What is the recommended dose of Diflucan (fluconazole) for an uncomplicated yeast infection?

Diflucan Dose for Yeast Infection

For uncomplicated vaginal yeast infections, take a single 150 mg oral dose of fluconazole (Diflucan). This achieves clinical cure rates of 92-99% and is the standard first-line treatment recommended by both the Infectious Diseases Society of America and the American College of Obstetricians and Gynecologists 1, 2, 3, 4.

Uncomplicated vs. Complicated Disease

Uncomplicated vulvovaginal candidiasis includes:

• Mild-to-moderate symptoms 3
• Sporadic, non-recurrent episodes 3
• Normal immune function 3
• Infection caused by Candida albicans (which accounts for 83-92% of cases) 3, 5

For severe acute disease, the dosing changes significantly:

• Fluconazole 150 mg every 72 hours for a total of 2-3 doses 1, 2, 3
• This multi-dose regimen achieves significantly higher clinical cure rates compared to single-dose therapy in severe cases (P = 0.015 at day 14) 5
• Severe disease is characterized by extensive vulvar erythema, edema, excoriation, and fissure formation 1

Recurrent Infections

For recurrent vulvovaginal candidiasis (defined as 4 or more episodes per year):

• Initial induction therapy: Oral fluconazole or topical agent for 10-14 days 1, 3
• Maintenance therapy: Fluconazole 150 mg weekly for 6 months 1, 2, 3
• This regimen keeps 90.8% of women disease-free at 6 months 2

Non-albicans Species

For C. glabrata infections unresponsive to oral azoles:

• First-line alternative: Topical intravaginal boric acid 600 mg daily in gelatin capsules for 14 days 1, 2
• Second-line: Nystatin intravaginal suppositories 100,000 units daily for 14 days 1
• Non-albicans Candida species predict significantly reduced response to fluconazole regardless of treatment duration 5

Common Pitfalls

• Do not treat empirically without confirmation: Approximately 10-20% of women harbor Candida asymptomatically, and symptoms are nonspecific 1, 3
• Confirm diagnosis with wet mount preparation using saline and 10% potassium hydroxide to demonstrate yeast or hyphae before treatment 2
• Check vaginal pH: Normal pH (4.0-4.5) is typical with candida infections; elevated pH suggests bacterial vaginosis or trichomoniasis instead 2
• Inadequate treatment duration may lead to recurrence of active infection 4

Safety and Tolerability

Fluconazole is well tolerated with minimal side effects:

• Mild gastrointestinal complaints are the most common adverse effects 6
• Serious adverse effects are rare 5
• The single 150 mg dose has excellent bioavailability (>93%) and achieves therapeutic concentrations rapidly 7