluconazole is typically administered orally in the form of tablets or liquid. The dosage and duration of treatment depend on the type and severity of the infection. For vaginal yeast infections, a single dose of 150 mg is often sufficient. However, for more severe or recurrent infections, multiple doses may be necessary.

• Typical single dose for vaginal yeast infections: 150 mg
• Treatment duration: Usually single dose, but can extend to multiple doses for severe cases
• Available forms: Tablets and oral suspension

Potential Side Effects of Fluconazole

While fluconazole is generally well-tolerated, it can cause some side effects in certain individuals. Common side effects may include:

• Nausea
• Headache
• Dizziness
• Diarrhea
• Stomach pain
• Changes in taste perception

In rare cases, more severe side effects can occur, such as liver problems or allergic reactions. It’s crucial to consult a healthcare provider if you experience any unusual or severe symptoms while taking fluconazole.

Miconazole: A Versatile Topical Antifungal Solution

Miconazole is another antifungal medication that is primarily used topically to treat various fungal skin infections. It is available in several forms, including creams, powders, and suppositories.

Mechanism of Action

Like fluconazole, miconazole belongs to the azole class of antifungal drugs. It works by disrupting the fungal cell membrane, leading to the death of fungal cells. Miconazole is effective against a wide range of fungi, including those responsible for athlete’s foot, jock itch, ringworm, and vaginal yeast infections.

Applications of Miconazole

Miconazole topical is used to treat various fungal skin infections, including:

• Athlete’s foot
• Jock itch
• Ringworm
• Tinea versicolor
• Cutaneous candidiasis
• Vaginal yeast infections (when used as a suppository)

Side Effects and Precautions

Miconazole is generally safe when used as directed. However, some people may experience mild side effects such as:

• Skin irritation
• Itching
• Burning sensation
• Redness at the application site

It’s important to avoid getting miconazole in your eyes, nose, or mouth. If you’re pregnant or breastfeeding, consult your doctor before using miconazole, as its safety in these situations is not fully established.

Clotrimazole: An Effective Treatment for Vaginal Yeast Infections

Clotrimazole is another antifungal medication that is commonly used to treat vaginal yeast infections. It is available as a vaginal cream or suppository.

How Clotrimazole Works

Clotrimazole, like fluconazole and miconazole, is an azole antifungal. It works by inhibiting the synthesis of ergosterol, a crucial component of fungal cell membranes. This action leads to increased permeability of the fungal cell membrane and ultimately results in the death of the fungal cells.

Usage and Administration

Clotrimazole vaginal is specifically designed for use in the vagina to treat yeast infections. It’s typically available in the following forms:

• Vaginal cream
• Vaginal suppositories

The treatment course usually lasts for 1 to 7 days, depending on the specific product and the severity of the infection. It’s crucial to complete the full course of treatment, even if symptoms improve before the medication is finished.

Potential Side Effects

While clotrimazole is generally well-tolerated, some women may experience mild side effects such as:

• Burning sensation
• Itching
• Redness
• Swelling in the vaginal area

If these side effects persist or worsen, it’s important to consult a healthcare provider.

Comparing Fluconazole, Miconazole, and Clotrimazole

While all three medications – fluconazole, miconazole, and clotrimazole – are effective antifungal treatments, they have some key differences in their applications and administration methods.

Route of Administration

• Fluconazole: Oral (tablets or suspension)
• Miconazole: Topical (creams, powders) or vaginal (suppositories)
• Clotrimazole: Primarily vaginal (cream or suppositories)

Spectrum of Activity

All three medications are effective against Candida species, which are responsible for most yeast infections. However, their broader spectrum of activity differs:

• Fluconazole: Effective against various systemic fungal infections
• Miconazole: Treats a wide range of superficial fungal infections
• Clotrimazole: Primarily used for vaginal yeast infections

Duration of Treatment

The duration of treatment can vary depending on the specific medication and the severity of the infection:

• Fluconazole: Often a single dose for uncomplicated vaginal yeast infections
• Miconazole: Usually 7-14 days for skin infections, 1-7 days for vaginal infections
• Clotrimazole: Typically 1-7 days for vaginal yeast infections

Choosing the Right Antifungal Treatment

The choice between fluconazole, miconazole, and clotrimazole depends on various factors, including the type and location of the infection, the patient’s overall health, and potential drug interactions.

