infectious

Vaginal candidiasis (vulvovaginal thrush)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources2 sources

CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Vulvovaginal Candidiasis - Recommended Regimens, Oral Agent · Egyptian National Drug Formulary - Antimicrobial 2023 (clotrimazole monograph)

Verified against3 documents

CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Vulvovaginal Candidiasis - Recommended Regimens, Oral Agent
Egyptian National Drug Formulary - Antimicrobial 2023 (clotrimazole monograph)
Vaginal Candidiasis - disease-level clinical article (vaginal-candidiasis-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (2)

Vulvovaginal itching, burning, and irritation are the hallmark symptoms and often worsen just before menses [itching]
Many patients have had the same symptoms before and have already tried an over-the-counter antifungal

Signs — what you find (4)

Vulvar and vaginal redness with a thick, white, clumped discharge and swelling are the typical findings [redness]
The cervix looks normal, without cervical motion tenderness or abnormal discharge from the os
Candida glabrata infection tends to cause only mild symptoms, unlike typical acute candidiasis
An ulcer, asymmetric swelling, a mass, or a foreign body on exam should raise a different diagnosis [foreign body]

Tests (4)

Vaginal pH under 5 is typical of a yeast infection
A negative whiff test with budding yeast or hyphae seen on a KOH prep supports the diagnosis
Culture is reserved for recurrent disease or a negative work-up despite classic symptoms
Culturing an asymptomatic woman is discouraged since Candida can be a normal vaginal resident

If not this — what else fits (2)

Lichen simplex chronicus is on the differential for vulvar itching and irritation
Physiologic leukorrhea is a normal-discharge differential to distinguish from a yeast infection

SourceStatPearls "Vaginal Candidiasis" - disease-level clinical article

Presentation findings are traced to the source above.

Rx: Not pregnant | In pregnancy | Main treatment

NOT PREGNANT

FLUCONAZOLE

Not pregnant

1st line

Strength150 mg

Formoral.solid

Adult dose and duration

150 mg single oral dose - Single dose

Paediatric dose

Not routinely indicated for vaginal candidiasis in pre-pubertal children

Dose source

CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Vulvovaginal Candidiasis - Recommended Regimens, Oral Agent

Why

Convenient single-dose oral treatment of choice for uncomplicated candidiasis

Cautions

CONTRAINDICATED in pregnancy (use topical azole instead).
Caution with concurrent CYP3A4/CYP2C9 metabolized drugs.
In severe/recurrent cases, repeat 150 mg dose after 72 hours.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
JENFUNGA 150 MG 1 CAPS.	EGPI > JENIKO MEDICINE PHARMACEUTICALS	4.50 EGP (4.50/unit)
AMRIFLUCAN 150 MG 2 CAPS.	AMRIYA	11.00 EGP (5.50/unit)
FLUDCONRIZOLE 150 MG 1 CAPS.	RIVA PHARMA S.A.E.	6.00 EGP (6.00/unit)
FLUCORAL 150 MG 4 CAPS.	SEDICO	60.00 EGP (15.00/unit)
TRICONAL 150 MG 1 CAPS.	T3A PHARMA > PAXAL	26.50 EGP (26.50/unit)
NAVILUCA 150 MG 2 CAPS.	INTERNATIONAL DRUG INDUSTRIES > ROTABIOGEN	69.00 EGP (34.50/unit)
NAZOWELL 150 MG 3 CAPS.	EGPI > HEALTH WELL	108.00 EGP (36.00/unit)
DIFLUCAN 150 MG 1 CAPS.	PFIZER	111.00 EGP (111.00/unit)
DIFLUNAZOLE 25MG/5ML SYRUP 70ML? strength differs? different route - not oral solid	CID	28.80 EGP
FLUCAZONIL 25MG/5ML SYRUP 70 ML? strength differs? different route - not oral solid	EL NILE.	28.80 EGP

IN PREGNANCY

CLOTRIMAZOLE

In pregnancy

1st line

Strength100 mg

Formvaginal

Adult dose and duration

Insert 100 mg vaginal pessary at bedtime for 6 nights (or 500 mg single dose) x 6 nights (or 1 night for 500 mg)

Paediatric dose

Pediatric vulvovaginitis requires specialist evaluation

Dose source

Egyptian National Drug Formulary - Antimicrobial 2023 (clotrimazole monograph)

Why

Topical azole preferred in pregnant women

Cautions

MSF Essential Drugs 2024 records no contra-indication in pregnancy, with one proviso: do not use the applicator, which can damage the cervix. Insert with a finger, not the applicator.
May damage latex condoms and diaphragms.
Local vaginal burning or irritation may occur.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
CANDISTAN 100 MG 6 VAG.TABS.	ARAB DRUG COMPANY (ADCO)	9.00 EGP
KREMA-ROSA 100MG 6 VAG.TABS.	EIPICO	10.50 EGP
LOCASTEN 100 MG 6 VAG. TABS.	ALEXANDRIA	10.50 EGP

MAIN TREATMENT

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line

Dose source

Vaginal Candidiasis - disease-level clinical article (vaginal-candidiasis-clinical.txt)

Why

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

Cautions

RED FLAG - Persistent symptoms after standard treatment require fungal culture to evaluate for non-albicans Candida species.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.