The most common medicine for a vaginal yeast infection is either an antifungal cream applied inside the vagina or a single pill taken by mouth. Over-the-counter creams containing miconazole or clotrimazole and the prescription pill fluconazole are the standard first-line treatments, clearing symptoms in 80% to 90% of women who complete therapy. Most infections improve within a few days, though a full course can take up to a week.
Over-the-Counter Creams and Suppositories
For a straightforward yeast infection, you can start treatment without a prescription. The two most widely available active ingredients are miconazole (sold as Monistat and generics) and clotrimazole. Both come in creams and vaginal suppositories, and both work by blocking the production of ergosterol, a building block that fungal cells need to keep their membranes intact. Without it, the yeast cells can’t maintain themselves and stop growing.
These products are sold in 1-day, 3-day, and 7-day versions. All concentrations are considered equally effective at clearing the infection, but they deliver very different amounts of medicine per dose. The 7-day miconazole contains 100 mg per application, while the 1-day version packs 1,200 mg into a single dose. That concentrated hit sometimes causes a contact-like irritation, with burning and inflammation that can feel like the infection is getting worse. Some doctors steer patients toward the 3-day or 7-day options for this reason, though no formal guidelines recommend one duration over another.
A third OTC option is tioconazole, an ointment applied in a single dose.
Fluconazole: The Prescription Pill
If you prefer not to use a cream, fluconazole is a single 150 mg pill that treats vaginal yeast infections from the inside. It’s the most commonly prescribed oral antifungal and works through the same mechanism as the topical creams, starving yeast of the ergosterol they need to survive.
Common side effects are mild: nausea, headache, stomach pain, diarrhea, or a temporary change in taste. Serious reactions are rare but can include liver problems (watch for dark urine, yellowing skin, or unusual fatigue) and heart rhythm changes. Fluconazole also interacts with several other medications, so let your provider know what you’re taking before filling the prescription.
Prescription Creams
When OTC products aren’t the right fit, a few prescription-only topical options exist. Terconazole comes as a cream or suppository used for 3 to 7 days. Butoconazole is available as a single-dose bioadhesive cream that sticks to the vaginal walls and releases medicine over several days. These are typically reserved for cases where OTC treatments haven’t worked or when a provider suspects a less common yeast strain.
Treatment During Pregnancy
About 10% of women develop a vaginal yeast infection during pregnancy. Topical antifungal creams are the recommended first-line treatment. Oral fluconazole carries meaningful risks in early pregnancy: a single dose has been linked to more than double the risk of miscarriage, and doses of 150 mg or higher during the first trimester are associated with an increased risk of heart defects in the newborn. For pregnant women, sticking with a topical cream like miconazole or clotrimazole is the safest choice.
What to Do for Recurring Infections
If you get four or more yeast infections in a year, the standard single-dose approach usually isn’t enough. Providers often prescribe additional doses of fluconazole spread over time, or switch to a different strategy altogether. Boric acid vaginal capsules are one well-studied option for recurrent infections and for strains that resist standard antifungals, particularly Candida glabrata. The typical protocol is one capsule inserted vaginally each night for two weeks, followed by twice-weekly use for 6 to 12 months to keep the infection from returning.
A newer oral medication, ibrexafungerp, was specifically approved both to treat vaginal yeast infections and to reduce the chance of recurrence. It works differently than azole drugs, killing yeast by disrupting their cell walls rather than their membranes. The treatment dose is two 150 mg tablets taken twice in one day, about 12 hours apart. It’s available for adults and adolescents who have started menstruating.
Yeast Infections in the Mouth and Throat
Not all yeast infections are vaginal. Oral thrush, a yeast overgrowth in the mouth and throat, is treated with antifungal gels or lozenges applied directly inside the mouth for 7 to 14 days. Clotrimazole, miconazole, and nystatin are the usual choices for mild to moderate cases. Severe oral infections typically require fluconazole in pill form.
Yeast infections that spread to the esophagus, causing pain with swallowing, are almost always treated with oral fluconazole as well. These deeper infections are more common in people with weakened immune systems and generally require a longer course of treatment than a vaginal or oral infection.
How Quickly the Medicine Works
Most people notice itching and discomfort starting to ease within the first two to three days of treatment. A full resolution typically takes about a week for uncomplicated infections. More severe cases can take longer. If your symptoms don’t improve after finishing a course of treatment, or if they come back quickly, the infection may involve a resistant yeast strain that needs a different medication.