Factors Influencing Treatment Choice

• Type of infection (superficial vs. systemic)
• Location of infection (skin, vaginal, oral)
• Severity of symptoms
• Patient’s medical history and current medications
• Pregnancy or breastfeeding status
• Personal preference (oral vs. topical application)

It’s crucial to consult a healthcare provider to determine the most appropriate antifungal treatment for your specific situation. They can consider all relevant factors and recommend the most effective and safe option.

Precautions and Considerations for Antifungal Use

While antifungal medications are generally safe and effective, there are some important precautions and considerations to keep in mind:

Drug Interactions

Antifungal medications, especially oral ones like fluconazole, can interact with other medications. It’s crucial to inform your healthcare provider about all medications you’re taking, including over-the-counter drugs and supplements.

Pregnancy and Breastfeeding

The safety of antifungal medications during pregnancy and breastfeeding is not fully established. Always consult a healthcare provider before using these medications if you’re pregnant or breastfeeding.

Underlying Health Conditions

Certain health conditions, such as liver disease, may affect how your body processes antifungal medications. Be sure to discuss your full medical history with your healthcare provider.

Proper Use and Completion of Treatment

To ensure the effectiveness of antifungal treatments and prevent the development of drug-resistant fungi, it’s crucial to use the medication as directed and complete the full course of treatment, even if symptoms improve before the medication is finished.

Natural Remedies and Prevention Strategies

While antifungal medications are effective in treating yeast infections, there are also several natural remedies and prevention strategies that can complement medical treatment or help prevent recurrent infections:

Dietary Modifications

• Reducing sugar intake: Yeast thrives on sugar, so limiting sugar consumption may help prevent yeast overgrowth.
• Incorporating probiotics: Consuming probiotic-rich foods or supplements can help maintain a healthy balance of microorganisms in the body.
• Garlic: Known for its antifungal properties, garlic can be incorporated into your diet or used topically (with caution).

Lifestyle Changes

• Wearing breathable, cotton underwear
• Avoiding tight-fitting clothing
• Practicing good hygiene
• Avoiding douching
• Managing stress levels

Natural Topical Treatments

Some people find relief from mild yeast infections using natural topical treatments such as:

• Tea tree oil (diluted)
• Coconut oil
• Apple cider vinegar (diluted)

However, it’s important to note that while these natural remedies may provide some relief, they are not substitutes for medical treatment in cases of severe or recurrent yeast infections. Always consult a healthcare provider before trying any new treatment.

When to Seek Medical Attention

While many yeast infections can be treated effectively with over-the-counter antifungal medications, there are situations where it’s crucial to seek medical attention:

Persistent or Recurrent Symptoms

If your symptoms persist after completing a course of antifungal treatment, or if you experience frequent recurrences of yeast infections, it’s important to consult a healthcare provider. This could indicate a resistant strain of fungus or an underlying health condition that needs to be addressed.

Severe Symptoms

Seek medical attention if you experience severe symptoms such as:

• Intense itching, burning, or irritation
• Unusual or foul-smelling discharge
• Fever or chills
• Abdominal pain

First-Time Infections

If you’ve never had a yeast infection before, it’s best to consult a healthcare provider for an accurate diagnosis. Other conditions, such as bacterial vaginosis or sexually transmitted infections, can sometimes mimic the symptoms of a yeast infection.

Pregnancy

Pregnant women should always consult their healthcare provider before using any antifungal medications, as some treatments may not be safe during pregnancy.

Underlying Health Conditions

If you have diabetes, a weakened immune system, or other chronic health conditions, it’s important to seek medical advice for proper management of yeast infections.

Remember, while antifungal medications like fluconazole, miconazole, and clotrimazole are effective treatments for many yeast infections, proper diagnosis and personalized treatment plans are crucial for optimal health outcomes. Always consult with a healthcare professional for persistent or concerning symptoms.

