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Every woman faces thrush at least once in her life. It ranks second in the structure of vaginal diseases after its bacterial infection. Thrush is the “popular name” of the disease, and the scientific name is vaginal candidiasis.
The disease is diagnosed mainly in women of childbearing age. Many patients experience it for the first time during pregnancy. During this period, the frequency of visits to the gynecologist for candidiasis increases by 3 times.
Thrush is caused by fungi of the genus Candida, which live on the skin and mucous membranes, including healthy people. A sharp increase in their number occurs when the immune system is weakened. This can be provoked by various factors: infectious and non-infectious diseases, taking antibacterial drugs, vitamin deficiency, radiation therapy, and more.
The main symptoms of thrush are unbearable itching in the perineum and abundant curdled discharge. They significantly worsen the quality of life of a woman, make her experience severe discomfort. In the article, we have collected the best pills for thrush, which will help you quickly and effectively cope with the disease. [1], [2], [3], [4], [5].
Possible complications from improper treatment
Thrush requires complex treatment. It must be carried out in full, with mandatory testing. If you interrupt the course, or choose the wrong drug, there is a risk of transferring the disease from the acute phase to the chronic one. She, in turn, threatens health problems in the form of atrophy of the vaginal mucosa, narrowing of the entrance to the vagina, the spread of fungal flora to the external genital organs, the urethra and bladder. A serious complication of thrush is endometritis and infertility.
In pregnant women, candidiasis often leads to miscarriage or premature onset of labor. Therefore, treatment should be timely and complete.
Approximately 82% of thrush symptoms are caused by strains of C. albicans. However, this is not the only Candida fungus that can show pathological activity. It is possible to identify strains of C. glabrata, C. tropicalis, C. krusei and not only. For species identification of fungi and determination of sensitivity to various drugs, it is necessary to conduct a PCR test and ELISA.
With a mild course of the disease, it is possible to use only local therapy in the form of suppositories for thrush, creams and vaginal tablets. If the thrush recurs, or the fungi show increased activity, oral administration of drugs is recommended. The modern pharmacological industry produces many tablets from thrush with different active ingredients. Each of the drugs has its own advantages and disadvantages, which will be discussed below.
Which drug is right for you?
To date, there are several groups of tablets that have an antifungal effect. They act on the body in different ways, their spectrum of activity is different. [6].
Polyene antimycotics are of natural origin. When ingested, they disrupt the integrity of the fungal cell membrane, thereby causing the death of Candida. Nystatin belongs to this group. Such drugs can be used for prophylactic purposes and for the treatment of an uncomplicated form of the disease. With recurrent candidiasis, polyene remedies do not always cope.
Triazole antimycotics. Their action is aimed at preventing the fungus from multiplying and increasing the number of its colony. Drugs are excreted from the body for a long time, so they can be taken in a short course. This group includes Flucostat and Diflucan tablets. They can be taken to get rid of acute and chronic thrush.
Imidazole agents disinfect the mucous membrane of the vagina, penetrate into its deep structure, due to which they completely destroy the fungus. These drugs include Clotrimazole and Ketoconazole.
Tablets from thrush: pros and cons
Before making a choice in favor of a particular drug, you need to familiarize yourself with its advantages and disadvantages. What matters is the price of the drug, the way it is used, indications and contraindications. We have compiled the top 12 most prescribed pills for thrush.
Pimafucin
Price: 300 rubles.
The active ingredient is natamycin. The drug violates the integrity of the fungus cell, thereby destroying it. Tablets are prescribed for recurrent and chronic thrush, with uncomplicated forms of the disease, local therapy can be limited. The course should last at least a week. It is necessary to take 1 tablet, 4 times a day.
Pros:
Most fungi of the genus Candida are sensitive to the drug.
Cases of resistance to natamycin have not been reported.
The drug acts only in the intestinal lumen, without affecting the organs of the digestive system.
The effect develops a day after the start of therapy.
There is only one absolute contraindication – hypersensitivity to the components that make up the drug.
Can be used during breastfeeding and pregnancy.
Therapy does not depend on food intake.
Cons:
High price.
Side effects in the form of nausea and diarrhea.
