From the Guidelines
Chloroquine and hydroxychloroquine are anti-malaria medications that can cause vulvovaginal candidiasis as a side effect. These medications can disrupt the normal vaginal flora by altering the pH and immune response in the vaginal environment, which allows for overgrowth of Candida species, particularly Candida albicans 1. Women taking these medications for malaria prophylaxis or treatment should be aware of symptoms such as vaginal itching, abnormal discharge, and discomfort. If these symptoms develop, over-the-counter antifungal treatments like fluconazole (150 mg oral single dose) or topical azoles (such as clotrimazole or miconazole) are typically effective.
Some key points to consider:
- Maintaining good hygiene, wearing cotton underwear, and avoiding douches can help prevent infections 1.
- Women with recurrent infections while on these medications should consult their healthcare provider, as an alternative anti-malarial regimen might be considered, especially for long-term prophylaxis.
- The treatment of vulvovaginal candidiasis should not differ based on HIV infection status, and identical response rates are anticipated for HIV-positive and HIV-negative women 1.
- For recurring vulvovaginal candidiasis, 10–14 days of induction therapy with a topical agent or oral fluconazole, followed by fluconazole, 150 mg weekly for 6 months, is recommended 1.
From the FDA Drug Label
that the use of doxycycline might increase the incidence of vaginal candidiasis. The anti-malaria medication that can cause vulvovaginal candidiasis is doxycycline 2.
From the Research
Anti-Malaria Medication and Vulvovaginal Candidiasis
- There is no direct evidence in the provided studies that links a specific anti-malaria medication to the cause of vulvovaginal candidiasis.
- However, some studies mention the use of certain medications and their effects on the body, which could potentially lead to an increased risk of infections such as vulvovaginal candidiasis.
- For example, a study on atovaquone + proguanil 3 mentions that this combination is less effective against other Plasmodium species and has some adverse effects, but it does not specifically mention vulvovaginal candidiasis.
- Another study on mefloquine and doxycycline 4 compares their efficacy and tolerability as prophylaxis for malaria, but it does not discuss vulvovaginal candidiasis.
- Studies on fluconazole and clotrimazole 5, 6 discuss their use in treating vulvovaginal candidiasis, but they do not mention anti-malaria medications as a cause of the infection.
- A study on antifungal therapy for recurrent vulvovaginal candidiasis 7 aims to assess the efficacy of antifungal agents, but it does not mention anti-malaria medications.