Antifungal Medications, Yeast Infection, Side effects, Mechanism of Action, Brand Generics
Table of Contents
Antifungal Medications
Antifungals are medications used to treat fungal infections, which can affect the skin, nails, hair, mucous membranes (like the mouth or vagina), and internal organs (systemic infections). They work by either killing fungi (fungicidal) or stopping their growth (fungistatic).
| Brand Name | Generic Name | Mechanism of Action |
| Diflucan | Fluconazole | Azole; inhibits fungal cytochrome P450 |
| Sporanox | Itraconazole | Azole; inhibits fungal cytochrome P450 |
| Vfend | Voriconazole | Azole; inhibits fungal cytochrome P450 |
| Noxafil | Posaconazole | Azole; prevents ergosterol synthesis |
| Cresemba | Isavuconazole | Azole; inhibits ergosterol synthesis (broad-spectrum) |
| Monistat, Lotrimin | Miconazole | Azole; topical antifungal (blocks ergosterol synthesis) |
| Lotrimin, Mycelex | Clotrimazole | Azole; topical antifungal (yeast infections, ringworm) |
| Nizoral | Ketoconazole | Azole (oral/topical); inhibits ergosterol synthesis (dandruff) |
| Lamisil | Terbinafine | Allylamine; inhibits squalene epoxidase |
| Naftin | Naftifine | Allylamine; topical, disrupts fungal cell membrane |
| AmBisome, Fungizone | Amphotericin B | Polyene; binds ergosterol, forms pores in fungal membrane |
| Mycostatin | Nystatin | Polyene; binds ergosterol (topical/oral thrush treatment) |
| Cancidas | Caspofungin | Echinocandin; inhibits β-(1,3)-D-glucan synthase |
| Mycamine | Micafungin | Echinocandin; blocks fungal cell wall synthesis |
| Eraxis | Anidulafungin | Echinocandin; inhibits glucan synthesis |
| Ancobon | Flucytosine (5-FC) | Pyrimidine analog; disrupts RNA/DNA synthesis in fungi |
| Gris-PEG | Griseofulvin | Disrupts fungal microtubules (inhibits mitosis) |
| Penlac, Loprox | Ciclopirox | Disrupts fungal cell membrane & metal ion uptake |
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Types of Antifungal Drugs
Antifungals are classified based on their chemical structure and mechanism of action:
1. Azoles
Mechanism fo Action: Inhibit fungal cytochrome P450 enzymes, disrupting ergosterol synthesis (a key component of fungal cell membranes).Topical:
- Clotrimazole,
- Miconazole,
- Ketoconazole
- Fluconazole,
- Itraconazole,
- Voriconazole,
- Posaconazole,
- Isavuconazole
- Candida infections (thrush, vaginal yeast infections)
- Dermatophytes (ringworm, athlete’s foot)
- Systemic fungal infections (aspergillosis
- Cryptococcosis).
2. Polyenes
Mechanism of Action: Bind to ergosterol in fungal cell membranes, creating pores that leak cell contents.Examples:
- Amphotericin B (systemic, for severe infections like invasive candidiasis, cryptococcal meningitis)
- Nystatin (topical/oral, for thrush and skin infections)
- Side Effects: Nephrotoxicity (Amphotericin B), infusion reactions.
3. Echinocandins
Mechanism of Action: Inhibit β-(1,3)-D-glucan synthase, weakening fungal cell walls.Examples:
- Caspofungin
- Micafungin
- Anidulafungin
Advantage: Low toxicity (good for patients with kidney issues).
4. Allylamines
Mechanism of Action: Inhibit squalene epoxidase, blocking ergosterol synthesis.Examples:
- Terbinafine (oral/topical, for nail fungus, ringworm)
- Naftifine (topical)
5. Other Antifungals
Flucytosine (5-FC): Converted into 5-fluorouracil inside fungal cells, disrupting RNA/DNA synthesis. Used with Amphotericin B for cryptococcal meningitis.Griseofulvin: Binds to microtubules, inhibiting fungal mitosis. Used for dermatophyte infections (less common now due to newer drugs).
