How is Monistat (clotrimazole/miconazole) used to treat vaginal yeast infections?

Treatment of Vaginal Yeast Infections with Monistat (Clotrimazole/Miconazole)

Monistat (containing either miconazole or clotrimazole) is an effective over-the-counter treatment for vaginal yeast infections, with topical formulations providing relief in 80-90% of patients who complete therapy. 1

Diagnosis Before Treatment

Before using Monistat, it's important to ensure you have a vaginal yeast infection:

• Common symptoms include:

  • Vaginal itching
  • Thick, white, lumpy discharge resembling cottage cheese
  • Vaginal soreness, irritation, or burning
  • Rash or redness on the vulva
  • Burning during urination
  • Painful intercourse 2

• Yeast infections do NOT cause fever, chills, lower abdominal pain, foul-smelling discharge, or missed periods (these may indicate STDs or other conditions requiring medical attention) 2

• Self-treatment is appropriate only if:

  • You've been previously diagnosed with a yeast infection
  • You have the same symptoms as your previous infection 2

Treatment Options

Monistat comes in different formulations:

Miconazole Options:

• Miconazole 2% cream: Apply 5g intravaginally for 7 days
• Miconazole 200mg vaginal suppository: Insert one suppository for 3 days
• Miconazole 100mg vaginal suppository: Insert one suppository for 7 days
• Miconazole 1200mg vaginal ovule: Single-dose treatment 1, 2

Clotrimazole Options:

• Clotrimazole 1% cream: Apply 5g intravaginally for 7-14 days
• Clotrimazole 100mg vaginal tablet: Insert one tablet for 7 days
• Clotrimazole 100mg vaginal tablet: Insert two tablets for 3 days
• Clotrimazole 500mg vaginal tablet: Insert one tablet as a single application 1, 3

Administration Instructions

1. Time of application: Both bedtime and daytime administration are equally effective. The efficacy against a broad spectrum of pathogens is similar regardless of administration time, offering women convenience in treatment. 4

2. External symptoms: For external vulvar itching and irritation, apply the included miconazole 2% cream to the affected area twice daily for up to 7 days. 2, 4

3. Duration: Complete the full course of treatment even if symptoms improve before finishing. 1

4. Sexual activity: Avoid sexual intercourse until treatment is completed and all symptoms have resolved. 5

5. Important precaution: These oil-based creams and suppositories may weaken latex condoms and diaphragms. 1

Effectiveness and Time to Relief

• Single-dose miconazole nitrate (1200mg) ovules provide faster symptom relief compared to multi-day treatments, with median time to complete relief of 3-4 days. 6

• Overall cure rates for different formulations range from 61-75%, with both miconazole and clotrimazole showing similar effectiveness. 6, 7

• Some studies suggest miconazole may have lower relapse rates compared to clotrimazole and nystatin. 8

When to See a Doctor

Return to your healthcare provider if:

• Symptoms persist after completing treatment
• Symptoms recur within 2 months
• No improvement is seen after 72 hours of treatment
• This is your first yeast infection (diagnosis should be confirmed)
• You have multiple sex partners or a new partner (to rule out STDs)
• You are pregnant, diabetic, immunocompromised, or taking antibiotics/steroids 1, 2

Treatment of Partners

• Vaginal yeast infections are not typically sexually transmitted
• Treatment of male partners is generally not recommended unless they show symptoms
• Some male partners may develop balanitis (inflammation of the glans penis) characterized by erythematous areas and pruritus, which may benefit from topical antifungal treatment 1, 5