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HomeHealth ConditionsYeast Infection

Yeast Infection Medicine: Is OTC Monistat (Miconazole) or Prescription Diflucan (Fluconazole) Better for Yeast Infections?

Katie MuiChristina Aungst, PharmD
Written by Katie Mui | Reviewed by Christina Aungst, PharmD
Updated on September 13, 2021

Key takeaways:

  • Yeast infection medicines such as over-the counter (OTC) creams or a prescription pill — called Diflucan (fluconazole) — are similarly effective in treating yeast infections. The pill may be less messy, but it requires a prescription.

  • Avoid natural remedies, and see your healthcare provider if treatment doesn’t help your symptoms.

  • There are many ways to save on yeast infection medicines. Many options are available as lower-cost generics and have copay savings opportunities. GoodRx can help make your prescription more affordable.

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If you’re experiencing thick discharge and genital itching or burning, there’s a chance you could have a vaginal yeast infection. This type of infection is very common, affecting 3 out of 4 people with internal reproductive organs at some point during their lives. But common or not, you probably want to know how to get rid of it.

There are several different yeast infection medicines to choose from — some are available over-the-counter (OTC) and others require a prescription. But which one is most likely to work best for you?

Here, we’ll discuss the various available yeast infection medicines on the market and how they compare to one another.

What causes a yeast infection?

Yeast infection medicines are used to treat genital yeast infections, which are most often caused by Candida albicans, a type of yeast (fungus) that’s naturally found in the vagina of most people assigned female at birth. It’s also naturally found on the skin and in other parts of the body. However, an overgrowth of Candida can lead to a common fungal infection called a vaginal yeast infection, or vaginal candidiasis.

While the exact cause of a yeast infection can be different for each infection you experience, there are certain health conditions and medications that can raise your risk of this happening. The following people may have a higher risk of developing a yeast infection:

  • Pregnant people

  • People using hormonal birth control

  • People who have diabetes

  • People with weakened immune systems, such as people living with cancer or HIV

  • People who have recently taken antibiotics

Telltale signs of a yeast infection may include the following:

  • Itching or soreness in or around the internal reproductive opening

  • Pain during sex

  • Pain while urinating

  • Thick, white discharge that may have an odor

Given how unpleasant these symptoms can be, it’s no surprise that people want to get the best possible yeast infection medicine. Below, we’ll compare popular yeast infection medicines, including prescription and OTC options.

Monistat and other OTC yeast infection medicines 

Topical yeast infection medicines — called azole antifungals — are available both OTC and with a prescription. Most OTC options contain one of the following medications:

Monistat (miconazole) is a popular brand of OTC yeast infection products, which comes in different strengths and forms. These include:

  • Ovule® form, which is a medication shaped like an egg that is inserted into the vagina

  • Suppository, or a medication that melts or dissolves once inserted into the vagina

  • Cream, which is applied with an applicator

Which form of yeast infection medicine you choose should be based on what you find more comfortable to use, as suppositories and creams were found to work similarly well in one study.

These topical yeast infection medicines are available in 1-day, 3-day, and 7-day regimens. If your symptoms are milder, 1- or 3-day versions should be enough to treat it. But if your symptoms are more severe, you may require the 7-day course. It’s best to check with your healthcare provider if you aren’t sure how long you should use topical OTC yeast infection medicines.

How much do OTC yeast infection medicines cost?

There are many ways to save on yeast infection medicines. GoodRx can help you navigate your options, which may include GoodRx discounts, copay savings cards, and patient assistance programs. Details on how to save can be found below.

Monistat and other OTC yeast infection medicines

By asking your healthcare provider to write a prescription for OTC Monistat, you can apply a free GoodRx coupon to help you save on it. GoodRx can help you save over 60% off the average retail price of the generic version of Monistat.

Diflucan and other prescription medicines for yeast infections

The most commonly prescribed oral yeast infection medicine is Diflucan. It’s also available as fluconazole, a lower-cost generic version. It’s thought to be similarly effective to the OTC creams mentioned above. But, because the creams can get messy, some people prefer an antifungal pill.

There are many ways to save on Diflucan. GoodRx can help you navigate between the various savings opportunities.

  • Save with GoodRx. GoodRx can help you save over 70% off the average retail price of the generic version. Generic Diflucan’s price at certain pharmacies is less than $7 with a free GoodRx discount.

  • Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Diflucan’s patient assistance program, which offers the medication free of cost.

Brexafemme

The newest prescription yeast infection medicine available is Brexafemme (ibrexafungerp). This oral pill works differently than other yeast infection medicines, making it an option if you are prone to yeast infections or have had a hard time treating yeast infections in the past. In studies, Brexafemme was found to be similarly effective to fluconazole (Diflucan).

