9 over-the-counter treatments for vulvar yeast infection

Vaginal thrush is caused by a fungus, most often Candida albicans. In the absence of a medical consultation, it is possible to obtain certain local antifungal drugs from the pharmacy to quickly treat the infection: an egg, a cream, an emulsion… The different molecules have comparable efficacy with generally a disappearance of symptoms in 3 to 5 days. Here are the 9 treatments available without a prescription to effectively relieve vulvar mycosis:

1. Gyno-Pevaryl® (econazole) in ovule

The egg should be placed deep in the vagina with a finger, preferably in the evening at bedtime in a lying position. It relieves conditions of the vulva and vagina such as itching, burning, swelling, redness, white discharge and superinfection bacteria if any. The schedule of administration varies depending on the formulation of the drug:
► In immediate release (Gyno-Pevaryl® and its generics): 1 egg for three days, to be renewed 7 days later if the mycosis persists or recurs
► In prolonged release (Myleugyne® LP and Gynopura® LP: generics of Gyno-Pevaryl® LP which is no longer marketed): 1 single egg to be renewed the next morning in case of persistence of symptoms
Extended-release drug is active for 3 daysit is therefore not possible to interrupt its distribution in the event of an allergy or intolerance. This antifungal can increase the itching and cause burns, irritation, allergy, swelling and pain in the genital mucous membranes. In this case, treatment should be discontinued. Gyno-Pevaryl® and its generics are contraindicated in case of allergy to one of the components or to one of the drugs of the same family (imidazoles). This type of egg cannot be used only from the 2nd trimester of pregnancy after an assessment of the benefit/risk balance and during breast-feeding with caution. Similarly, vigilance is required in a patient taking an oral anticoagulant such as Coumadin®. Due to the increased risk of bleeding, the INR assay should be performed more frequently. In addition, the use of latex condoms or diaphragms is prohibited during treatment at the risk of rupture. Similarly, spermicides may be inactivated.

2. Pevaryl® (econazole) emulsion

In addition to a gynecological egg, this emulsion can be applied 2 to 3 times a day on the vulva until lesions disappear (maximum 4 weeks) to relieve swelling, redness and itching. The application must be carried out in massaging lightly to facilitate penetration of the active substance. The bottle should be shaken before use.
► This medicine can cause burning, irritation, allergy, swelling and pain in the genital mucous membranes. In this case, treatment should be discontinued.
► The Pevaryl® emulsion is contraindicated in case of allergy to one of the components or to one of the drugs of the same family (imidazoles). Use is not possible only from the 2nd trimester of pregnancy after an assessment of the benefit/risk balance and may be considered during breast-feeding with caution. Likewise, vigilance is required in a patient taking a vitamin K antagonist (anticoagulant). Due to the increased risk of bleeding, the INR assay should be performed more frequently.

3. Lomexin® (fenticonazole) soft capsule

This capsule relieves conditions of the vulva and vagina such as itching, burning, swelling, redness, white discharge and bacterial superinfection if there is any. She must be placed deep in the vagina with a finger, preferably in the evening at bedtime in a lying position. If the symptoms persist after 3 days, the administration of a new egg is recommended.
► This medication isposes a risk of burning, itching and redness located in the vulva and vagina. Rare cases of local allergy have been observed.
► Lomexin® in vaginal capsule is formally contraindicated in allergic women to one of the components and more particularly in those allergic to peanuts or soy because of the ppresence of soy lecithin. It is possible to use this treatment in the context of pregnancy or breastfeeding provided that it is followed by a doctor. Furthermore, the use of latex condoms or diaphragms is prohibited during treatment at risk of breaking. Similarly, spermicides may be inactivated.

4. Terlomexin® (fenticonazole) soft capsule

This capsule relieves conditions of the vulva and vagina such as itching, burning, swelling, redness, white discharge and bacterial superinfection if necessary. It should be placed at the bottom of the vagina with a finger, preferably in the evening at bedtime in a lying position. This operation must be repeated 3 days in a row. If the mycosis persists or recurs, the treatment can be repeated immediately or 7 days after the last administration.
► This medicinal product exposes risk of burning, itching and redness located in the vulva and vagina. Rare cases of local allergy have been observed.
► Terlomexin® is contraindicated in case of allergy to any of the components of the drug. It is possible to use this treatment in the context of pregnancy or breastfeeding provided that it is followed by a doctor. In addition, the use of latex condoms or diaphragms is prohibited during treatment at the risk of rupture. Likewise, spermicides may be inactivated.