Ciclopirox: Topical antifungal (shampoos, nail lacquers) with broad-spectrum activity.
Antifungal Medications Side Effects & Resistance
- Azoles: Liver toxicity, drug interactions (CYP450 inhibitors).
- Polyenes (Amphotericin B): Kidney damage, fever, chills.
- Echinocandins: Few side effects, but can cause flushing.
- Terbinafine: GI upset, taste disturbances, liver enzyme elevation.
- Resistance: Overuse of antifungals (especially azoles) leads to resistant strains (e.g., Candida auris).
Antifungal Medications for Yeast Infections
| Infection | Common Antifungals Used |
| Athlete’s Foot (Tinea Pedis) | Terbinafine, Clotrimazole, Miconazole |
| Ringworm (Tinea Corporis) | Terbinafine, Clotrimazole |
| Jock Itch (Tinea Cruris) | Terbinafine, Miconazole |
| Nail Fungus (Onychomycosis) | Terbinafine (oral), Ciclopirox (topical) |
| Vaginal Yeast Infection (Candidiasis) | Fluconazole (oral), Clotrimazole (cream) |
| Oral Thrush (Oropharyngeal Candidiasis) | Nystatin (swish & swallow), Fluconazole |
| Systemic Candidiasis | Echinocandins, Fluconazole, Amphotericin B |
| Aspergillosis | Voriconazole, Isavuconazole, Amphotericin B |
| Cryptococcal Meningitis | Amphotericin B + Flucytosine, then Fluconazole |
Natural Antifungals
🌿 Natural antifungals are substances found in nature, especially in plants, herbs, and oils. These have antifungal properties which are often used in traditional medicine or as complementary treatments. Let’s discuss some common natural antifungals, what they do, and where they come from:
1. Garlic (Allicin)
- Active Compound: Allicin
- Action: Disrupts fungal cell membranes and inhibits fungal growth.
- Used For: Candida infections, skin fungal infections.
- How: Raw garlic, garlic oil, or supplements.
2. Coconut Oil
- Active Compounds: Caprylic acid, lauric acid
- Action: Breaks down the cell wall of Candida and other fungi.
- Used For: Oral thrush, skin infections, vaginal yeast infections.
- How: Topically or in cooking.
3. Tea Tree Oil (Melaleuca alternifolia)
- Active Compounds: Terpinen-4-ol
- Action: Destroys fungal cell membranes.
- Used For: Athlete’s foot, nail fungus, ringworm.
- How: Topical application (diluted only—never ingest).
4. Apple Cider Vinegar (ACV)
- Active Component: Acetic acid
- Action: Changes skin/environment pH to inhibit fungal growth.
- Used For: Skin or scalp infections, Candida.
- How: Diluted in water for topical or oral rinse.
5. Oregano Oil
- Active Compounds: Carvacrol, thymol
- Action: Antifungal, antibacterial, and antiviral properties.
- Used For: Candida, skin fungus.
- How: Capsules, diluted topical oil (very strong—must be diluted).
6. Turmeric (Curcumin)
- Active Compound: Curcumin
- Action: Inhibits fungal cell proliferation, antioxidant.
- Used For: Systemic fungal infections, skin conditions.
- How: Supplements, topical paste, or in food.
7. Ginger
- Active Compound: Gingerol
- Action: Mild antifungal and anti-inflammatory.
- Used For: Digestive Candida overgrowth, general immune support.
- How: Tea, raw ginger, supplements.
8. Neem (Azadirachta indica)
- Active Compounds: Nimbin, nimbidin
- Action: Broad-spectrum antimicrobial, including antifungal.
- Used For: Skin conditions, oral Candida.
- How: Neem oil (topical), neem powder or capsules.
9. Clove Oil
- Active Compound: Eugenol
- Action: Disrupts fungal cell membranes.
- Used For: Oral thrush, skin fungus, nail fungus.
- How: Essential oil (diluted), mouth rinse.
10. Aloe Vera
- Action: Soothes skin and has mild antifungal properties.
- Used For: Skin irritation caused by fungal infections.