Miconazole Topical (Remedy (Miconazole)) – Side Effects, Interactions, Uses, Dosage, Warnings

Brand Names:Aloe Vesta, Aloe Vesta 2 in 1 Antifungal, Aloe Vesta Clear Antifungal, Azolen, Baza, Baza Antifungal

Reviewed: June 23, 2020

Miconazole topical is an antifungal medication. Miconazole topical prevents fungus from growing on your skin.

Miconazole topical (for the skin) is used to treat skin infections such as athlete’s foot, jock itch, ringworm, tinea versicolor (a fungus that discolors the skin), and yeast infections of the skin.

Miconazole topical may also be used for purposes not listed in this medication guide.

uses

What is Miconazole Topical (Remedy (Miconazole)) used for?

• Cutaneous Candidiasis
• Tinea Corporis
• Tinea Cruris
• Tinea Pedis
• Tinea Versicolor
• Vaginal Candidiasis

warnings

What is the most important information I should know about Miconazole Topical (Remedy (Miconazole))?

You should not use this medicine if you are allergic to miconazole.

Ask a doctor or pharmacist if it is safe for you to use this medicine if you have other medical conditions, especially:

• if you are using a blood thinner such as warfarin, Coumadin, Jantoven.

It is not known whether miconazole topical will harm an unborn baby. Do not use this medicine without a doctor’s advice if you are pregnant.

It is not known whether miconazole topical passes into breast milk or if it could harm a nursing baby. Do not use this medicine without a doctor’s advice if you are breast-feeding a baby.

Side Effects

What are the side effects of Miconazole Topical (Remedy (Miconazole))?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using miconazole topical and call your doctor at once if you have:

• severe blistering, redness, or irritation of treated skin.

Common side effects may include:

• itching, peeling, or dry skin.

Although the risk of serious side effects is low when miconazole topical is applied to the skin, side effects can occur if the medicine is absorbed into your bloodstream, including:

• dry mouth, sore tongue, tooth pain, red or swollen gums;
• altered sense of taste;
• nausea, diarrhea; or
• headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Pregnancy & Breastfeeding

Can I take Miconazole Topical (Remedy (Miconazole)) if I’m pregnant or breastfeeding?

It is not known whether miconazole topical will harm an unborn baby. Do not use this medicine without a doctor’s advice if you are pregnant.

It is not known whether miconazole topical passes into breast milk or if it could harm a nursing baby. Do not use this medicine without a doctor’s advice if you are breast-feeding a baby.

Interactions

What drugs and food should I avoid while taking Miconazole Topical (Remedy (Miconazole))?

Avoid getting this medication in your eyes, nose, or mouth.

Avoid wearing tight-fitting, synthetic clothing that doesn’t allow air circulation. Wear loose-fitting clothing made of cotton and other natural fibers until the infection is healed.

Dosage Guidelines & Tips

How to take Miconazole Topical (Remedy (Miconazole))?

Use Miconazole Topical (Remedy (Miconazole)) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

What should I do if I missed a dose of Miconazole Topical (Remedy (Miconazole))?

Apply the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

Overdose Signs

What happens if I overdose on Miconazole Topical (Remedy (Miconazole))?

If you think you or someone else may have overdosed on: Miconazole Topical (Remedy (Miconazole)),  call your doctor or the Poison Control center

(800) 222-1222

If someone collapses or isn’t breathing after taking Miconazole Topical (Remedy (Miconazole)), call 911

911

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Medical Disclaimer

Drugs A-Z provides drug information from Everyday Health and our partners, as well as ratings from our members, all in one place. Cerner Multum™ provides the data within some of the Overview, Uses, Warnings, Side Effects, Pregnancy, Interactions, Dosage, Overdose, and Images sections. The information within all other sections is proprietary to Everyday Health. 

Clotrimazole-3 (Clotrimazole Vaginal) – Side Effects, Interactions, Uses, Dosage, Warnings

Reviewed: June 23, 2020

Clotrimazole is an antifungal medication that fights infections caused by fungus.

Clotrimazole vaginal (for use in the vagina) is used to treat vaginal candida (yeast) infections.

