Yeast infection can be treated at home with over-the-counter topical antifungals: miconazole (2% cream or 100 mg suppository daily for 3–7 days) or clotrimazole (1% cream applied daily for 7–14 days). Consult a doctor if symptoms persist, as other infections may require antibiotics. For recurrent or severe cases, prescription options like fluconazole (150 mg single oral dose) or extended antifungal therapy may be necessary.
January 13, 2025

Yeast Infection: Over-the-Counter Treatment

Evidence-Based Over-The-Counter Guide

William Shen

William Shen

Co-founder & CPO

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Vaginal candidiasis, commonly referred to as a yeast infection, is caused by an overgrowth of Candida species, leading to itching, discharge, and discomfort. First-line treatment are topical antifungal medications available over the counter but seeing a doctor can be helpful to distinguish between other vaginal infections that may require prescription antibiotics. 

First-line recommendations:

Prescription medications:

  • Oral antifungals: Fluconazole 150 mg orally as a single dose (off-label).

  • Recurrent infections: Extended antifungal therapy.

Citations:

Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR. Recommendations and Reports. 2021; 70(4): p.1-187. doi: 10.15585/mmwr.rr7004a1

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  • For each condition, we performed a literature review to find a recent widely cited expert group guideline published in the leading specialty-specific peer-reviewed journal or top general medical journal.

  • Based on the recommendations in the publication, we identify recommended active ingredients and devices that are available over-the-counter per FDA regulations.

What evidence is prioritized?

Levels of evidence considered:

  • Tier 1 (Safe and Definitely Effective): Professional field consensus or multiple randomized controlled clinical trials showing the same conclusion. Wherever possible, we use Tier 1 evidence for "first-line" recommendations.

  • Tier 2 (Safe and Probably Effective): Individual clinical trials which may be discordant or large-scale observational experience. Tier 2 evidence may inform "first-line", "second-line", or "supplement" recommendations.

  • Tier 3 (Safe and Maybe Effective): Mechanistic plausibility without high-quality clinical evidence of efficacy but high-quality evidence of safety. Tier 3 evidence may inform "second-line" or "supplement" recommendations.

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  • Based on the top clinical recommendation, we evaluate products containing the recommended active agent with FDA-approved dosage based on price, average customer reviews, how often it is purchased, and how quickly it will ship to home. 

  • We provide public documentation of the active ingredients in our recommendations, using all 32 FDA monographs, Prescription-to-Nonprescription (Rx-to-OTC) Switches, as well as New Drug Application (NDA) approvals.

How does MDandMe select recommended devices?

  • Based on the top clinical recommendation, we evaluate devices that are FDA-cleared or comply with other medical guidelines (if not a FDA-regulated category) by reputability, price, and average customer reviews.

  • We provide public documentation of supporting evidence for each device.  

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