Diflucan
Price: 450 rubles.
The main active ingredient is fluconazole. The drug is active against all strains of fungi of the genus Candida. It can be used for chronic and acute thrush. The effectiveness of the oral form is higher than local therapy. Tablets can be used to prevent the disease. They are taken orally, as a whole, once at a dose of 150 mg. To prevent the recurrence of the disease, 3 doses of 150 mg are used, on the first, fourth and seventh days. Then the maintenance dose is taken once a week. Therapy can last up to six months.
Pros:
Treatment is effective, regardless of which strain provoked the development of candidiasis.
Taking the drug does not affect the level of steroids in young women.
High biological activity when taken orally.
Quick effect and elimination of symptoms of thrush.
Can be used in the treatment of children older than 3 years.
Cons:
The strain of Candida krusei is resistant to the drug.
The drug interacts with certain drugs.
During pregnancy, it can be used only in emergency cases, under the supervision of a physician.
The drug is found in breast milk, its use during lactation is not recommended.
Ketoconazole
Price: 200 rubles.
The main active ingredient is ketoconazole. Its intake contributes to the destruction of the fungal cell by changing the composition of its lipid components. The drug is prescribed mainly for chronic recurrent thrush, in the absence of the effect of local therapy. Dosage – 2 tablets of 200 mg each, with meals, 1 time per day. The course should last at least 5 days.
Pros:
The drug is active against fungi of the genus Candida and other mycoses.
The action develops quickly, within 2 hours after ingestion.
High efficiency.
Cons:
The drug should not be used in the treatment of persons over 50 years of age.
During pregnancy, the drug is not recommended, except in emergency cases.
The tablets must be taken with meals.
Side effects in the form of disorders in the functioning of the digestive system, headaches, allergies and more.
Ketoconazole interacts with various drugs, so only a doctor can prescribe it.
Terbinafine
Price: 300 rubles.
Each tablet contains 125 or 250 mg of the active substance (terbinafine). The drug is active against the strain of C. albicans, which most often causes thrush. It is used in recurrent forms of the disease, when local treatment does not achieve the desired effect. Terbinafine is taken at a dosage of 0,25 g 1 time per day.
Pros:
A wide range of actions.
It is quickly distributed in tissues.
The drug is not toxic.
Cons:
Prohibited during pregnancy and lactation.
Terbinafine is contraindicated in liver disease.
Relationship between dose and food.
Side effects in the form of disorders of the digestive system, hematopoietic organs. Allergic reactions are possible.
The drug interacts with various drugs, which requires its careful use.
Itraconazole
Price: 450 rubles for 14 pieces.
The main active ingredient is itraconazole in spherical granules. Being a derivative of triazole, the drug has a destructive effect on the cell membrane of various strains of fungi of the genus Candida albicans and Candida parapsilosis. The drug is prescribed for acute and chronic thrush, at a dosage of 200 mg 2 times a day on the first day, or at a dosage of 200 mg 1 time per day for 3 days.
Pros:
Broad-spectrum drug.
It penetrates well into the mucous membrane of the vagina.
The course of treatment is short, lasting 1 or 3 days.
Cons:
C. glabrata strains are resistant to the drug. C. krusei, C. tropicalis.
Taking with food increases the bioavailability of the drug.
Side effects in the form of indigestion, liver disorders, allergic reactions, menstrual irregularities and more.
Do not use in the treatment of pregnant and lactating women, patients with chronic heart failure.
Mycosist
Price: 300 rubles for 1 piece.
The main active ingredient is fluconazole. The drug is prescribed for thrush in acute and chronic form. It depends on how you take it. With vaginal candidiasis, diagnosed for the first time, the drug is prescribed once. If the disease recurs, the capsules are used once a month for 1 months. Sometimes the course can be extended up to a year.
Pros:
The drug does not affect the functioning of the liver, does not have androgenic activity.
Active against the most common strains of the fungus of the genus Candida.
High bioavailability, which is 90%.
The drug penetrates well into the mucous membrane of the vagina.
Cons:
Not recommended during pregnancy.
High cost, which is especially noticeable when long-term use is required.