Clotrimazole vaginal may also be used for purposes not listed in this medication guide.

uses

What is Clotrimazole-3 (Clotrimazole Vaginal) used for?

• Cutaneous Candidiasis
• Tinea Corporis
• Tinea Cruris
• Tinea Pedis
• Tinea Versicolor
• Vaginal Candidiasis

warnings

What is the most important information I should know about Clotrimazole-3 (Clotrimazole Vaginal)?

You should not use clotrimazole vaginal if you are allergic to it.

If this is the first time you have ever had symptoms of a vaginal yeast infection, ask your doctor before using clotrimazole vaginal.

Tell your doctor if you have had more than 3 vaginal infections within 6 months. Frequent vaginal yeast infections that do not clear up with treatment may be a sign of a more serious condition.

Ask a doctor or pharmacist if it is safe for you to use this medicine if you have other medical conditions, especially:

• fever, chills, pain in your back or shoulder;
• stomach pain, vomiting;
• foul-smelling vaginal discharge;
• diabetes; or
• HIV or AIDS.

FDA pregnancy category B. Clotrimazole vaginal is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Do not use clotrimazole vaginal without medical advice if you are breast-feeding a baby.

Do not give this medicine to a child younger than 12 years old without medical advice.

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Side Effects

What are the side effects of Clotrimazole-3 (Clotrimazole Vaginal)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have new or worsening vaginal symptoms.

Common side effects may include:

• slight increase in vaginal discomfort (burning, itching, irritation).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Pregnancy & Breastfeeding

Can I take Clotrimazole-3 (Clotrimazole Vaginal) if I’m pregnant or breastfeeding?

B

No evidence of risk in humans

Based on FDA pregnancy categories

FDA pregnancy category B. Clotrimazole vaginal is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Do not use clotrimazole vaginal without medical advice if you are breast-feeding a baby.

Interactions

What drugs and food should I avoid while taking Clotrimazole-3 (Clotrimazole Vaginal)?

Do not have sexual intercourse. This medicine will not prevent the infection from spreading to your partner. Clotrimazole topical can also cause damage to a condom or a diaphragm. These forms of birth control may be less effective if you use them during treatment.

Avoid getting this medicine in your eyes, nose, or mouth.

Avoid wearing tight-fitting, synthetic clothing that doesn’t allow air circulation. Wear clothing made of loose cotton and other natural fibers until the infection is healed.

Dosage Guidelines & Tips

How to take Clotrimazole-3 (Clotrimazole Vaginal)?

Use Clotrimazole-3 (Clotrimazole Vaginal) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

What should I do if I missed a dose of Clotrimazole-3 (Clotrimazole Vaginal)?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

Overdose Signs

What happens if I overdose on Clotrimazole-3 (Clotrimazole Vaginal)?

If you think you or someone else may have overdosed on: Clotrimazole-3 (Clotrimazole Vaginal),  call your doctor or the Poison Control center

(800) 222-1222

If someone collapses or isn’t breathing after taking Clotrimazole-3 (Clotrimazole Vaginal), call 911

911

Find Another Drug

Search prescription drugs, over-the counter medications, and supplements

Medical Disclaimer

Drugs A-Z provides drug information from Everyday Health and our partners, as well as ratings from our members, all in one place. Cerner Multum™ provides the data within some of the Overview, Uses, Warnings, Side Effects, Pregnancy, Interactions, Dosage, Overdose, and Images sections. The information within all other sections is proprietary to Everyday Health. 

Inexpensive and effective tablets for thrush for men and women

THERE ARE CONTRAINDICATIONS. POSSIBLE SIDE EFFECTS. A SPECIALIST’S CONSULTATION IS REQUIRED. Thrush

Author of the article

Khokhrina Kristina Sergeevna, pharmacist

All authors

Content of the article

• For women 9 0014
• For men
• Ask an expert on the topic of the article

Antibiotics, hormones, immunosuppressants help in the treatment of serious diseases. But with irrational or prolonged use, they can be harmful. They disrupt the composition of the intestinal microflora, weaken the immune system, and then mushrooms enter the “scene”. The most common fungal infection is candidiasis, which is caused by yeast-like fungi Candida . In a small amount, they are present in the human body, but when the immune system is weakened, they begin to multiply actively. For example, Candida albicans in 95% of cases is the cause of thrush in women.

