Diflucan vs. Monistat: 6 Ways These Yeast Infection Medications Compare

1. Diflucan and Monistat work in similar ways

Diflucan and Monistat work in similar ways.

Both are part of a group of medications called azole antifungals. Azole antifungals work by destroying a fungus’ protective covering. This stops the fungus from growing and kills it.

2. Diflucan is prescription-only, and Monistat is available OTC

Diflucan is a prescription-only medication. You’ll need to be evaluated by a healthcare professional to get it. It comes as both a brand-name and generic medication.

Monistat is available OTC. So you can purchase it without needing to see a healthcare professional first. It’s readily available at pharmacies and other retailers as both a brand-name and generic product.

If it’s tough for you to get to a healthcare professional’s office, Monistat may be a more accessible treatment. But keep in mind that many telehealth services, such as GoodRx Care, can consult with you virtually and prescribe yeast infection medications. This can make it easier to obtain a prescription for Diflucan without having to leave home.

3. Diflucan is an oral medication, while Monistat is a vaginal cream

Diflucan is available as an oral tablet. It comes in doses ranging from 50 mg to 200 mg. It’s also available as an oral liquid. The typical Diflucan dosage for vaginal yeast infections is 150 mg by mouth one time.

The most popular Monistat products include:

• Monistat 1: Comes with a single vaginal insert that contains miconazole 1,200 mg, plus an external itch relief cream that contains miconazole 2%.

• Monistat 3: Comes with three prefilled applicators that contain either vaginal suppositories, inserts, or cream. Each applicator provides a dose of miconazole 200 mg. Most Monistat 3 products also include an external itch relief cream that contains miconazole 2%.

• Monistat 7: Comes with seven prefilled applicators that each contain miconazole 2% cream. There’s also a combination pack that includes the seven prefilled applicators and an external itch relief cream that contains the same active ingredient.

Good to know: There are other products in the Monistat line that have different active ingredients. For example, there is another version of Monistat 1 that contains a different antifungal medication called tioconazole. Other products only contain itch relief medications and don’t treat yeast infections. Be sure to read the OTC labels carefully when selecting a Monistat product, and ask the pharmacist for guidance if you need it.

4. Treatment time with Diflucan is shorter than with Monistat

Most times, you’ll only need to take a single dose of Diflucan for it to work. Monistat treatment times vary. But there’s an easy way to remember it. The numbers on the Monistat package tell you the number of days you should use them.

You would use Monistat 1 for 1 day, Monistat 3 for 3 days, and Monistat 7 for 7 days. If your product also comes with a tube of external itch cream, you can apply it for up to 7 days. Keep in mind that generic versions of Monistat may not have the number of days featured as prominently on the package. Read the instructions on the OTC label to see how long you should use it.

Keep in mind you may not always experience relief right away. You may notice symptom relief about 24 hours after taking Diflucan. But it can take up to 3 days for it to fully work. If your symptoms haven’t resolved after 3 days, contact your prescriber.

It takes about 3 days before most people notice that Monistat is working. But it may take up to a week to feel back to normal. If you’re still having symptoms more than 7 days after starting Monistat, tell a healthcare professional.

5. Diflucan and Monistat are first-choice options for most yeast infections

Both Diflucan and Monistat are first-choice options to treat most vaginal yeast infections. About 80% to 90% of people experience full relief of symptoms after completing treatment.

One exception to this is if you have a yeast infection and you’re pregnant. In this case, it’s recommended to use Monistat 7. Shorter courses of Monistat haven’t been studied as well for safety during pregnancy. And there’s concern that Diflucan could harm a developing fetus.

6. Side effects for Diflucan and Monistat are different

Side effects for Diflucan and Monistat are different. The table below highlights the most common ones for each. But keep in mind that both Diflucan and Monistat are typically well tolerated.

The difference in side effects is due to how you administer each medication. Monistat is a topical medication. Your body doesn’t absorb much of the medication through your skin or vagina. Most of its effects are limited to the areas around where you apply it. It has a lower risk of side effects in other areas.

Diflucan is an oral medication. It can irritate your digestive tract after you take it. And once the medication reaches your bloodstream, it travels throughout your body. This means Diflucan can have full-body side effects.

Can you use Diflucan and Monistat together?

No, it’s not recommended to combine Diflucan and Monistat. This is because both medications work similarly. And each one works well on its own. If you find that Diflucan or Monistat isn’t working for you, talk to a healthcare professional. You may need a longer course of antifungals or a different treatment altogether.

How do you pick between Diflucan and Monistat?

The choice between Diflucan and Monistat is usually based on personal preference and cost. Here are some questions to consider when deciding which one is better for you:

• Are you uncomfortable with using a vaginal applicator? If this is the case, Diflucan may be easier for you, since it’s taken by mouth.

• Are you sensitive to digestive side effects when taking oral pills? These are common Diflucan side effects. You may tolerate Monistat better.

• Is it tough to carve out time in your schedule to see a prescriber? Monistat may be easier to get started with because it’s available OTC.

• Do you have prescription insurance? Diflucan is covered by most insurance plans, including Medicare, and it may be cheaper through your insurance. Since Monistat is available OTC, it’s common for insurance providers not to cover it.

• How severe are your symptoms? Your healthcare team may recommend different medications or treatment times depending on how you’re feeling.

• Are you pregnant? Always talk to your prenatal care team about treatment first. But there’s a good chance they’ll recommend Monistat over Diflucan.

• How often do you experience yeast infections? Your prescriber or pharmacist may suggest a different yeast infection medication than the last time, especially if your last infection wasn’t too long ago.

How to save on Diflucan and Monistat

There are ways to save on Diflucan and Monistat, which are available as both brand-name and generic medications. GoodRx can help you save as much as 90% off the average retail price of the generic versions.

Generic Diflucan’s (fluconazole’s) price at certain pharmacies is as low as $9.51 per tablet with a free GoodRx discount.

If your healthcare professional writes you a prescription for Monistat, you can also use GoodRx to save on it. The prices of each version of generic Monistat (miconazole) may be as low as:

• Generic Monistat 1: $14.25

• Generic Monistat 3: $11.31

• Generic Monistat 7: $5.12

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Written by:

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP, has over a decade of experience as a pharmacist, professor, and researcher. She currently practices as a clinical pharmacist at Buffalo General Medical Center.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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