Terconazole 0.8% Treatment Regimen for Vaginal Yeast Infection

For uncomplicated vulvovaginal candidiasis, use terconazole 0.8% cream 5 grams intravaginally for 3 consecutive days. 1

Standard Dosing Protocol

Apply 5 grams of terconazole 0.8% cream intravaginally once daily for 3 days as the complete treatment course 1
This 3-day regimen achieves clinical cure rates of 81% at 7-14 days post-treatment and mycological cure rates of 79.3% 2
Short-term evaluation shows 75% of patients become asymptomatic with 83.3% mycologically cured by 8-11 days after therapy 3

Reserve 3-day terconazole regimens for uncomplicated mild-to-moderate VVC 1
For severe or complicated VVC, extend treatment to 7-14 days using terconazole 0.4% cream (5 grams daily for 7 days) rather than the 0.8% formulation 1, 4
Complicated cases include severe symptoms, immunocompromised patients, or non-albicans Candida species 4

If the 0.8% cream is unavailable or unsuitable:

Terconazole 0.4% cream: 5 grams intravaginally for 7 days 1
Terconazole 80 mg suppository: one suppository intravaginally for 3 days 1
The 80 mg suppository for 3 days demonstrates clinical cure rates of 89-92% and mycological cure rates of 80-85% at 8-10 days post-therapy 5

Use only topical azole therapies applied for 7 days during pregnancy 4
Switch to terconazole 0.4% cream for 7 days rather than the 3-day 0.8% regimen, as 7-day courses are more effective than shorter regimens in pregnancy 6
Oral fluconazole must be avoided during pregnancy 4

For maintenance therapy after initial treatment, consider weekly applications of terconazole 0.8% cream for 26 weeks 7
This prophylactic approach effectively prevents recurrent episodes during the treatment period (p < 0.001 compared to post-treatment period) 7
If non-albicans Candida persists despite azole therapy, nystatin vaginal suppositories may be considered as maintenance 4

C. glabrata shows >388-fold higher MIC for terconazole at vaginal pH 4, indicating clinically relevant resistance 4
Consider switching to nystatin 100,000-unit vaginal tablet for 14 days for azole-resistant infections, which achieves 64.3% cure rate for C. glabrata versus 12.5% with fluconazole 4

No significant difference exists between 0.8% and 1.6% terconazole cream formulations in terms of clinical or mycological cure rates 3
Terconazole 80 mg suppository for 3 days shows no statistically significant difference compared to miconazole nitrate 100 mg suppository for 7 days 5
For severe VVC, terconazole 80 mg suppository daily for 6 days demonstrates comparable efficacy to oral fluconazole 150 mg (two doses), with clinical cure rates of 81.0% vs. 75.8% at day 7-14 2

Local irritation is the primary adverse event with terconazole, though side effects are rare and mild 3, 2
This contrasts with oral fluconazole, which causes systemic side effects, though both are minimal 2
Weekly prophylactic use of terconazole 0.8% cream is well tolerated over 26 weeks 7

Do not treat asymptomatic Candida colonization, as 10-20% of women normally harbor Candida species without requiring treatment 1, 6
Confirm diagnosis with wet mount showing yeasts/pseudohyphae or positive culture before initiating treatment, along with clinical symptoms (pruritus, white discharge, vulvar erythema) and normal vaginal pH ≤4.5 1, 6
Oil-based creams and suppositories may weaken latex condoms and diaphragms 4
Instruct patients to return if symptoms persist after treatment or recur within 2 months, as this warrants medical re-evaluation rather than self-treatment 1, 4

Sex partner treatment is not recommended for VVC, as it is not typically sexually transmitted 6
Partners with symptomatic balanitis may benefit from topical antifungal treatment 6