Side effects in the form of nausea, vomiting, diarrhea, headache, allergic reactions, changes in the blood picture.
The drug interacts with other drugs, so it should be prescribed by a doctor.
Orungal
Price: 3000 rubles.
The main active ingredient is itraconazole. Being a derivative of triazole, it has a pathological effect on the fungal cell membrane, violating its integrity. The drug is active against most strains of Candida. It is prescribed for any form of thrush. The course can last 1 or 3 days.
Pros:
Broad-spectrum drug.
Resistance rarely develops.
Italian quality.
Cons:
Reduced sensitivity to the drug in strains such as: C. krusei, C. glabrata and C. Tropicalis
Numerous side effects.
Food addiction.
Contraindications in the form of chronic heart failure, sucrose intolerance.
The drug is incompatible with a number of other drugs: atorvastatin, cisapride, irinotecan, etc.
High price.
Prohibition of use during pregnancy and lactation.
Canditral
Price: 1200 rubles.
The main active ingredient is itraconazole granules. It affects ergosterol, which is part of the fungal membrane, destroying it, thereby leading to cell death. The drug is active against all strains of Candida, so it is used for acute and chronic thrush. Recommended dose: 200 mg 2 times a day or 1 time per day. The course can last 1 or 3 days, depending on the severity of the disease.
Pros:
The drug is well distributed in the affected tissues.
The effect develops quickly, the elimination of negative symptoms can be felt within 4 hours after ingestion.
A wide range of actions.
Cons:
To achieve optimal biological activity, the drug should be taken immediately after a meal.
Efficacy may be reduced in immunocompromised patients.
Not recommended during pregnancy and while breastfeeding.
High price.
Rumicosis
Price: 1100 rubles.
The main active ingredient is itraconazole. It has a wide spectrum of activity, is active against most strains of Candida, including those that most often provoke thrush. The drug is prescribed for acute and recurrent vaginal candidiasis at a dosage of 200 mg 2 times a day once. With a persistent course of the disease, the course is done up to 3 days, taking 200 mg of the drug daily.
Pros:
Good distribution in liquids and tissues, which ensures a high therapeutic effect.
High antifungal activity.
After the end of a three-day course of therapy, high concentrations of itraconazole remain in the vaginal mucosa for another 3 days, which ensures a full recovery.
The minimum list of contraindications.
Cons:
Relationship with food. To increase bioavailability, the drug should be taken after meals.
The ban on the simultaneous use of Rumikoz with various drugs and substances, in particular: triazole, cisapride, ergometrine, etc.
The drug is recommended for the treatment of pregnant women.
The most inexpensive
Fluconazole
Price: 30 rubles.
Tablets for oral administration with the active ingredient – fluconazole at a dosage of 50, 100 and 150 mg. The drug is effective against Candida spp. It is used for the treatment and prevention of thrush, it can be used for acute and recurrent forms of the disease.
Pros:
High bioavailability of 90%.
Eating does not affect the activity of the drug.
Can be used to treat combined fungal diseases.
Доступная цена.
High efficiency.
Cons:
You can not combine taking Fluconazole with Astemizole and Terfenadine.
Do not use in the treatment of children under 3 years of age.
Pregnant women are prescribed as an exception. Breastfeeding women are not shown to take the drug.
Side effects in the form of taste distortion, abdominal pain, liver disorders, headaches, allergies and more.
The drug interacts with various drugs, which requires its careful administration.
Nystatin
Price: 140 rubles.
The main active ingredient is nystatin at a dosage of 55,5 mg or 111 mg. The drug is active against fungi of the genus Candida. It is prescribed for the treatment of acute and chronic thrush, as well as for the prevention of its occurrence when taking antibiotics and other risk factors. In an uncomplicated form of the disease, 111 mg is prescribed 3-4 times a day (for adult patients).
Pros:
The drug is active against all strains of fungi that cause thrush.
It interacts only with amphotericin B and clotrimazole.
Доступная цена.
The toxic effect on the body is weakly expressed.
The symptoms of thrush pass quickly, relief comes as early as 24 after taking the first dose.
There is no dependence of taking the drug on food.
Cons:
The presence of contraindications in the form of pancreatitis, stomach ulcers.
