What Medications Are Available to Help Treat Oral Thrush? - GoodRx (2024)

Oropharyngeal candidiasis, commonly known as oral thrush, is a type of yeast infection in your mouth and throat. It’s caused by an overgrowth of the fungus Candida albicans (C. albicans). C. albicans is an organism that is normally found in the mouth. It only becomes a problem when there’s too much of it.

Oral thrush is more likely to occur in people whose immune system isn’t working as well as it should. This includes older people, and people with cancer or HIV. Babies are also more likely to get thrush because their immune systems aren’t fully developed when they’re born. Other risk factors for oral thrush include wearing dentures, poor oral hygiene, and smoking.

Medications can cause thrush, too. Antibiotics and inhaled steroids change the balance of bacteria in your mouth, which allows C. albicans to grow. And chemotherapy can damage the mouth and weaken your immune system, making oral thrush more likely.

But there’s good news. Oral thrush is often treatable with medication. Read on to learn more about the options for treating oral thrush.

What medications are best for oral thrush?

Antifungals are a group of medications that can treat oral thrush. They do this by changing the cell wall of the fungus. This can either prevent the fungus from growing, or cause it to die. The best medication for oral thrush depends on how severe it is. Below, we’ll talk about treatment options for mild cases, and more serious cases, of thrush.

Mild oral thrush

If you have a mild case of thrush, your healthcare provider may prescribe a topical antifungal. When taken orally, topical antifungals deliver medication to the mouth area only. They aren’t absorbed by the body, so they have fewer side effects and drug interactions than medications that are swallowed by mouth or given intravenously (IV).

The antifungals used to treat oral thrush are clotrimazole lozenges, nystatin liquid suspension, and miconazole (Oravig).

Moderate to severe oral thrush

If your symptoms are more severe or topical medications didn’t work, your healthcare provider may prescribe an oral medication. The first-choice oral option is fluconazole (Diflucan). It’s available as tablets or a liquid suspension.

If fluconazole doesn’t work or you have a bad reaction to it, itraconazole solution (Sporanox) and posaconazole suspension (Noxafil) are alternative options. Only the liquid forms of these medications are FDA-approved for oral thrush. Other options for severe oral thrush are used off-label — meaning they’re being used in a way that’s not FDA-approved.

These include:

• Voriconazole (Vfend)

• Amphotericin B (Ambisome)

• Caspofungin (Cancidas)

• Micafungin (Mycamine)

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Amphotericin B, caspofungin, and micafungin are only available as IV medications.

How do I take medications for oral thrush?

The easiest and safest way to treat mild oral thrush is to use a topical antifungal, like clotrimazole or nystatin. Clotrimazole is a lozenge that you suck on and nystatin is a liquid that you swish around in your mouth.

For more severe or difficult to treat thrush, your healthcare provider may decide to treat you with an oral or injectable form of an antifungal. General dosing recommendations are below, but always follow your provider’s instructions when taking an antifungal.

Mild Oral Thrush

Moderate to Severe Oral Thrush

Since amphotericin B, caspofungin, and micafungin are only available as IV medications, they are given in a hospital setting. They are usually reserved for severe situations when an oral medication doesn’t work.

How quickly will I feel symptom relief?

For mild cases of thrush, you may start to feel relief within a few days. But, it’s important to take the full course of antifungals prescribed by your healthcare provider, even if you feel better before you finish your medication.

What side effects can I expect from oral thrush medications?

Side effects from antifungals can range from mild to more severe. It depends on what medication you’re taking and how well your immune system works.

The table below discusses common side effects. Rarely, serious side effects can occur. If you experience trouble breathing, unusual bleeding, or mood changes, contact your healthcare provider immediately.

Antifungal Side Effects

How do I know if I need treatment for oral thrush?

Oral thrush has distinct symptoms that make it easier to identify without needing lab tests. You might notice white patches on your inner cheek, roof of your mouth, or tongue. These patches may be able to be wiped off with a cloth, revealing a red, sometimes bloody patch, beneath.

You may also feel pain, especially while swallowing, and notice cracks at the sides of your mouth. These symptoms, combined with a loss of taste, can make it difficult to eat.

If you have any of these signs of oral thrush, contact your healthcare provider to see if you need treatment.

Can oral thrush go away on its own?

It’s possible that mild cases of oral thrush can go away on their own. But, in some people, thrush can last for months, or even years, if it isn’t treated. That’s why it’s important to talk to your healthcare provider and find out if treatment is necessary.

What happens if oral thrush isn’t treated?Oral thrush doesn’t usually cause serious health issues, but it can be uncomfortable. And, if it’s left untreated, it can spread to other areas of the body. In people with weakened immune systems, this is especially concerning.

Left untreated, oral thrush can spread and cause disease in other parts of your body such as brain (meningitis), heart (endocarditis) and esophagus (esophagitis). It could also affect your eyes and joints.