Pharmacist Kristina Khokhrina talks about pills that are used to treat candidiasis in men and women.

For women

Thrush or vulvovaginal candidiasis is an inflammation of the mucous membrane of the genital tract caused by a fungus of the genus Candida . The “folk” name of the disease comes from the manifestation of the disease in the form of white curdled discharge. Another characteristic symptom of candidiasis is severe itching and burning in the vulva and vagina. Thrush does not go away on its own; effective and inexpensive drugs in dosage forms have been developed for its treatment:

• oral tablets: Fluconazole, Itraconazole
• topical antimycotics: vaginal suppositories, creams, tablets: Clotrimazole, Pimafucin, Zalain

Oral thrush tablets have advantages and disadvantages over topical medication.

Pros :

• high efficiency
• work in all lesions that can cause a recurrence of the disease, but are not amenable to topical agents
• they can be taken during menstruation
• comfort and ease of reception

Cons :

• serious side effects
• interaction with other drugs in the body

We list drugs in the form of tablets and capsules that are prescribed for the treatment of thrush:

• Diflucan, Fluconazole, Flucostat – the active substance is fluconazole
• Irunin, Orungal, Rumikoz – active substance itraconazole
• Pimafucin, Ecofucin – active ingredient natamycin
• Medicine with fluconazole is considered by doctors as the drug of choice for thrush. It is most active against Candida and well tolerated. In acute candidiasis, a single dose of 150 mg of fluconazole is sufficient to cure.

All products Pimafucin

20 reviews

All products Diflucan

20 reviews

All products Irunin

25 reviews

All products Fluconazole

21 reviews

For men

Candide oz or thrush in men is rare. Signs of the disease: redness, white coating on the glans penis, accumulations of a curdled appearance under the foreskin, severe itching and burning during urination.

Drugs for the treatment of candidiasis in men are practically the same as those used in women. Of course, with the exception of vaginal suppositories and tablets. Patients are prescribed external antifungal drugs – solutions, creams and ointments. If necessary, the treatment is supplemented with oral tablets.

Tablets help to quickly cure thrush, but may have a negative effect on the body. They can only be used as directed by a doctor.

Disease is easier to prevent than to cure. To prevent candidiasis, you need to strengthen the immune system, maintain the intestinal microflora, avoid stress and self-treatment, follow the rules of personal hygiene, be attentive to your health and the health of your sexual partner.

Ask an expert about the topic of the article

Still have questions? Ask them in the comments below and our experts will answer you. There you can also share your experience with other readers of Megasovets.

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what are there and how to choose

The human body is inhabited by many microorganisms that are in a state of necessary balance and coexistence with the host. This balance helps them mutually survive. Any shift in one direction or another, arising from an increase in the number of individual representatives of microorganisms, leads to a violation of the overall composition of the vaginal microflora, and as a result, the occurrence of diseases ¹ . So, with excessive reproduction of yeast-like fungi of the genus Candida, candidiasis (“thrush”) develops – an infectious disease of the mucous membranes and mycosis when the skin is damaged by this pathogen.

Fungal infection of the vulva and vagina is called vulvovaginal candidiasis.

In Russia, vaginal candidiasis ranks second among all infectious lesions of the vagina ² . In the United States and European countries, up to 13 million cases of this disease are registered annually ³ .

Symptoms of vaginal candidiasis (thrush)

As a rule, active reproduction of yeast-like fungi Candida is manifested by:

• itching and burning in the perineum
• swelling and severe redness 14
• vaginal discharge similar to cottage cheese
• pain during
• increased symptoms after showering, before menstruation and during pregnancy

In severe vulvovaginal candidiasis, small blisters with cloudy fluid, called “vesicles”, may appear. They can burst and form damage to the surface layer of the skin – the epithelium ⁴ .

