Yeast infection pills: Brands, costs, and when you need a prescription

In this article:

• Do you need a prescription for yeast infection pills?
• Which yeast infection pills are available?
• Yeast infection pill alternatives

In this article

• Do you need a prescription for yeast infection pills?
• Which yeast infection pills are available?
• Yeast infection pill alternatives

Vaginal yeast infections, otherwise known as vulvovaginal candidiasis, are caused by the overgrowth of a fungus called Candida. These fungal infections can cause very uncomfortable symptoms, including intense itching, thick, chunky discharge, and pain with sex. Thankfully, there are several different effective ways to treat yeast infections, including over-the-counter antifungal medications, lifestyle modifications, and prescription medications.

One of the most effective ways to treat a yeast infection is with yeast infection pills. These pills generally work quickly and are much less messy than the ointments and creams often recommended for treatment. The most common yeast infection treatment pill is Diflucan (fluconazole). Treatment with Diflucan usually eliminates yeast infections within 24 to 72 hours. But Diflucan isn’t the only option. For hard-to-treat or chronic yeast infections, your healthcare provider might recommend other yeast infection treatment pills, such as Vivjoa (oteseconazole) and Brexafemme (ibrexafungerp).

Here, we’ll discuss everything you need to know about pills for yeast infections and alternative treatment options.

Do you need a prescription for yeast infection pills?

Yes, yeast infection pills like Diflucan require a prescription. But there are many over-the-counter creams and ointments available to treat yeast infections. These include popular choices like Vagisil and Monistat, found at most drug stores.

“It is always acceptable to try an over-the-counter remedy (OTC) like Monistat for new onset of symptoms,” says Sheetal J. Dedania, MD, OB-GYN, and physician manager at Reiter, Hill & Johnson of Advantia. Still, sometimes these treatments don’t work well enough. At other times, you may have a yeast infection that keeps recurring. In these cases, a yeast infection pill might be advised.

“If the symptoms are not alleviated with the OTC treatment, then I would recommend following up with a healthcare provider for an evaluation and potential prescription for Fluconazole,” Dr. Dedania recommends. However, keep in mind that there are no over-the-counter yeast infection pills. All yeast infection pills need to be prescribed by a health professional.

Although there are many over-the-counter yeast infection remedies available, some physicians prefer to stick with prescription yeast infection treatments in most cases. Still, this doesn’t necessarily mean yeast infection pills. There are prescription yeast infection creams as well, such as ​​Terazol (terconazole) and Gynazole-1 (butoconazole). These medications are applied topically to the vagina, rather than taken in pill form.

“I would prefer the prescription pill or the prescription cream in practically all cases,” explains Donna Adams-Pickett, PhD, MD, board certified OB-GYN at Augusta Women’s Health & Wellness Center. Dr. Adams-Pickett says that a significant percentage of her patients report localized irritation, discomfort, and burning with some over-the-counter yeast infection treatments. “It is my personal preference that patients seek one of the prescription creams or the pill.”

Which yeast infection pills are available?

While Diflucan is by far the most commonly prescribed yeast infection pill, there are other options as well, such as Vivjoa (oteseconazole) and Brexafemme (ibrexafungerp). But these are generally only used if Diflucan doesn’t work or if you are experiencing chronic yeast infections. Importantly, these Diflucan alternatives can’t be used by pregnant women or by anyone who may become pregnant in the future.

Here’s what to know about yeast infection pills.

Diflucan (fluconazole)

Diflucan is the brand name for fluconazole. It’s the most commonly used pill for vaginal yeast infections. It’s typically prescribed as one 150 mg dose that you take by mouth. But it can also be given via intravenous injection. While one dose usually eliminates symptoms in 24 to 72 hours, some people will need more than one dose, or may need to take daily doses of Diflucan for several weeks.

Diflucan typically works well for people, with few side effects. Common side effects include headaches, nausea, dizziness, and gastrointestinal upset. “It’s effective and well tolerated,” says Jung Baccam FNP-BC, a board-certified family nurse practitioner at Atlas Ketamine. “I rarely use other oral antifungals unless fluconazole isn’t appropriate.”

Healthcare professionals also feel confident in the fact that Diflucan has been around for many years, whereas Diflucan alternatives are newer. “The pill fluconazole is quite effective and has been around for quite some time, so we have had a chance to look at the side effects and success in controlling infection,” Dr. Adams-Pickett says.

Most health insurance companies cover Dilfucan, though you may need to pay a copayment or coinsurance.

Vivjoa (oteseconazole)

Vivjoa is the brand name for oteseconazole. It’s prescribed for people who experience recurrent vaginal yeast infections. But there are some important caveats. “Oteseconazole should only be used in patients who have no possibility of becoming pregnant,” Dr. Adams-Pickett says. It should also not be used in people who are currently pregnant.

Vivjoa is taken over a period of weeks. It’s usually taken as four capsules on the first day, three capsules on the second day, and then one capsule a week for 11 weeks, though sometimes these doses are spread out over different intervals. Side effects include headaches, indigestion, nausea, and hot flashes.

Another point to keep in mind, according to Dr. Adams-Pickett, is that many pharmacies don’t carry Vivjoa, and it can be quite costly. 

Brexafemme (ibrexafungerp)

Brexafemme is the brand name for ibrexafungerp, an anti-fungal medication prescribed to treat resistant and recurrent vaginal yeast infections.. Like Vivjoa, pregnant women or people who may become pregnant should not take Brexafemme.

For resistant yeast infections, the dose is typically two 150 mg tablets taken 12 hours apart. The medication is taken monthly for six months to reduce recurrent yeast infections. Side effects include nausea, stomach pain, dizziness, diarrhea, and vomiting.

Similar to Vivjoa, Dr. Adams-Pickett says that it can be hard to find Brexafemme in pharmacies. 

Yeast infection pill alternatives

Yeast infection pills are not the only way to treat yeast infections. There are several prescription creams, over-the-counter antifungal medications, and at-home remedies.

Topical treatments

Topical treatments are creams and ointments that you apply directly to the vagina or vulva or that you apply via a suppository. “I recommend these when oral meds aren’t suitable or if symptoms are mostly external,” Baccam says.

Prescription topical treatments include Terazol (terconazole) and Gynazole-1 (butoconazole). The most commonly used over-the-counter optical treatments are Vagisil and Monistat. Your healthcare provider or pharmacist can help you determine the best treatment options for you.

While these treatments work well enough for many, sometimes a yeast infection pill is a better option. “If the symptoms are not alleviated with the OTC treatment, then I would recommend following up with a healthcare provider for an evaluation and potential prescription for Fluconazole,” Dr. Dedania says.

Lifestyle modifications

There are some lifestyle modifications that can be helpful when it comes to treating and preventing yeast infections. Here’s what Dr. Dedania and Dr. Adams-Pickett recommend:

• Eating more foods with probiotics, such as yogurt
• Decreasing sugar in your diet
• Avoiding irritants like high-fragrance soap and detergents
• Wearing cotton underwear
• Avoid wearing wet bathing suits or damp athletic clothing
• Avoid restrictive clothing
• Avoid unnecessary use of antibiotics

If you have further questions about yeast infection treatments, you should seek medical advice from a doctor, pharmacist, or other trusted healthcare provider.