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Medicine For Yeast Infections by Species

Medically Reviewed by Dr. Vibhuti Rana

This article takes a look at medicine for yeast infections and their risks. I personally believe and practice natural and herbal therapies with almost all my health needs, preferring to use a doctor in surgical or extreme prolonged illness. The body if provided the necessary food based nutrients can usually almost always heal itself. Here are a few medicines that are used in case of yeast-based infections.

Nystatin

Nystatin is a naturally occurring anti-fungal agent derived from a filamentous bacteria (Streptomyces noursei). It is the most widely prescribed medicine for yeast infections and is extremely safe due to it being very poorly absorbed by the body.  However, this poor absorption limits its effectiveness in many cases because apparently, it is unable to completely eradicate yeast infections that are firmly entrenched in the lining of the digestive system. But, Nystatin is effective in reducing the symptoms of yeast infection caused diseases. It is also extremely effective as a evaluation tool since you can take it for two weeks without any ill effects. If it gives you relief from the symptoms of your disease, then you most definitely have a yeast infection.

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For example, lets assume you have Crohns disease or irritable bowel syndrome. These are two yeast related diseases that modern medicine has no identifiable cause. Have your doctor prescribe Nystatin and take it for two weeks as you practice the Candida diet. If you have relief and show some improvement, then you have verified the cause of your disease. You can then continue on the Candida Diet and start herbal and natural therapies.

The Azole Drugs

The azole drugs including ketoconazole (Nizoral), fluconazole (Diflucan), and itraconazole (Sporanox) are medicine for yeast infections that have become quite popular in the treatment of vaginal yeast infections. These are strong medicines for yeast infections that do have a few side effects that every one should be aware of. All three are completely absorbed by the digestive system and are associated with liver damage and sometimes kidney damage, which occurs in roughly 1 out of 100 individuals. Severe liver damage happens to about 1 in 10,000 and death has also been recorded in rare cases.

There doesn't appear to be any way of determining who is at risk and is likely to suffer these severe consequences. Researchers have not been able to find any common link to daily dose, therapy, age, sex, or any associative factor. I recommend using these drugs as a "last-ditch" effort if you have a chronic or systemic fungal infection, owing to their greater health risks.

Out of the given Azole drugs,  Diflucan and Sporanox seem to be the safer options. Diflucan appears to be more effective for treating chronic systemic infections caused by Candida albicans, Candida parapsilosis, and Candida tropicalis. Sporanox seems to be more effective at treating infections that have skin and nail involvement. Many physicians will prescribe a combination of Nystatin and an azole drug in combination to treat your condition. The azole drugs are so well absorbed by the body that the effective concentration in the intestine is too low. With Nystatin added, which is digestive system specific, very good results are achieved.

Sporanox costs about $10 per pill and you take one to two per day as prescribed by your physician. Diflucan is $9.00 per pill and Nizoral about $6 per pill and is generally used for infections of the skin, most commonly dandruff. But very good success can be achieved for internal yeast as well.

Voriconazole is a newer azole class medicine for yeast infections that comes in a tablet form or can be used as an IV. It works well for Candida albicans, Candida parapsilosis, Candida lusitaniae and Candida tropicalis.

Posaconazole comes in a liquid form and works well against all species of candida including Candida glabrata and Candida krusei. These two strains of candida yeast are highly resistant to Diflucan.

The Enchinocandins

The Enchinocandins; Caspofungin, Micafungin and Anidulafungin are administered by IV. These drugs are not azoles but are classified in an independent class. They work directly on the biofilm and cell wall of yeast, resulting in cell death, much like coconut oil. These medicines for yeast are the drugs of choice for Candida glabrata and Candida krusei.

Polyene Antifungals

Amphotericin B is a polyene antifungal that is used primarily for life threatening fungal infections and is given intravenously; and sometimes surgical removal of the infection is required. This is the drug of choice for Rhodotorula yeast which I sometimes see in stool test results. It also works well for all species of Candida except for Candida lusitaniae.

When taking Amphotericin B for yeast infections it is important to be monitored for urea nitrogen, creatinine clearance and serum potassium levels. Any abnormalities should be rapidly dealt with. When taking these medicines for yeast infections it usually is a race to see how long the kidneys will hold out verses the the resilience of the yeast infection. Unfortunately, the fungal infection most often wins because it can get entrenched to such a magnanimous extent in the body.

Other Medicines for Yeast Infections

Some other medicines for yeast infection are FULVICIN-UF, GRIS-PEG, or Griseofulvin which is used to treat fungal infections of the skin, hair, fingernails, and toenails. Side effects can include diarrhea, nausea, gas, vomiting, fatigue, dizziness or insomnia as your body adjusts to the medication. If you develop a rash, hives, itching, increased sensitivity to sunlight, yellowing of eyes or skin, fever, soreness of the mouth/tongue/throat, notify your doctor at once.

Lamisil is another medicine for yeast infections that is used primarily on the skin. Side effects can include burning, redness or irritation the first few days as your body adjusts to the medication. If these symptoms continue or if you experience swelling, oozing or blistering, please contact your doctor as soon as possible.

Mycelex is a topical medicine for primarily skin yeast infections, although some doctors will prescribe it as an oral rinse for thrush or as a douche for vaginal yeast infection.

Fact Checked & Commentary by Dr. Vibhuti Rana

The above mentioned information regarding various drugs used for anti-fungal purposes is correct.

Amphotericin B was the only drug available for around 30 years (with high percentage of nephrotoxic side effects) before we found Nystatin, or mycostatin, which is a polyene compound made up of six large polyketide synthase proteins, decorated by glycosyltransferases or P450 monooxygenase that works by inhibiting fungal growth (by binding to ergosterol and changing fungal membrane permeability), generally in stomach and intestines. (1, 2) However, in most patients, it is accompanied by side effects like diarrhea or bloating.

In addition, system fungal treatment has been conducted by using the azole class of antifungals. Ketoconazole, fluconazole, and itraconazole are the major drugs belonging to this category. While ketoconazole was the earliest azole drug to be introduced, it is accompanied by side effects like dysregulation of hormones and hepatitis. In a review published in the New England Journal of Medicine in 1994, it was concluded that fluconazole is effective for patients with serious Candida syndromes such as candidemia. On the other hand, itraconazole works best for treating aspergillosis. (2)

Chandrasekar, in 2011 published an article on the role of polyenes in the invasive fungal infection management. He said that polyenes are the evergreen drugs since they have broad spectrum activity, lower resistance rate, and a trusted record of treatment, especially in immunocompromised individuals. (3) Some other drugs being used, in order to reduce the problem of drug resistance are Echinocandins (caspofungin, micafungin, and anidulafungin) and anti-metabolite 5-flucytosine (limited to Candida spp. and C. neoformans).

Updated 1/20/2020

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Any questions about these medicines for yeast infections or if you would like to know which one might be best for you, you can contact me through the contact page of this website.

Dr. Rana's References

1. Mahmoud A. Ghannoum, Louis B. Rice. Antifungal Agents: Mode of Action, Mechanisms of Resistance, and Correlation of These Mechanisms with Bacterial Resistance. Clinical Microbiology Reviews Oct 1999, 12 (4) 501-517; DOI: 10.1128/CMR.12.4.501.
2. Fjærvik, E. & Zotchev, S.B. Appl Microbiol Biotechnol (2005) 67: 436 Biosynthesis of the polyene macrolide antibiotic nystatin in Streptomyces noursei.
3. Como JA, Dismukes WE. Oral azole drugs as systemic antifungal therapy.  N Engl J Med. 1994 Jan 27;330(4):263-72. https://www.ncbi.nlm.nih.gov/pubmed/8272088
4. Pranatharthi Chandrasekar, Management of invasive fungal infections: a role for polyenes, Journal of Antimicrobial Chemotherapy, Volume 66, Issue 3, March 2011, Pages 457–465,

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