- How: Direct gel application from the plant or gel products.
Antifungals OTC
Here’s a solid breakdown of the most common over-the-counter (OTC) antifungal medications you’ll find in pharmacies. These are typically used for skin, nail, and vaginal fungal infections.
| Generic Name | Brand Name | Dosage Form | Medication Uses |
| Clotrimazole | Lotrimin AF, Gyne-Lotrimin | Cream, vaginal tablet | Athlete’s foot, ringworm, jock itch, yeast infections |
| Miconazole | Micatin, Monistat | Cream, powder, spray, suppository | Vaginal yeast infections, skin fungus |
| Terbinafine | Lamisil AT | Cream, gel, spray | Athlete’s foot, jock itch, ringworm |
| Tolnaftate | Tinactin | Cream, powder, spray, liquid | Ringworm, athlete’s foot, jock itch |
| Butenafine | Lotrimin Ultra | Cream | Athlete’s foot, jock itch, ringworm |
| Undecylenic Acid | Fungi-Nail, Tinactin Liquid | Liquid, cream | Nail fungus, skin fungus |
| Tioconazole | Monistat-1 | Vaginal ointment | Vaginal yeast infections |
Antifungal Shampoo
An antifungal shampoo is a medicated shampoo formulated to treat fungal infections of the scalp and hair follicles. It works by killing or stopping the growth of fungi that cause:
- Tinea capitis (scalp ringworm)
- Seborrheic dermatitis (flaky, red scalp)
- Pityriasis versicolor (discolored patches on skin)
- Dandruff (often caused by Malassezia, a yeast)
Common Antifungal Shampoos
| Active Ingredient | Brand Name | Antifungal Shampoo Uses |
| Ketoconazole 1% (OTC) | Nizoral A-D | Dandruff, seborrheic dermatitis |
| Ketoconazole 2% (Rx) | Nizoral (Rx strength) | Tinea capitis, severe seborrheic dermatitis |
| Selenium sulfide | Selsun Blue, Head & Shoulders Clinical | Dandruff, tinea versicolor |
| Zinc pyrithione | Head & Shoulders, DHS Zinc | Mild dandruff and itching |
| Ciclopirox (Rx) | Loprox Shampoo | Seborrheic dermatitis, tinea |
| Coal tar (OTC and Prescription Rx Strength) | Neutrogena T/Gel | Psoriasis, dandruff, seborrheic dermatitis (not strictly antifungal, but helps reduce scaling) |
How to Use Antifungal Shampoo
- Wet hair and scalp thoroughly.
- Apply shampoo and lather well, focusing on affected areas.
- Leave on for 3–5 minutes, unless otherwise directed.
- Rinse well.
- Use 2–3 times per week or as directed by a provider.
Antifungal Nail Paint
What is Antifungal Nail Paint?
An antifungal nail paint is a medicated lacquer applied directly to infected nails. It’s designed to penetrate the nail plate and kill or stop the growth of fungi (commonly dermatophytes, yeasts, or molds).When is Antifungal Nail Paint used?
- When the infection is mild to moderate
- In people who can’t tolerate oral antifungals
- Alongside oral meds for better results
Common Antifungal Nail Lacquers
| Active Ingredient | Brand Name | Availability | How Often | Notes |
| Ciclopirox 8% | Penlac | Prescription (Rx) | Daily |
Remove weekly with alcohol; works best on mild cases
|
| Amorolfine 5% | Loceryl, Curanail | OTC in some countries (Rx in others) |
1–2x / week | Widely used outside the U.S.; effective |
| Efinaconazole 10% | Jublia | Prescription (Rx) | Daily |
Used for toenail infections; no need to remove polish
|
| Tavaborole 5% | Kerydin | Prescription (Rx) | Daily | For mild to moderate toenail infections |
| Undecylenic acid | Fungi-Nail (not a lacquer) | OTC | Daily |
Often marketed for nail fungus, but less effective than Rx lacquers
|
How to Use Antifungal Nail Paint?
- Trim and file the infected nail to reduce thickness.