A course of Brexafemme consists of four tablets — you take two tablets 12 hours apart from each other. So within 24 hours, you’re done with your prescription.

GoodRx can help you save on Brexafemme, which is only available as a brand-name medication. If you have commercial insurance, you may be eligible to pay as little as $30 for Brexafemme using a savings card from the manufacturer. If you don’t have insurance, you may be eligible to pay as low as $120.

Prescription yeast infection creams and suppositories 

There are some antifungal creams you can get with a prescription, but they're not as popular. These can include: 

While some may claim these prescription creams are stronger or work better, studies and guidelines have shown this isn’t always true. Current research suggests that topical yeast infection medicines — both OTC and prescription — work similarly well.

There are many ways to save on prescription-only antifungal creams. You can find yeast infection cream prices as low as $21 with a free GoodRx discount.

Which yeast infection medicine is better: Monistat or Diflucan?

While it can be tempting to go to the pharmacy and pick up an OTC yeast infection medicine right away, this may not be the best idea. Yeast infection symptoms can be similar to urinary tract infection (UTI) symptoms for some people, and yeast infection medicine won’t treat a UTI. It’s best to contact your healthcare provider before treating symptoms on your own.

Depending on your medical and medication history, your healthcare provider may ask you which yeast infection medicine you would prefer to use, since fluconazole (Diflucan) and Monistat work similarly well. If your provider allows you to choose between these options, you should consider what you’re more comfortable using. 

Here are some questions to consider with your healthcare provider so you can decide which yeast infection medicine is best for you:

  • Are you able to use or comfortable using a vaginal applicator? If this is an issue, Monistat and other creams or suppositories may be more difficult for you to use.

  • Do you tend to be sensitive to stomach side effects (e.g., upset stomach, diarrhea, etc.) when taking oral pills? These types of side effects are more common when taking Diflucan. We’ve included more information on side effects below. 

  • How severe are your symptoms? Your healthcare provider’s recommendation may be different depending on how you’re feeling.

  • How often do you experience yeast infections? Your provider may suggest using a different yeast infection medicine than last time, especially if your last infection wasn’t too long ago.

Why does my yeast infection medicine burn? 

The last thing to consider are potential side effects. Side effects can vary between yeast infection medicines, depending on which form you’re using (cream or oral pill).

The most common side effects of Monistat are: 

  • Burning where you applied the cream

  • Itching where you applied the cream

  • Irritation during or after applicator insertion

Because you apply Monistat directly where the yeast infection is happening, skin and genital irritation can occur. This is expected and should go away once you’re done using the medicine.

The side effects of Diflucan are different. People taking Diflucan for yeast infections most commonly experience:

  • Headache

  • Nausea

  • Stomach pain

Yeast infections medicines are generally well-tolerated. But just as with other medicines, an allergic reaction is possible. Stop using your yeast infection medicine and contact your healthcare provider right away if you experience any of the following:

  • Shortness of breath

  • Coughing

  • Wheezing

  • Fever

  • Rash

  • Swelling

  • Hives

  • Blisters 

How long do yeast infection medicines like Monistat and Diflucan take to work?

If it’s a yeast infection, the yeast infection medicines we’ve covered — like OTC creams and fluconazole (Diflucan) — work more than 90% of the time. You should feel relief within 5 to 7 days of your first dose, but you may get relief faster if your infection is on the milder side. 

If your symptoms don’t resolve with yeast infection medicine after a week, you should contact your healthcare provider. They may need to do additional testing to determine what strain of yeast is causing your infection and what medicine would best treat it.

What about using non-antifungal medicines for yeast infections? 

There are many OTC products (such as Vagisil or Summer’s Eve) targeted toward vaginal issues, like itchiness and irritation. It’s important to read the labels carefully. Many wipes, ointments, and gels may only help you get temporary relief but won’t actually treat the infection itself.

Experts recommend avoiding natural remedies and other non-antifungal products for yeast infections, with one notable exception. For people who experience frequent or hard-to-treat yeast infections, healthcare providers may sometimes prescribe boric acid if all other yeast infection medicines have failed. This product would need to be made by a compounding pharmacy — it’s not recommended to try it on your own.

The bottom line

Yeast infection medicines — like OTC creams and prescription pills — are effective for yeast infections. Some people prefer the pills because they are less messy than the creams. However, the pills require a prescription. Either way, it’s best to stay clear of natural remedies, which won’t actually treat the yeast infection. 

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