Yeast infections can be uncomfortable, and you may reach for over-the-counter (OTC) or home remedies to treat them. But prescription medications may be necessary to get rid of the infection.
Vaginal yeast infections are common. They can be uncomfortable and cause itching, swelling, and discharge.
Treatment usually involves an antifungal medication. Options include creams or ointments applied inside the vagina to stop the growth of the fungus that’s causing the infection. Some medications are available OTC, while others are only available on prescription.
External creams can also help relieve symptoms of burning and irritation.
Some oral prescription medications may help treat yeast infections. Two options are fluconazole (Diflucan) and ibrexafungerp (Brexafemme).
Fluconazole (Diflucan)
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Fluconazole (Diflucan) is a common antifungal medication doctors prescribe to treat yeast infections. It’s known as a fungistatic medication, which means it slows the growth of the fungus rather than killing it.
Doctors usually recommend a single oral dose of 150 milligrams (mg) for vaginal yeast infections, although they may prescribe fluconazole in different doses for other conditions. You should always follow the doctor’s instructions for taking fluconazole.
Fluconazole usually takes a few days to clear your infection, and you may notice a reduction in your symptoms within 24 hours. But if you don’t see any improvement after a few days, consider contacting a doctor.
You may experience some side effects with fluconazole. These include:
headache and dizziness
diarrhea
stomach pain
heartburn
nausea and vomiting
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Ibrexafungerp is a newer medication that received approval from the Food and Drug Administration (FDA) in 2021 for the treatment of vaginal yeast infections. It’s a fungicidal medication, meaning that it kills the fungus that causes the infection.
The usual dosage of Brexafemme is 300 mg (two 150-mg tablets) taken twice per day for 2 days, reaching a maximum dose of 600 mg. According to a 2021 study, most patients taking ibrexafungerp saw their symptoms resolve within 14 days.
It may cause several side effects, including:
diarrhea
nausea and vomiting
stomach pain
dizziness
Note that pregnant people should not use Brexafemme.
Is Brexafemme better than Diflucan?
Different medications affect people differently, so there’s no way to say whether one is better than the other. However, each may have pros and cons to consider when deciding what to take.
Brexafemme and Diflucan work differently from each other. Fluconazole (Diflucan) slows fungus growth, whereas ibrexafungerp (Brexafemme) kills the fungus.
Brexafemme also attacks the fungus differently than any other option on the market. Fungi called Candida cause internal yeast infections, and there are many different strains. Research has found that Brexafemme fights more strains than other treatments. This gives people another option for infections that may be difficult to treat.
In terms of effectiveness, a 2023 study suggests that fluconazole and ibrexafungerp have similar efficacy against vaginal fungus after 10 days, but after 25 days, ibrexafungerp performed significantly better.
Diflucan seems to work faster than Brexafemme. Plus, you only need to take one pill, while Brexafemme requires you to take two tablets twice per day for 2 days.
If you have a vaginal yeast infection, you may want to speak with a doctor or healthcare professional. They can prescribe either medication for 6 months for recurring infections. You’ll typically take Diflucan weekly, whereas Brexafemme is prescribed once per month.
Who should take Brexafemme?
Always check in with your doctor before treating a yeast infection.
Symptoms of a yeast infection can appear similar to a sexually transmitted infection or bacterial vaginosis, which healthcare professionals treat differently. An estimated 2 out of 3 people who treat yeast infections themselves don’t actually have one, according to the Department of Health and Human Services’ Office on Women’s Health. This can make infections harder to treat when you do get them, and it may lead to antifungal resistance.
However, if you do have a yeast infection, your treatment may depend on how severe the infection is.
“Brexafemme is probably not necessary for every woman with a yeast infection,” says Mary Jane Minkin, MD. She’s a gynecologist and clinical professor of obstetrics, gynecology, and reproductive sciences at Yale University.
“Diflucan is an effective treatment for many. But for women who have a tough yeast infection, Brexafemme is effective against more strains.”
Brexafemme is not approved for pregnant females. The FDA requires SCYNEXIS, the company that makes Brexafemme, to study whether there are risks for pregnant people, developing fetuses, and newborns.
For now, the prescribing healthcare professional may ask you to take a pregnancy test before treatment. And if you’re using birth control, you should continue using it during treatment with Brexafemme.
Other options
There are many other options for treating a yeast infection. They include a range of OTC creams, such as:
Doctors may also recommend prescription medications that may be stronger than OTC options. Alongside Diflucan and Brexafemme, a doctor or healthcare professional may prescribe terconazole (Terazol) vaginal cream or suppositories.
Summary
Yeast infections can be uncomfortable, but they’re often not serious. There are many OTC creams that you might consider trying, but there are also prescription drugs available to manage your condition.
They include fluconazole (Diflucan) and ibrexafungerp (Brexafemme). Doctors might prescribe them for difficult-to-treat vaginal yeast infections.
While there’s no way to say which will be best for you, they each have their own benefits. A doctor can help determine whether you have a yeast infection and which treatment is the most appropriate to minimize or prevent your risk of antifungal resistance.
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