How It Works
Fungal cells rely on a sterol lipid called ergosterol, which helps maintain function and fluidity within the cell membrane. Terconazole vaginal cream works by inhibiting enzyme cytochrome P-450, which is essential for converting other sterols into ergosterol.
Blocking this conversion disrupts fungal cell membrane formation, eventually leading to fungal cell death.
| Quick Facts | |
|---|---|
| Common Brands | Terazol 3, Terazol 7 |
| Drug Class | Triazole antifungal agent |
| Generic Status | Generic version available |
| Availability | Prescription only |
Dosing
Terconazole cream is designed for localized treatment within the vaginal canal. Per standard guidelines, consistent application throughout the treatment course is essential for eradicating the fungus. Dosing guidelines vary by which version of the drug the patient is using.
- Terconazole 0.4% cream: Standard guidelines advise patients to apply 0.4% cream once daily at bedtime for 7 consecutive days.
- Terconazole 0.8% cream: Standard guidelines advise patients to apply the 0.8% cream once a day at bedtime for 3 consecutive days.
- Terconazole 80mg suppository: This form of the drug is inserted high into the vagina at bedtime, and typically used for 3 consecutive days.
- Administration: Terconazole vaginal cream comes with an applicator for administering the topical effectively. Instructions will indicate how the applicator should be used.
- Timing: Applying the medication at bedtime is recommended because it allows the medication to remain in close contact with affected tissue for several hours. Using the cream before bed also helps minimize leakage that can occur due to gravity and movement.
- Consistency: Per standard guidelines, patients are advised to complete the treatment course, even if their symptoms clear or their menstrual period begins before the course is complete. Stopping medication before the course is complete can allow the fungal cells to regrow.
Note: Dosing information below is educational only. Your prescribing physician will determine your specific dose based on your individual health needs. Always follow your healthcare provider’s instructions for exact dosing.
Uses
FDA-Approved Uses
Terconazole vaginal cream is FDA-approved to treat vulvovaginal candidiasis, commonly known as vaginal yeast infections. Specifically, the drug is approved for the local symptoms of candida fungal overgrowth, including itching, burning, and discharge.
Off-Label Uses
You may see terconazole vaginal cream prescribed for uses that are not “FDA-approved.” This is a common and legal practice called “off-label” prescribing, where a doctor uses their clinical judgment to prescribe a drug for a different (but well-researched) purpose.
Common off-label uses for terconazole vaginal cream currently found in clinical research and practice include:
- Non-albicans candida infection: Candida albicans fungus is the most common cause of vaginal yeast infections, but other strains like Candida glabrata can be resistant to over-the-counter medication. Terconazole may be effective against other resistant Candida strains as well.
- Recurrent vulvovaginal candidiasis: Providers may recommend terconazole as long-term maintenance suppression therapy for people who experience four or more vaginal yeast infections per year.
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Side Effects
Common Side Effects
Terconazole vaginal cream is localized, but the body can still absorb the medication. Patients may also experience side effects due to tissue reacting to the drug. The most common side effects from using terconazole vaginal cream include:Dizziness or lightheadedness
- Headache
- Temporary stinging or burning at the application site
- Cramping or “period”-like pain (dysmenorrhea)
- Mild stomach or pelvic discomfort
Serious Side Effects
Serious side effects are rare, but it’s important to know what to look for if they do occur.
Serious side effects from using terconazole vaginal cream can include:
- Toxic epidermal necrolysis (TEN): Terconazole cream can produce this rare but severe skin reaction, which is characterized by a painful red rash, blistering, and peeling of the skin or mucous membranes.
- Flu-like symptoms: People who are sensitive to terconazole vaginal cream may react to the medication with a high fever, chills, or widespread body aches.
- Severe allergic reaction: As with any prescription medication, terconazole vaginal cream can cause anaphylaxis in people who are allergic to one or more of the drug’s active ingredients.
Call your doctor immediately if you experience any concerning or prolonged symptoms.
Pharmacist Tips
Wearing Cotton Can Help
Providers generally recommend wearing loose-fitting cotton undergarments during and after terconazole vaginal cream treatment. Synthetic fabrics like nylon and polyester trap moisture and heat, which can encourage yeast to grow.
Avoid Using Tampons
Most people who use the cream experience some leakage the following morning, but tampons are not advised because they absorb the medication and make it less effective. Fragrance-free panty liners are recommended instead.
Wipe Front to Back
Per standard guidelines, wiping the cream from front to back is the most effective way to prevent reinfection and the introduction of new bacteria into the vagina.
Skip Fragrant Products
It is advised to avoid scented soaps, bubble baths, and feminine hygiene sprays while using terconazole cream. These products can further irritate the vagina’s mucous membranes and disrupt the vagina’s normal pH balance.
Stay the Course
Standard guidelines state patients should complete their entire prescribed treatment course, even if the itching and other symptoms subside quickly. Stopping early can allow the infection to return.
Drug Interactions
Terconazole’s systemic absorption level is low, so the drug does not typically interact with oral medications. However, localized interactions can occur. Known interactions with terconazole vaginal cream include:
- Vaginal products: Douches, spermicides, and other vaginal creams can interfere with terconazole’s ability to coat the vaginal wall as intended. It is advised to avoid these products during your treatment course unless your doctor instructs otherwise.
- Contraceptives: Terconazole has been shown to weaken the latex found in condoms and diaphragms. Patients are advised to use alternative methods of birth control or abstain from intercourse while using terconazole vaginal cream.