Do not administer to pregnant and lactating women, as well as children under 3 years of age.
With a long course, the risk of side effects in the form of a disorder on the part of the digestive system increases.
Flucostat
Price: 200 rubles per pack with one tablet.
The main active ingredient is fluconazole. The drug is effective in the acute form of thrush. With candidiasis, which was detected for the first time, a single dose of 150 mg is sufficient. If the disease has a severe course, then on the first day they take 150 mg of the drug, on the 4th day the same dose is taken again.
Pros:
Bioavailability after oral administration is high, it is 90%.
Absorption is not affected by food intake.
Quick effect when taking a loading dose.
Treatment can be carried out in debilitated patients, including those with cancerous tumors, at the stage of AIDS and not only.
The minimum set of contraindications.
May be used to treat pregnant women.
Cons:
Side effects in the form of disorders of the digestive system, headaches, liver disorders, allergic reactions and more.
The drug is forbidden to be taken simultaneously with such drugs as: Astemizol, Quinidine, Erythromycin, Rifampicin, Amitriptyline and not only. The list is extensive.
Tablet from thrush with 1 piece per pack
If thrush was diagnosed for the first time, then you can limit yourself to a loading dose of the drug in 150 mg, taken once. On sale there are preparations with 1 capsule per package, which is very convenient and economical. Almost all of the products listed above are commercially available in 1 capsule packaging, and with a dosage of 150 mg.
For pregnant
Thrush is often diagnosed during pregnancy, which is associated with a weakened immune system. If the disease has an uncomplicated course, then it is recommended to limit yourself to local therapy in the form of creams and ointments. When the lighter option does not work, resort to the help of oral medications. The dose should be minimal, since many drugs during pregnancy can only be taken if the disease is severe, so as not to harm the growing child.
That is why it is impossible to prescribe yourself pills for thrush on your own, no matter how safe they may seem. A doctor’s consultation is required. Women in the first trimester of pregnancy should be especially careful, since during this period the fetus is especially vulnerable. At this time, Pimafucin becomes the drug of choice.
Candles and vaginal tablets
In the treatment of an uncomplicated form of the disease, the choice is made in favor of drugs in the form of suppositories and vaginal tablets. Acting at the local level, they do not have a systemic effect on the body.
The list of vaginal suppositories for thrush is extensive. Various components act as the main active substance, so it will not be difficult to choose the optimal remedy for the price and composition.
Contraindications and side effects
Each drug is accompanied by an instruction that lists all possible contraindications. They will differ, depending on the active ingredient included in the composition.
The most common restrictions are:
Hypersensitivity to the components of the drug.
Liver and kidney disorders.
Pregnancy and lactation (for some medicines).
Age under 3 years old.
The most common side effect is gastrointestinal disturbances. It can be nausea, diarrhea, abdominal pain. Women also experience allergic reactions. Dizziness and headaches are not excluded. However, given that the treatment of uncomplicated thrush lasts about 3-5 days, in most patients these symptoms disappear without a trace after the completion of therapy, and sometimes do not occur at all.
practical recommendations
Thrush can be cured forever if you approach this issue correctly. First you need to find out the cause of its occurrence.
Very often, women do not associate thrush and high blood sugar, although these two factors are directly dependent on each other. The more simple carbohydrates a person eats, the more likely they are to develop thrush. This disease often affects people with already diagnosed diabetes mellitus.
The second significant factor in the occurrence of vaginal candidiasis is a decrease in immunity. Moreover, the reasons may not be obvious in the form of a chronic sluggish infection, nutritional deficiencies, constant stress, and more. Even lack of sleep can lead to the activation of Candida fungi. Under such conditions, thrush will not keep you waiting long.
The third risk factor is the unreasonable and uncontrolled use of antibiotics.
Treatment of thrush can be divided into 3 stages:
Determination of the sensitivity of Candida to an antifungal drug.
Restoration of microflora in the vagina.
Boosting the immune system.
For the eradication of the causative agent of the disease, oral administration of the drug is recommended. Local therapy is often ineffective and leads to the fact that periodically the disease will worsen. It is not necessary to refuse it, the basis of therapy is an integrated approach.
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