Itching in the intimate area

Why does itching occur in the intimate area, and how to eliminate this unpleasant symptom?

Read more

Causes that provoke the appearance of thrush

Active reproduction of Candida fungi begins due to the influence of the following unfavorable factors, such as:

• Taking medications acceptives, corticosteroids, chemotherapy
• Chronic diseases accompanied by a decrease in immunity: oncology, chronic inflammation of the uterus
• Endocrine diseases : diabetes mellitus, hypothyroidism synthetic tissues, use of an intrauterine device, damage to the tissues of the vagina
• Physiological : pregnancy, menopause
• Psychological : stress, chronic fatigue
• Other : dysbacteriosis, metabolic disorders, climate change, non-compliance with the rules of intimate hygiene

The presence of these factors is not a prerequisite for the occurrence of “ thrush “, but the likelihood of its occurrence and a more severe course of the disease significantly increases. Effective treatment should be complex, that is, not only suppress fungi Candida , but also eliminate the causes that provoked their growth.

Diagnosis of vaginal candidiasis

Diagnosis is carried out by a gynecologist based on visual examination, patient complaints and laboratory test results that identify the type of fungi, their number and response to various antifungal drugs. The combination of these methods allows you to choose the most effective treatment.

Vaginal candidiasis can be acute or chronic. The acute form of candidiasis is characterized by pronounced manifestations of the disease, and the duration does not exceed two months. If the treatment is chosen incorrectly, the disease may last longer or constantly return. Then the disease has a chronic course. Therefore, it is very important to choose the right drug for treatment, which will not cause fungi to become addicted to it.

How to treat vaginal candidiasis (thrush)?

For the treatment of thrush, both systemic agents (tablets for oral administration) and local agents are used, which are injected directly into the site of infection – vaginal suppositories and tablets, irrigation solutions, ointments.

The most commonly used in gynecological practice are vaginal suppositories, the main advantages of which are:0014

What are suppositories for thrush

The main difference between vaginal suppositories is a different active substance, due to which there are different therapeutic effects.

Conventionally, drugs that are part of suppositories for thrush can be divided into the following groups:0014

Consider the mechanisms of action and properties of suppositories based on the above drugs.

Candles against thrush based on antiseptics

Povidone-iodine (Betadine®)

Povidone-iodine is an antiseptic. It is a complex of iodine and povidone. Thanks to this formula, upon contact with the skin and mucous membranes, active iodine is gradually released from povidone, which ensures a long-term effect of the drug ⁵ .

The mechanism of action of the drug is based on the inactivation and destruction of the main proteins and enzymes that make up the cells of harmful microorganisms. As a result, a fungicidal effect occurs – the death of the fungus. Most pathogens can die within 1 minute ⁶ . Biofilms are combinations of microorganisms that create a protective “dome” that prevents the penetration of drugs. Candles Betadine ^® based on povidone-iodine demonstrate efficacy against such microorganisms that are capable of forming biofilms.

Often, the ineffectiveness of the treatment of thrush is associated with the “addiction” of fungi to a particular drug. According to the results of studies, povidone-iodine does not cause the development of resistance – the insensitivity of microorganisms to the effects of drugs ⁷ .

It happens that candidiasis (thrush) is combined with other infections, such as bacterial vaginosis. The wide spectrum of action of suppositories Betadine ^® allows you to treat even such concomitant diseases.

For the treatment of vaginal candidiasis, 1 suppository is inserted into the vagina at night for 7 days. Before treatment, it is necessary to consult a doctor, as the drug has contraindications.

Thus, suppositories based on povidone-iodine (Betadine ^® ) meet the modern requirements of medicines. The drug in many patients demonstrates good tolerance ⁹ , and also supports the ability to restore the vaginal microflora ⁸ .

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Vaginal tablets based on dequalinium chloride

Dequalinium chloride is an antiseptic preparation, the mechanism of action of which is based on the disruption of the fungal cell enzymes, which subsequently leads to the death of the fungal cell.

The drug is active against gram-positive and gram-negative bacteria , fungi and viruses. Has an anti-inflammatory effect.