- Clean the nail with alcohol before applying.
- Apply the lacquer to the entire nail surface, edge, and under the tip.
- Allow it to dry completely (usually a few minutes).
- Continue treatment for several months—often 6 – 12 months for toenails.
How Long Does It Take?
- Fingernails: ~6 months
- Toenails: ~9–12 months
Antifungal Soap
What Is Antifungal Soap?
An antifungal soap is a cleansing product (liquid or bar) that contains ingredients designed to:- Kill fungi (fungicidal) or
- Inhibit fungal growth (fungistatic)
Antifungal Soap is used for:
- Athlete’s foot
- Jock itch
- Ringworm
- Body yeast infections
- Fungal acne (Malassezia folliculitis)
- Post-gym hygiene or sweat-prone areas
Ingredients in Antifungal Soaps
| Ingredients | Effects / Uses | Brand Names or Store Brands |
| Ketoconazole | Antifungal | Nizoral Body Wash (Rx or OTC) |
| Tea Tree Oil | Natural antifungal & antibacterial | Defense Soap, Purely Northwest |
| Triclosan | Antimicrobial | (Less common now due to regulation) |
| Benzalkonium chloride | Antiseptic, mild antifungal | Hibiclens (more antibacterial) |
| Undecylenic acid | Natural antifungal | FungiFoam, FungaSoap |
| Sulfur | Antifungal, keratolytic | Sulfur soaps for acne/fungal skin |
| Selenium sulfide | Yeast control | Selsun Blue (also used as body wash) |
| Pyrithione zinc | Antifungal/anti-yeast | DermaHarmony, Noble Formula |
Popular Antifungal Soap Brands
- Defense Soap (tea tree & eucalyptus oil)
- Purely Northwest Antifungal Body Wash
- FungaSoap by Pedifix (tea tree & other botanicals)
- Nizoral Body Wash (with ketoconazole)
- DermaHarmony Zinc Soap (great for dandruff & fungal acne)
- Dr. Eddie’s Happy Cappy (for kids, anti-yeast/dandruff)
How to Use Antifungal Soap?
- Wet the area with warm water.
- Apply soap and gently scrub the affected and surrounding areas.
- Let it sit for 1–2 minutes before rinsing (if safe).
- Dry thoroughly, especially between toes, folds, etc.
- Use 1–2 times daily, depending on severity.
Best Antifungal Soaps for Private Parts
These soaps are gentle, non-irritating, and contain antifungal or yeast-fighting ingredients safe for intimate use
Defense Soap
- Key Ingredients: Tea tree oil, eucalyptus oil
- Pros: Natural antifungal, gym-friendly, helps with jock itch
- Notes: May tingle slightly due to essential oils
Purely Northwest Antifungal Body Wash
- Key Ingredients: Tea tree, oregano, aloe vera
- Pros: Great for sensitive areas; fights odor, itch, fungus
- Use: Safe for external genital use (not internal)
Dr. Eddie’s Happy Cappy Medicated Shampoo/Body Wash
- Key Ingredients: Zinc pyrithione
- Pros: Gentle enough for babies; works on yeast and seborrheic dermatitis
- Use: Great for sensitive skin or rashes in skin folds
DermaHarmony Zinc Soap
- Key Ingredient: 2% Pyrithione zinc
- Pros: Fights yeast, balances skin
- Notes: Mild and effective for groin and under-breast irritation
5. Nizoral (Ketoconazole 1%) Shampoo (used as body wash)
- Key Ingredient: Ketoconazole
- Pros: Medical-grade antifungal
- Use: Use externally only; effective for yeast and fungal acne
Antifungal Powder
What Is Antifungal Powder?
Antifungal powder is a dry, medicated product that:
Kills or inhibits fungal growth
Absorbs moisture
Prevents chafing
Helps keep skin dry and irritation-free
Perfect for athletes, people who sweat heavily, or anyone prone to recurring fungal infections.
