Diflucan Treatment Duration for Yeast Infections
For uncomplicated vaginal yeast infections, take a single 150 mg dose of Diflucan (fluconazole) once. 1, 2, 3
Uncomplicated Vulvovaginal Candidiasis
A single oral dose of fluconazole 150 mg is the standard treatment for straightforward vaginal yeast infections, achieving clinical cure or improvement in 94-97% of patients within 14 days. 1, 3
This single-dose regimen is as effective as 7 days of topical antifungal therapy and offers superior convenience. 3
Topical azole agents applied for 1-3 days are equally effective alternatives if you prefer non-oral treatment. 1
Complicated or Severe Vulvovaginal Candidiasis
If you have severe symptoms or the infection doesn't respond to the first dose, take fluconazole 150 mg every 72 hours for a total of 3 doses. 4, 5
The 2-dose or 3-dose regimen achieves significantly higher clinical cure rates (P=0.015) compared to single-dose therapy in severe disease. 4, 5
Complicated disease includes: severe symptoms (extensive vulvar erythema, edema, excoriation, fissure formation), non-albicans Candida species, uncontrolled diabetes, immunosuppression, or pregnancy. 4
If the 3-dose fluconazole regimen fails, switch to topical azole therapy for 7-14 days. 4
Recurrent Vulvovaginal Candidiasis
For recurrent infections (4 or more episodes per year), use an induction phase followed by 6 months of maintenance therapy. 1, 4, 6
Induction Phase:
- Either 10-14 days of topical azole therapy OR three doses of fluconazole 150 mg every 72 hours to achieve clinical remission. 4, 6
Maintenance Phase:
Fluconazole 150 mg once weekly for 6 months after achieving clinical remission. 1, 4, 6
This maintenance regimen keeps 90.8% of women disease-free at 6 months versus only 35.9% with placebo (P<0.001). 4, 6
The median time to recurrence extends to 10.2 months with maintenance therapy compared to 4.0 months without it (P<0.001). 6
Species-Specific Considerations
Candida albicans (92% of cases): Responds well to standard fluconazole dosing as outlined above. 1, 5
Candida glabrata: First-line treatment is boric acid 600 mg intravaginal capsules daily for 14 days, as this species often shows reduced fluconazole susceptibility. 4
Candida krusei: Use topical azole therapy for 7-14 days, as this species is inherently fluconazole-resistant but remains susceptible to topical azoles. 4
Important Caveats
Confirm the diagnosis with wet mount and vaginal pH before extended therapy; obtain cultures if initial testing is negative or if treatment fails. 4
Women with recurrent vaginitis history are significantly less likely to respond to treatment (P<0.001) and require the extended maintenance approach. 3
Side effects are minimal, primarily mild gastrointestinal symptoms (nausea, abdominal discomfort) and headache, occurring in approximately 27% of patients. 7, 3
No clinically significant fluconazole resistance develops with long-term weekly maintenance therapy. 6