Terconazole is a prescription antifungal medication used to treat vaginal yeast infections in adults. You can find it as a vaginal cream (terconazole 0.4% or 0.8%) or a suppository. This medication is inserted vaginally nightly. Treatment usually lasts 3 to 7 days, depending on the strength of the medication. Common side effects include headaches, and vaginal burning and itching. Terconazole is generally not recommended in first trimester of pregnancy, but your obstetrician-gynecologist (OB-GYN) might prescribe it in the second or third trimester if the benefits outweigh the risks.
Treatment of a vaginal yeast infection
Terconazole is an azole antifungal medication. It works by blocking a protein needed to make the fungal cell membrane, which is the structure that surrounds and protects the cell. In doing so, terconazole weakens the cell membrane, preventing the fungus from growing and eventually killing it to treat the infection.
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Burning feeling in the vagina
Incidence not known
Blistering, peeling, or loosening of the skin
chills
difficulty with swallowing
dizziness
fast heartbeat
general feeling of discomfort or illness
headache
hives or welts
hoarseness
irritation
joint or muscle pain
joint pain, stiffness or swelling
loss of appetite
muscle aches and pains
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
rash
red skin lesions, often with a purple center
red, irritated eyes
redness of the skin
shivering
skin rash
sores, ulcers, or white spots in the mouth or on the lips
sweating
swelling of the eyelids, face, lips, hands, or feet
tightness in the chest
trouble sleeping
troubled breathing
unusual tiredness or weakness
vomiting
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Incidence not known
Difficulty with moving
lack or loss of strength
muscle aching or cramping
muscle pain or stiffness
swollen joints
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Available as a vaginal cream or suppository
Can treat most vaginal yeast infections in 3 or 7 days, depending on the strength of medication
Only need to use once a day
Can leak out after inserting into the vagina, which can be messy or cause discomfort
Suppository might damage latex or rubber in condoms and diaphragms
Might be difficult for some people to use safely and as directed
Consider wearing cotton underwear or loose-fitting clothes during and after treatment with terconazole. This can create a breathable environment to help your yeast infection heal faster.
If you have belly, back, or shoulder pain, fever, chills, nausea, vomiting, or foul-smelling vaginal discharge, let your healthcare team know before using terconazole. These aren't typical symptoms for a yeast infection, and you might have a more serious condition that needs more medical attention.
Let your healthcare team know if you have yeast infections often (such as once a month, or 3 times in 6 months) or if your symptoms come back within 2 months. Your care team can check to make sure there aren't other medical conditions that are causing your symptoms, such as diabetes, pregnancy, or a weakened immune system (e.g., human immunodeficiency virus or HIV).
Don't have sex until you've finished treatment with terconazole and have no more symptoms. Sex can make your symptoms worse. In addition, having vaginal intercourse before you're fully healed from the infection can put your partner at risk for also getting a yeast infection.
Avoid using tampons, douches, spermicides, or other vaginal products during treatment with terconazole as well since they can affect how well the medication works.
Make sure to wipe from front to back (away from the vagina) after using the bathroom.
How to use terconazole cream
1) Wash your hands, and then attach the open end of the applicator to the tip of the tube of cream. Gently squeeze the tube until the applicator is full or the plunger stops.
2) Lie on your back with your knees bent and gently insert the applicator into the vagina as far as it will go comfortably.
3) Push the plunger all the way into the applicator to empty all the medication.
4) Wash the empty applicator and plunger with warm soapy water and dry both pieces completely.
How to use terconazole suppository
1) Wash your hands, and then remove one suppository from the strip of suppositories and take off the wrapper.
2) While lying on your back with bent knees, insert the suppository slowly into the vagina with either an applicator or your finger.
Terconazole can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Though rare, some people who have used terconazole have experienced serious allergic reactions. These can include anaphylaxis, which might cause symptoms like a rash, hives, difficulty breathing, or swelling of the face. Another rare reaction is toxic epidermal necrolysis (TEN), a severe skin condition that can cause fever, a painful rash, and peeling or blistering of the skin. If you notice any of these symptoms while using terconazole, get medical attention right away. Your healthcare team will likely stop the medication and recommend a different treatment option.
Terconazole should only be used vaginally. Don't take this medication by mouth, and never use it in your eyes, nose, or ears. If you think that you or your child might have accidentally swallowed this medication, call your Poison Control Center at 1-800-222-1222 right away.
If your vaginal yeast infection symptoms (itching, irritation, or thick discharge) haven't gotten any better 3 days after using terconazole, let your healthcare team know. Also speak with your healthcare team if your infection isn't completely cleared up after 7 days. In both of these situations, you might need a different medication to treat your infection.
Terconazole 0.4% cream: The typical dose is to insert 1 applicatorful of cream into the vagina once daily at bedtime for 7 days.
Terconazole 0.8% cream: The typical dose is to insert 1 applicatorful of cream into the vagina once daily at bedtime for 3 days.
Terconazole 80 mg suppository: The typical dose is to insert 1 suppository into the vagina once daily at bedtime for 3 days. You can insert the suppository either with or without the applicator.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
Treatment of vaginal yeast infection
Relief of vaginal yeast infection symptoms (itching and irritation outside of the vagina)
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Centers for Disease Control and Prevention. (2021). Vulvovaginal candidiasis (VVC).
Dixon, D. M., et al. (1996). Chapter 76 Antifungal agents. Medical Microbiology, 4th edition.
E. Fougera & Co. a division of Fougera Pharmaceuticals Inc. (2021). Terconazole vaginal cream 0.8%- terconazole cream [package insert]. DailyMed.
Padagis Israel Pharmaceuticals Ltd. (2023). Terconazole suppository [package insert]. DailyMed.
Taro Pharmaceuticals U.S.A., Inc. (2024). Terconazole cream [package insert]. DailyMed.
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