Ingredients in Antifungal Powder
| Ingredient | Action | Common Brands |
| Miconazole | Fungicidal/fungistatic | Micatin Powder, Zeasorb AF |
| Clotrimazole | Fungicidal/fungistatic | Lotrimin AF Powder |
| Tolnaftate | Fungistatic | Tinactin Powder, Zeasorb |
| Undecylenic Acid | Natural antifungal | Fungi Cure Powder, Desenex |
| Talc + Zinc Oxide | Moisture-absorbing base | Gold Bond Medicated Powder |
| Cornstarch-based | Gentle alternative base | Anti Monkey Butt Powder (with calamine) |
Popular Antifungal Powders
Zeasorb AF Powder
- Active Ingredient: Miconazole
- Use: Athlete’s foot, jock itch, ringworm
- Pros: Super absorbent; great for humid climates
Lotrimin AF Powder
- Active Ingredient: Clotrimazole
- Use: Tinea infections
- Pros: Trusted brand, works well for groin & feet
Tinactin Powder
- Active Ingredient: Tolnaftate
- Use: Prevents and treats athlete’s foot
- Pros: Great for long-term prevention
Fungi Cure Powder
- Active Ingredient: Undecylenic acid
- Use: Mild antifungal and deodorizer
- Pros: More natural-leaning formula
Gold Bond Medicated Powder
- Active Ingredient: Menthol, Zinc Oxide
- Use: Rash, chafing, odor
Where to Use Antifungal Powder?
- Feet/toes (between and underneath)
- Groin area
- Under breasts
- Armpits
- Skin folds (especially in obese or diabetic patients)
- Inside shoes or socks (for prevention)
Antifungal Mouthwash
What Is Antifungal Mouthwash?
Antifungal mouthwash is a liquid rinse designed to:- Kill or inhibit fungi in the mouth and throat
- Treat oral candidiasis (thrush)
- Reduce fungal overgrowth often caused by antibiotics, steroids, or immunosuppression
Common Prescription Antifungal Mouthwashes
| Name | Active Ingredient | Form | Use |
| Nystatin Suspension | Nystatin (polyene antifungal) | Swish and swallow/spit | First-line for oral thrush |
| Clotrimazole Troche | Clotrimazole | Dissolvable lozenge | For mild-to-moderate thrush |
| Amphotericin B Suspension | Amphotericin B | Compounded rinse | For resistant infections |
| Fluconazole (oral) | Fluconazole (systemic) | Tablet/suspension | For severe/systemic cases |
How to Use Antifungal Mouthwash (like Nystatin) Shake well.
- Measure prescribed dose (usually 4–6 mL).
- Swish in mouth for 1–2 minutes.
- Swallow if instructed, or spit out.
- Avoid eating or drinking for 30 minutes after use.
- Use after meals and at bedtime.
Antifungal Cream
What is an Antifungal Cream?
An antifungal cream is a topical medication that’s applied directly to the skin to treat fungal infections like:- Athlete’s foot (tinea pedis)
- Ringworm (tinea corporis)
- Jock itch (tinea cruris)
- Yeast infections on the skin (cutaneous candidiasis)
- Nail fungus (though creams are less effective than oral meds for nails)
Antifungal Creams OTC
| Generic Name | Brand Name | Typical Uses |
| Clotrimazole | Lotrimin AF, Canesten | Ringworm, jock itch, athlete’s foot |
| Miconazole | Micatin, Desenex | Yeast infections, ringworm, athlete’s foot |
| Terbinafine | Lamisil AT | Athlete’s foot, jock itch, ringworm |
| Butenafine | Lotrimin Ultra | Athlete’s foot, jock itch, ringworm |
| Tolnaftate | Tinactin | Athlete’s foot, jock itch, ringworm |
| Ketoconazole (Rx and sometimes OTC) | Nizoral Cream | Yeast infections, seborrheic dermatitis, tinea |
How Do Antifungal Creams Work?
Antifungal Creams work by:- Disrupting fungal cell membranes, causing the fungus to die.
- Inhibiting ergosterol synthesis, a key part of fungal cell walls.
- Azoles (clotrimazole, miconazole, ketoconazole)
- Allylamines (terbinafine, butenafine)
- Others (tolnaftate)