5. Monazol® (sertaconazole) in ovule

This egg relieves conditions of the vulva and vagina such as itching, burning, swelling, redness, white discharge. It should be placed deep in the vagina with a finger, preferably in the evening at bedtime while lying down. In case of recurrence of the mycosis, a new egg can be administered 7 days later.
► Allergy and transient worsening of itching or burns have been observed with this antifungal.
► The use of this medicine is contraindicated in case of allergy to one of the components or to one of the drugs of the same family (imidazoles). Throughout treatment, spermicides are not recommended due to their potential inactivation. Similarly, the use of latex condoms or diaphragms is to be excluded at the risk of rupture.
► A Monazol® egg can be completely administered to a pregnant or breastfeeding woman if necessary.

6. Monazol® (sertaconazole) cream

In addition to a gynecological egg, Monazol® cream can be applied 1 time per day for 8 days on the vulva to relieve swelling, redness and itching. The application on the lesions must be carried out by massaging lightly to facilitate the penetration of the active substance.
► The use of this medication is contraindicated in case of allergy to one of the components or to one of the drugs of the same family (imidazoles). The app is possible in a pregnant or breastfeeding woman if necessary.
► The preservatives contained in the cream may be responsible for a allergy and inflammation of the treated area. Similarly, a transient worsening of itching or burning may occur.

7. MycoHydralin® (clotrimazole) tablet

This vaginal tablet relieves conditions of the vulva and vagina such as itching, burning, swelling, redness and white discharge. It must not be swallowed but must be introduced into the bottom of the vagina with your finger or using the applicator provided, referring to the instructions for optimal use. The use of the applicator is not recommended for pregnant women.
The administration schedule varies according to the dosage:

• 200 mg: 1 tablet for 3 consecutive days, to be renewed if symptoms persist
• 500 mg: 1 single tablet, to be renewed 3 days later if symptoms persist. This tablet is active for 3 days, so it is not possible to interrupt its distribution in case of allergy or intolerance.

This antifungal has side effects such as vaginal discomfort, itching, burning, and associated pain. When the mucous membranes are very damaged, the active substance can pass into the blood and induce difficulty in breathing and hypotension.
► The use of this treatment is contraindicated in case of allergy to one of the components. A MycoHydralin® egg can be administered to a pregnant or breastfeeding woman if necessary. Moreover, medical supervision is required in women taking an immunosuppressant such as Prograf®, Advagraf®, (tacrolimus) or Rapamune® (sirolimus). Indeed, MycoHydralin® exposes to a risk of overdose of these drugs. Throughout treatment, spermicides are not recommended due to their potential inactivation. Similarly, the use of latex condoms or diaphragms is to be excluded at the risk of rupture.

8. MycoHydralin® (clotrimazole) cream

In addition to a gynecological egg, MycoHydralinl® cream can be applied twice a day for 7 days on the vulva to relieve swelling, redness and itching. The application on the lesions must be carried out by massaging lightly to facilitate the penetration of the active substance.
► This cream can cause a discomfort, itching, burning and pain in the vulva and vagina which may be increased by the product’s excipients. When the mucous membranes are very damaged, the active substance can pass into the blood and induce difficulty in breathing and hypotension.
► The use of this cream is contraindicated in case of allergy to one of the components or to one of the drugs of the same family (imidazoles). The application is possible in a pregnant or breastfeeding woman. In addition, medical supervision is required in women taking an immunosuppressant such as Prograf®, Advagraf® (tacrolimus) or Rapamune® (sirolimus). Indeed, MycoHydralin® exposes you to a risk of overdose of these drugs. Throughout treatment, spermicides are not recommended due to their potential inactivation. Similarly, the use of latex condoms or diaphragms is to be excluded at the risk of rupture.

9. Fazol® (isoconazole) emulsion

► In addition to a gynecological egg, Fazol® emulsion can be applied twice a day until the lesions disappear (maximum 4 weeks) on the vulva to relieve swelling, redness and itching. The application on the lesions must be carried out by massaging lightly to facilitate the penetration of the active substance. The bottle should be shaken before use.
► The use of this drug is contraindicated in case of allergy to one of the components or to one of the drugs of the same family (imidazoles). The application is possible in a pregnant or breastfeeding woman.
► This emulsion may be responsible allergies, itching, burning and contact eczema accentuated by the presence of excipients.