# Vaginal candidiasis (vulvovaginal thrush) - Category: infectious - Review status: reviewed (every claim checked against a document named on this page) - Sources: CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Vulvovaginal Candidiasis - Recommended Regimens, Oral Agent · Egyptian National Drug Formulary - Antimicrobial 2023 (clotrimazole monograph) - Verified date: 2026-08 ## Verified against - CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Vulvovaginal Candidiasis - Recommended Regimens, Oral Agent - Egyptian National Drug Formulary - Antimicrobial 2023 (clotrimazole monograph) - Vaginal Candidiasis - disease-level clinical article (vaginal-candidiasis-clinical.txt) ## Treatment metadata - Fluconazole — 150 mg — oral.solid - Clotrimazole — 100 mg — vaginal - Referral & safety-netting (no drug therapy) ## Complete treatment card ```text VAGINAL CANDIDIASIS (VULVOVAGINAL THRUSH) Sources: CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Vulvovaginal Candidiasis - Recommended Regimens, Oral Agent · Egyptian National Drug Formulary - Antimicrobial 2023 (clotrimazole monograph) Review status: REVIEWED against CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Vulvovaginal Candidiasis - Recommended Regimens, Oral Agent, Egyptian National Drug Formulary - Antimicrobial 2023 (clotrimazole monograph), Vaginal Candidiasis - disease-level clinical article (vaginal-candidiasis-clinical.txt) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (2) - Vulvovaginal itching, burning, and irritation are the hallmark symptoms and often worsen just before menses [itching] - Many patients have had the same symptoms before and have already tried an over-the-counter antifungal SIGNS - what you find (4) - Vulvar and vaginal redness with a thick, white, clumped discharge and swelling are the typical findings [redness] - The cervix looks normal, without cervical motion tenderness or abnormal discharge from the os - Candida glabrata infection tends to cause only mild symptoms, unlike typical acute candidiasis - An ulcer, asymmetric swelling, a mass, or a foreign body on exam should raise a different diagnosis [foreign body] TESTS (4) - Vaginal pH under 5 is typical of a yeast infection - A negative whiff test with budding yeast or hyphae seen on a KOH prep supports the diagnosis - Culture is reserved for recurrent disease or a negative work-up despite classic symptoms - Culturing an asymptomatic woman is discouraged since Candida can be a normal vaginal resident IF NOT THIS - what else fits (2) - Lichen simplex chronicus is on the differential for vulvar itching and irritation - Physiologic leukorrhea is a normal-discharge differential to distinguish from a yeast infection Source StatPearls "Vaginal Candidiasis" - disease-level clinical article Status traced to the source above Rx: Not pregnant | In pregnancy | Main treatment NOT PREGNANT 1. FLUCONAZOLE [1st line] Adult 150 mg single oral dose - Single dose Peds Not routinely indicated for vaginal candidiasis in pre-pubertal children Source CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Vulvovaginal Candidiasis - Recommended Regimens, Oral Agent Why Convenient single-dose oral treatment of choice for uncomplicated candidiasis Caution CONTRAINDICATED in pregnancy (use topical azole instead). Caution with concurrent CYP3A4/CYP2C9 metabolized drugs. In severe/recurrent cases, repeat 150 mg dose after 72 hours. Egypt JENFUNGA 150 MG 1 CAPS. EGPI > JENIKO... 4.50 EGP (4.50/unit) AMRIFLUCAN 150 MG 2 CAPS. AMRIYA 11.00 EGP (5.50/unit) FLUDCONRIZOLE 150 MG 1 CAPS. RIVA PHARMA S... 6.00 EGP (6.00/unit) FLUCORAL 150 MG 4 CAPS. SEDICO 60.00 EGP (15.00/unit) TRICONAL 150 MG 1 CAPS. T3A PHARMA > ... 26.50 EGP (26.50/unit) NAVILUCA 150 MG 2 CAPS. INTERNATIONAL... 69.00 EGP (34.50/unit) NAZOWELL 150 MG 3 CAPS. EGPI > HEALTH... 108.00 EGP (36.00/unit) DIFLUCAN 150 MG 1 CAPS. PFIZER 111.00 EGP (111.00/unit) DIFLUNAZOLE 25MG/5ML SYRUP 70ML CID 28.80 EGP -> ? strength differs, ? different route - not oral solid FLUCAZONIL 25MG/5ML SYRUP 70 ML EL NILE. 28.80 EGP -> ? strength differs, ? different route - not oral solid IN PREGNANCY 2. CLOTRIMAZOLE [1st line] Adult Insert 100 mg vaginal pessary at bedtime for 6 nights (or 500 mg single dose) x 6 nights (or 1 night for 500 mg) Peds Pediatric vulvovaginitis requires specialist evaluation Source Egyptian National Drug Formulary - Antimicrobial 2023 (clotrimazole monograph) Why Topical azole preferred in pregnant women Caution MSF Essential Drugs 2024 records no contra-indication in pregnancy, with one proviso: do not use the applicator, which can damage the cervix. Insert with a finger, not the applicator. May damage latex condoms and diaphragms. Local vaginal burning or irritation may occur. Egypt CANDISTAN 100 MG 6 VAG.TABS. ARAB DRUG COM... 9.00 EGP KREMA-ROSA 100MG 6 VAG.TABS. EIPICO 10.50 EGP LOCASTEN 100 MG 6 VAG. TABS. ALEXANDRIA 10.50 EGP MAIN TREATMENT 3. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Vaginal Candidiasis - disease-level clinical article (vaginal-candidiasis-clinical.txt) Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution RED FLAG - Persistent symptoms after standard treatment require fungal culture to evaluate for non-albicans Candida species. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)