Always give your doctor and pharmacist a complete list of all your medications, vitamins, and supplements to check for potential interactions.
FAQs
Why does terconazole come in both 3-day and 7-day options, and which one is better?
The 3-day terconazole cream (0.8%) is more concentrated and potent, while the 7-day cream (0.4%) has a lower concentration. Neither is necessarily better, but the 7-day treatment may be prescribed for stubborn infections and people with sensitive skin.
Can I use terconazole while I am on my period?
Yes, it is recommended to continue using terconazole vaginal cream while on your period. Using pads or fragrance-free panty liners instead of tampons can ensure the medication remains in your vaginal canal.
Why do I feel a burning or stinging sensation after inserting the cream?
A burning or stinging sensation after inserting the cream is a common side effect of terconazole and other azole medications. This occurs because the vaginal tissue is already inflamed and sensitive from the infection. Patients are advised to contact their provider if they experience severe burning or swelling.
How long do I need to wait after finishing the medication to have sex?
Providers typically recommend waiting until the terconazole vaginal cream treatment course is finished and all symptoms are resolved before resuming sexual intercourse.
Does terconazole weaken condoms or diaphragms?
Yes, terconazole is known to weaken the latex used in condoms and diaphragms. Alternative methods of birth control or sexual abstinence are recommended during the terconazole treatment course.
Can I drink alcohol while using terconazole?
Generally, yes. There are no known interactions between the drug and alcohol. However, limiting alcohol intake can improve hydration and support the immune system as your body fights the infection.
Is terconazole safe to use during the first trimester of pregnancy?
Per standard guidelines, pregnant people are generally not advised to use terconazole vaginal cream. Animal studies suggest terconazole poses some risks to fetal health. Speak with your doctor to see if terconazole is safe for you.
What should I do if the cream leaks out during the day?
Some leakage during the day is to be expected. To ensure as little of the cream leaks out as possible, it is recommended to apply the cream at night before bedtime and wear a fragrance-free panty liner the next day.
Can I use a tampon to keep the medicine inside?
No, it is not recommended to use a tampon to keep the medicine inside. Tampons absorb terconazole and can make the drug less effective at fighting the fungal infection.
Does terconazole treat bacterial vaginosis (BV) or just yeast?
Terconazole vaginal cream is a strictly antifungal medication. It cannot be used to treat bacterial infections or viral infections.
Is there a difference between the cream and the suppositories?
Terconazole creams and suppositories share the same active ingredient, but differ by application. The cream may allow for easier coating of the vulva if patients have external itching.
Does terconazole work for “resistant” yeast infections?
Yes, terconazole has been shown to work for resistant yeast infections. The drug is often prescribed off-label for recurring Candida infections, including some that are resistant to over-the-counter medication.
Can I use terconazole if I am breastfeeding?
Terconazole’s effect on breastfeeding women has not been specifically studied, so its safety is not known. The drug is not known to pass into human milk, but providers may still prefer other antifungal medications in these instances. Talk to your doctor or OB/GYN about the best antifungal options while you’re breastfeeding.
How far should I insert the applicator?
Per standard guidelines, patients should gently insert the terconazole applicator into the vagina as far as it will go comfortably. During application, it is recommended to lie on your back with both knees bent, or to stand with one leg on a chair.
Can my partner get a yeast infection if we have sex while I’m treating it?
Yes, your partner can get a yeast infection if you have sex while you’re treating your infection. It is recommended to wait until the treatment course is complete and all symptoms have cleared up before engaging in sexual intercourse.
Why did my doctor prescribe this instead of Diflucan (fluconazole)?
Your doctor may have chosen terconazole vaginal cream because it is a topical medication that works at the site of infection for faster relief from itching. Diflucan (fluconazole), an oral tablet, may need more time to take effect. Your doctor may also choose Diflucan because of your medical history.
Comparable Medications
Terconazole Vaginal Cream, Miconazole, Clotrimazole, Fluconazole, Metronidazole, or Clindamycin?
Terconazole vaginal cream is a topical medication used to relieve symptoms of vaginal yeast infections and stop fungal growth. Other drugs are used for the same purpose, and your doctor may choose a terconazole alternative based on factors like your age, medical history, and severity of symptoms. Alternatives to terconazole vaginal cream include:
Miconazole
Sold under the brand name Monistat, miconazole is an over-the-counter antifungal medication. Terconazole is effective against a broader spectrum of yeast strains.
Clotrimazole / Betamethasone Cream
From $29.89
Available under the brand name Gyne-Lotrimin, clotrimazole is an over-the-counter antifungal used to treat vaginal yeast infections as well as athlete's foot, ringworm, and jock itch.
Fluconazole
From $22.99
Fluconazole, available under the brand name Diflucan, is an antifungal medication taken as an oral-dose tablet that is processed through the liver.
Metronidazole
From $22.99
Metronidazole, available under the brand name MetroGel, is primarily prescribed for bacterial vaginosis and does not have antifungal properties.
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Important: Information on this page is for educational purposes only. Prescribing decisions are made by independent, licensed providers. TelyRx operates technology-enabled pharmacies and a telehealth platform that connects patients with board-certified licensed providers. Prescriptions, when provider-approved and issued, are filled and shipped by TelyRx-affiliated pharmacies. We do not employ physicians or make prescribing decisions. Learn more about our editorial standards here.