Fluconazole 150 mg for Vaginal Yeast Infection
Take fluconazole 150 mg as a single oral dose for uncomplicated vaginal yeast infection. 1, 2
Dosing Instructions
- Swallow one 150 mg tablet by mouth as a single dose 2
- Take with or without food 2
- No repeat dosing is needed for uncomplicated infection 1, 2
- This single dose provides therapeutic concentrations in vaginal secretions that persist long enough to cure the infection in over 90% of cases 3
When This Treatment Works Best
- Use single-dose therapy only for uncomplicated, mild-to-moderate vaginal yeast infection 1
- Uncomplicated infection means: first episode or infrequent episodes (fewer than 4 per year), mild-to-moderate symptoms, normal immune system, and likely caused by Candida albicans 4
- Expected cure rate is 90-99% at 5-16 days after treatment 3, 5
When You Need Different Treatment
If you have severe symptoms (extensive redness, swelling, cracking, or severe itching):
- Take fluconazole 150 mg every 72 hours (every 3 days) for a total of 2-3 doses 1, 6
- Alternatively, use topical azole cream or suppository for 7-14 days 1, 6
If you have recurrent infections (4 or more episodes per year):
- Start with fluconazole 150 mg repeated once 3 days later, OR topical therapy for 7-14 days 1, 6
- Then continue fluconazole 150 mg once weekly for 6 months to prevent recurrence 1, 7
- This maintenance therapy reduces recurrence from 64% to 9% at 6 months 7
Critical Warnings
Do NOT take fluconazole if you are pregnant or might be pregnant 6
- Fluconazole is associated with spontaneous abortion and birth defects 6
- Use only topical azole therapy for 7 days during pregnancy 6
Drug interactions to watch for 6:
- Warfarin (increases bleeding risk)
- Quinidine, erythromycin, pimozide (heart rhythm problems)
- Oral diabetes medications (low blood sugar)
- Phenytoin, cyclosporine (altered drug levels)
Expected Side Effects
- Headache occurs in 13% of patients 2
- Nausea in 7%, abdominal pain in 6%, diarrhea in 3% 2
- These are typically mild and resolve without stopping treatment 2, 5
When to Seek Follow-Up
- Return for evaluation only if symptoms persist after 5-7 days or recur within 2 months 1, 6
- If symptoms don't improve, you may need vaginal culture to identify non-albicans species like C. glabrata, which requires different treatment (boric acid suppositories) 1, 8
- Persistent symptoms may also indicate the infection is complicated and requires longer treatment 1, 6
Common Pitfalls to Avoid
- Do not use single-dose therapy if you have diabetes, HIV, or take immunosuppressive medications - these require longer treatment courses 6, 4
- Do not self-treat without prior confirmed diagnosis - only 35% of women who self-diagnose vaginal yeast infection are correct 4
- Do not treat if you have no symptoms - 10-20% of women normally carry Candida without infection, and treatment is unnecessary 1, 4