For the treatment of thrush 1 vaginal tablet is administered intravaginally for 6 days ¹³ . You must complete the full course.

Disadvantages of the drug: in case of excessive dryness of the vagina, there is a possibility that the tablet will remain undissolved, local reactions of irritation, itching, burning or redness of the vaginal mucosa may be observed.

It should be noted that today there is a decrease in the effectiveness of a number of antiseptics with a chlorine-containing molecule ¹⁰ .

Suppositories for thrush based on preparations of the azole group

Suppositories based on sertaconazole

Sertaconazole is a derivative of imidazole and benzothiophene. The drug is active against yeast-like fungi of the genus Candida , streptococci and staphylococci ¹⁴ .

Sertaconazole has a triple effect : inhibits the growth and reproduction of fungi (fungistatic action), causes the death of fungi (fungicidal action) and does not suppress the viability of the main representatives of the normal vaginal microflora – beneficial lactobacilli.

When administered topically, sertaconazole has a direct effect on fungi in the lesion. At the same time, it is not absorbed into the bloodstream, which means a high safety profile of the drug.

Mechanism of action of sertaconazole is to inhibit the synthesis of ergosterol and increase the permeability of the fungal cell membrane, which leads to its death.

For the treatment of thrush, suppositories with sertaconazole are used 1 time by inserting 1 suppository into the vagina. If symptoms persist, it is possible to re-introduce 1 suppository after another 7 days.

Suppositories based on ketoconazole

Ketoconazole is an antimycotic (antifungal) drug of the azole group.

Mechanism of action has a fungistatic and fungicidal effect.

However, fungal resistance to ketoconazole may develop and the disease may become chronic with exacerbations.

For the treatment of thrush, 1 suppository is inserted into the vagina for 3-5 days ¹⁵ .

It is important to follow the treatment regimen prescribed by the doctor, since incomplete therapy can contribute to the development of a chronic form of the disease.

Anti-thrush suppositories based on polyene antibiotics

Natamycin suppositories

Natamycin is an antifungal polyene antibiotic. It has a wide spectrum of antifungal activity, causes the death of fungi.

The mechanism of action of natamycin is based on disruption of the integrity and functioning of fungal cell membranes. The drug is active against most yeast fungi of the genus Candida. Dermatophytes – molds have less sensitivity to natamycin.

Apply the drug by inserting one suppository into the vagina 1 time / day at night for 3-6 days ¹⁶ .

The duration of the course is determined by the attending physician. It is not recommended to interrupt treatment immediately after the disappearance of symptoms.

Suppositories for thrush based on combined preparations

Suppositories based on the combination of nystatin + nifuratel

Suppositories based on nystatin and nifuratel are antimicrobial agents. This combination allows you to increase the spectrum of antibacterial action and enhance the antifungal effect. Also, the drug has antimicrobial and antiprotozoal activity.

The agent does not disturb the vaginal microflora, but helps to restore it. This allows you to avoid the occurrence of dysbacteriosis and cure diseases caused by a violation of the vaginal flora.

In the treatment of thrush, 1 suppository at bedtime is inserted into the upper part of the vagina for 8 days. During menstruation, the use of suppositories is suspended and resumed after the completion of critical days.

Suppositories based on the combination of metronidazole + miconazole

Combination preparation for vaginal use with antifungal, antibacterial and antiprotozoal activity.

The combination of these drugs allows you to actively influence the membrane of fungal cells, causing their death, as well as treat infections caused by several microorganisms.

The agent is injected into the vagina 1 suppository in the morning and evening for 7 days. There may be a local reaction in the form of itching, burning, irritation of the vaginal mucosa.

Conclusion

Before using any suppositories, you should consult with your doctor, since each drug has contraindications and its own dosage regimen, depending on the individual characteristics of the course of the disease.

Of course, it is worth giving preference to preparations with a broad spectrum of activity against fungal biofilms that remain effective against even drug-resistant microorganisms (for example, suppositories Betadine ^® based on povidone-iodine, suppositories based on sertaconazole).

Molchanov Oleg Leonidovich

Gynecologist, reproductive specialist, doctor of medical sciences.

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References

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