Thrush: Medications

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Medications

Thrush is a yeast infection that can develop in the mouth and throat and on the tongue. Thrush is most common in newborns, infants, and older adults, but it can occur at any age. In healthy newborns and infants, thrush is usually not a serious problem and is easily treated and cured.

Both nonprescription and prescription medicines that inhibit the growth of yeast (antifungals) are available for treating thrush. If nonprescription medicines do not cure thrush, you will need to see a doctor for a prescription medicine.

In infants, treatment is continued for at least 48 hours after the symptoms have gone away. Most adults need treatment for 14 days. In more severe or persistent infections, treatment may be continued beyond the normal treatment period.

Antifungal medicines are either applied directly to the affected area (topical) so the medicine affects only that area, or swallowed (oral) so the medicine affects the entire body.

Topical antifungal medicines

Topical antifungal medicines are applied to the affected area and are available in a variety of forms, such as rinses and lozenges.

Topical antifungal medicines need to be in contact with the affected area long enough to stop the growth of the yeast. Lozenges are preferred because they take longer to dissolve. Because the lozenges need moisture to dissolve, sipping water while using them may increase their effectiveness.

Because several of the topical antifungal medicines contain sugar, there is an increased risk of cavities when the medicines are used for long periods of time. Using a topical fluoride rinse or gel (if you are not already obtaining fluoride through other means) during treatment may help prevent cavities.

Oral antifungal medicines

Unlike topical antifungal medicines, oral antifungal medicines affect the whole body. Oral medicines are used alone to treat mild thrush infections, but they also may be combined with topical antifungal medicines to treat more severe thrush infections.

Oral antifungal medicines are used to prevent thrush in certain people with conditions that weaken the body's immune system.

Oral antifungal medicines should not be used during pregnancy because the fetus may be harmed. But oral antifungal medicines may be used in pregnant women who have a rare, severe infection that has spread to the blood.

In rare cases, an antifungal medicine will need to be injected into a vein (intravenous, or IV).

Medication Choices

Nonprescription medicines

• Gentian violet (1%) is a dye that kills bacteria and fungi, including the yeast that causes thrush.
• Listerine mouthwash has been recommended to help prevent thrush in people with acquired immunodeficiency syndrome (AIDS).

Prescription medicines

• Polyenes (such as Mycostatin and Fungizone)
• Azoles (such as Diflucan, Monistat, Mycelex, Nizoral, and Sporanox)
• Chlorhexidine (such as Peridex)

What To Think About

• Both polyenes and azoles cure thrush most of the time.
• Nystatin (a polyene) is the medicine used most often to treat infants with thrush.
• Although azoles have been shown to be safe for babies and children in a few limited studies, more research is needed.³ Polyenes are usually the first medicine tried for babies and children. Relapse rates are about the same for both medicines.³

Last updated:	March 10, 2008
Author:	Maria G. Essig, MS, ELS
Reviewed By:	Michael J. Sexton, MD - Pediatrics, Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC