How Long Does It Take for Fluconazole to Work?

Vaginal yeast infections (vulvovaginal candidiasis) are common fungal infections caused by an overgrowth of a yeast called Candida, which naturally lives in the vagina. When the balance of bacteria and yeast is disrupted, the yeast can grow out of control, leading to symptoms such as itching, burning, and a thick, white discharge.

Treating yeast infections typically involves antifungal medicine, which can be either topical or oral. One antifungal used to treat yeast infections is fluconazole. 

It's often chosen for its convenience as it typically involves taking a single dose, but is treating a yeast infection really as simple as popping a pill? And how long does fluconazole take to treat a yeast infection? Keep reading to learn more about fluconazole, and what to do if treatment fails. 

How does fluconazole work?

Fluconazole works by stopping the growth of Candida, the yeast that causes vaginal yeast infections. It does this by interfering with the cell membrane's formation, which is essential for their survival.

Specifically, fluconazole stops an enzyme called lanosterol 14-α-demethylase from doing its job, which is necessary for making a component that the yeast needs to keep their cell membrane strong. The cell membrane becomes weak without this component, and the yeast can't survive. For this reason, fluconazole is used to treat several fungal infections, including oral thrush.

By getting rid of the excess Candida, fluconazole helps bring back the natural balance of microorganisms in the vagina, which also gets rid of those uncomfortable yeast infection symptoms.

Some studies show that fluconazole is over 90% effective in treating vaginal fungal infections.

How to take fluconazole

Fluconazole is usually taken as a single dose of 150 mg for mild, uncomplicated, yeast infections. Your doctor might prescribe a different dosing regimen for more severe or recurrent yeast infections, such as taking one dose and then another 72 hours later. 

It's important to follow your doctor's instructions and complete the entire course of medication to ensure the infection is fully treated. It’s important to note that fluconazole isn’t recommended if you’re pregnant. 

How long does it take for fluconazole to work?

After taking a single dose of fluconazole, many women notice symptom relief within 24 hours. However, it can take up to three days for symptoms to significantly improve, and the infection may take up to seven days to fully clear. It's crucial to be patient and give the medication time to work.

If you find yourself dealing with recurrent vulvovaginal candidiasis (VVC) — which means having three or more yeast infections in less than a year — the Centers for Disease Control and Prevention (CDC) suggests taking fluconazole once a week for six months. 

What if fluconazole doesn’t work? 

While fluconazole is highly effective for treating a yeast infection, it doesn't always work for everyone. Here are a few reasons why:

Resistant strains of Candida

Although most vaginal yeast infections (90%) are caused by an overgrowth of Candida albicans, other Candida strains can be responsible. In some cases, the yeast causing the infection may be resistant to fluconazole. Some research shows that Candida glabrata and Candida krusei can be resistant to fluconazole. 

This resistance can develop with repeated use of antifungal medications, making them less effective over time. If you have recurrent yeast infections, your doctor might test the yeast to determine the best treatment option. 

Taking the wrong treatment might also explain why your vaginal infection just keeps coming back. Interestingly, C. glabrata and other non–albicans Candida species are found in 10%–20% of women with recurrent yeast infections.

An Evvy Vaginal Health Test uncovers which strains of Candida are in your vaginal microbiome, to test for potential fluconazole-resistant species. 

Incorrect diagnosis

Vaginal infections are super common, but can often be misdiagnosed. Misdiagnoses happen more often than correct diagnoses, which can lead to ineffective treatment. In a study of 220 people with vaginal symptoms, 77% of yeast infection diagnoses were incorrect.

It can be tricky because different vaginal infections can cause very similar symptoms, so it's easy to mistake one for the other because symptoms alone aren't always reliable. For example, bacterial infections such as cytolytic vaginosis and chlamydia can cause symptoms similar to a yeast infection. Bacterial vaginosis can also be mistaken for a yeast infection, even though it causes different symptoms.

Getting the right diagnosis also depends on the vaginal testing method used by your healthcare provider, but not all diagnostic tests are reliable or accurate.

If your symptoms don't improve after taking fluconazole, it's super important to get a proper diagnosis from your healthcare provider. 

Underlying health issues

Certain health conditions, such as uncontrolled diabetes or a weakened immune system, can put you at an increased risk of yeast infections and make them harder to treat. These conditions can create an environment where yeast thrives, leading to more frequent and stubborn infections. Managing the underlying condition is essential for effectively treating the yeast infection.

Drug interactions

Certain medications can affect how well fluconazole works, including some allergy tablets (Claritin), anxiety meds (Xanax), statins, and herbal supplements. You should always tell your healthcare provider if you're taking other medicines before they prescribe you any sort of treatment.

Dealing with a vaginal yeast infection can be frustrating, but treatments like fluconazole offer effective relief for many women. If your yeast infection doesn't improve after taking fluconazole, or if it recurs frequently, it's essential to see your healthcare provider. They may recommend taking a higher dose, a longer treatment course, or a different medication (such as other antifungal medications). They can also check for underlying conditions that might be contributing to the problem.

FAQ

How do you know if fluconazole is working?

One of the first signs that fluconazole is working is a noticeable decrease in itching and irritation. The thick, white discharge that typically accompanies a yeast infection should start to diminish. You might notice this change within a couple of days after taking fluconazole.

How long after taking fluconazole will I feel better?

After taking fluconazole, you may start to feel relief from symptoms such as itching and irritation within 24 hours. However, more noticeable improvements, including reductions in discharge and swelling, typically occur within three days. For some women, it may take up to a week for the infection to fully clear. If your symptoms persist beyond seven days or worsen, it's important to follow up with your healthcare provider.