The Ultimate Resource for Fungal and Yeast Infections

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Prescription Drug Overview

Overview Of Prescription Drugs Used For Treating Fungus, Yeast, And Candida Infections

Please see the associated page “Prescription Fungal Drugs” for detailed information.


Fluconazole (Diflucan)
(a triazole )

IV, Oral

Fungistatic against Candida, not fungicidal.
Well tolerated.
15%C. glabrata completely resistant to fluconazole
C. krusei is intrinsically resistant to fluconazole.
Std dose = 400mg/d; if C glabrata, dose should be 800 mg/d
Doses can be as high as 12 mg/kg -- for a 150 lb. person
     (70 kg)  = 840 mg/d)
For vulvovaginal candidiasis 150 mg single dose therapy
Only azole to cross blood-brain barrier to treat central nervous
      system infections

Voriconazole (Vfend)
(a triazole )

IV, Oral

New, structurally similar to fluconazole
Fungistatic against Candida, not fungicidal
Enhanced activity against fluconazole-resistant C. Glabrata
Dose at 200 mg/twice day

Itraconazole (Sporanox)
(a triazole )

IV, Oral (Capsules & Oral Solution)

Fungistatic against Candida, not fungicidal
Highly lipophilic – poor penetration into aqueous fluids
Capsule form has unpredictable absorption
     -- Oral Solution preferred
Dose at 100-400 mg/d. For 400 mg/d take 200 mg/twice/day

Ketoconazole (Nizoral)
(an imidazole)


Fungistatic against Candida, may be fungicidal
      at high doses

Highly lipophilic – poor penetration into aqueous fluids
Stronger liver toxicity than for fluconazole or itraconazole.
Less toxic than amphotericin-B; used for similar fungal
May decrease testosterone and cortisol levels
Dose at 200-400 mg once/day. Can increase to 600-800
     mg/day with increased risk of toxicity

(an imidazole)


Fungicidal against Candida.
Available as a troche (lozenge) for oropharyngeal Candidiasis
Dosage: 10 mg five times per day

Miconazole (Monistat)
(an imidazole)

Topical, oral gel

Effective against Candida - fungicidal at
     higher dosages.

Widely used topically for skin and vaginal yeast infections
Oral gel used for oral Candidiasis in some countries.
Not absorbed well orally -- not generally available in this form.
No hormonal side effects.
No hepatoxicity (liver)
Frequent hypersensitivity - fever and chills, skin rash or itching



Fungistatic, not fungicidal
Transports in aqueous media. Complements lipophilic drugs.
Use in combination with another drug to avoid building
Resistance by Candida is possible.
Dose at 25-37.5 mg/kg four times daily (100-150 mg/kg/day).

Nystatin (Mycostatin, Nilstat)
(a polyene)

Oral tablets, powder, solution

Not absorbed. Useful for GI infections only.
4 tabs (500,000 IU's each) four times daily or equivalent oral
     suspension (500,000 IU's per 5 ml)

(a polyene)


High toxicity to liver – most toxic anti-microbial in clinical use
AmB is the most potent antifungal available.
AmB Not absorbed by GI tract -- must use IV formulation for
     systemic treatment

(a polyene)


Lipid formulation of AmB
Can deliver higher concentrations with lower toxicity than

(a polyene)

Oral solution, Capsule

No longer available in capsule & suspension forms in US
     except from compounding pharmacies
Oral AmB absorption is negligible, not for systemic use
      -- for GI infections only.
AmB is the most potent antifungal available.
Safe: Oral formulation for GI infections avoids toxicity
      of IV formulation.
   Oral suspension: 100 mg (1 ml) four times daily
   Capsule: 250 - 500 mg four times daily

Caspofungin (Cancidas)


Recently approved, esp. for life-threatening fungal infections.
Fungicidal for Candida spp.


Terbinafine (Lamisil)

Oral, Topical

Mainly effective on dermatophytes (skin fungi)
Active against Candida in vitro.
Highly lipophilic – poor penetration into aqueous fluids
Has been combined with fluconazole to treat
     fluconazole-resistant Candida
Typical dose 250 mg/d, systemic dose 250-500 mg once daily