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Azoles for Treating Thrush

Examples

Generic Name Brand Name
clotrimazole Mycelex
fluconazole Diflucan
itraconazole Sporanox
posaconazole Noxafil
voriconazole VFEND

These prescription medicines are available as:

  • A mouth rinse that is put directly on the infected area (topical).
  • A lozenge that dissolves in the mouth (topical).
  • A tablet that is swallowed (oral).

How It Works

Azoles stop the growth of the yeast that causes thrush. This gives the body's immune system a better chance to destroy the yeast.

Why It Is Used

These medicines may be used for cases of thrush that have not responded to nystatin (a polyene).

How Well It Works

Azoles are effective in curing thrush, especially when other topical treatment has not been helpful.

Fluconazole, posaconazole, and voriconazole can cure thrush that has spread into the esophagus.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor right away if you have:

  • Hives.
  • A rash or itching.
  • Fever and/or chills.

Side effects of azoles are not common in otherwise healthy people. Side effects may include:

  • Constipation.
  • Diarrhea.
  • Feeling dizzy or sleepy.
  • Headache.
  • Nausea or vomiting.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Certain medicines can interact with azoles. This can make the azole less effective or can cause problems with the liver. Some of these medicines include:

  • Some ulcer medicines (sucralfate and acid reducers).
  • A seizure medicine called phenytoin (Dilantin).
  • A tuberculosis medicine (rifampin).
  • A medicine used to prevent rejection in organ transplants (cyclosporine).
  • A blood thinner called warfarin (Coumadin).

Tell your doctor if you take cisapride or dofetilide. Taking any of these medicines along with an azole may raise the risk of serious side effects that affect the heart.

Voriconazole may cause some people to have changes in vision, such as blurred vision and seeing bright spots or wavy lines. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you have vision changes.

If you take posaconazole, your doctor will likely do liver function tests during the time you take this medicine.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.

Women who use voriconazole during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant or planning to get pregnant, you and your doctor must weigh the risks of using this medicine against the risks of not treating your condition.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Credits

By Healthwise Staff
Primary Medical Reviewer Susan C. Kim, MD - Pediatrics
Specialist Medical Reviewer Thomas Emmett Francoeur, MD, MDCM, CSPQ, FRCPC - Pediatrics
Last Revised May 14, 2012

Last Revised: May 14, 2012

Author: Healthwise Staff

Medical Review: Susan C. Kim, MD - Pediatrics & Thomas Emmett Francoeur, MD, MDCM, CSPQ, FRCPC - Pediatrics

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