Diflucan (fluconazole) vs. Monistat 7 (miconazole)

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

Diflucan vs. Monistat 7

What is Diflucan? What is Monistat 7?

Diflucan (fluconazole) is an anti-fungal medication that prevents growth of fungi by preventing production of the membranes that surround fungal cells. Diflucan is used to treat vaginal, oral, and esophageal fungal infections caused by Candida; urinary tract infections, peritonitis, pneumonia and disseminated infections caused by Candida; cryptococcal meningitis; and to prevent Candida infections in patients treated with chemotherapy or radiation after bone marrow transplantation. Diflucan is related to clotrimazole (Lotrimin), ketoconazole (Nizoral), itraconazole (Sporanox), and miconazole (Micatin, Monistat).

Monistat 7 (miconazole) is an anti-fungal medication related to fluconazole (Diflucan), ketoconazole (Nizoral), itraconazole (Sporanox), and clotrimazole (Lotrimin, Mycelex). Monistat 7 is used to treat vaginal infections and other infections (athlete's foot, ringworm), and severe fungal infections.

What are the side effects of Diflucan and Monistat 7?

Diflucan

Common side effects of fluconazole include

Other important side effects include

Possible serious side effects include

  • seizures,
  • reduced number of white blood cells,
  • reduced number of blood platelets, and
  • toxic epidermal necrolysis.

Rarely, serious allergic reactions, including angioedema (swelling of tissues), may also occur. Liver dysfunction (jaundice, hepatitis) and abnormal heartbeats have been associated with fluconazole. Stevens-Johnson syndrome has also been reported.

Monistat 7

Irritation, burning, rash, and itching have been reported by patients using topical or vaginal miconazole.

What is the dosage of Diflucan vs. Monistat 7?

Diflucan

  • The usual adult dose is 50-400 mg daily depending on the type of infection. Although symptoms of oral Candida infections may subside in a few days, treatment is continued for 2 weeks.
  • Esophageal Candida infections are treated for 3 weeks or longer.
  • Treatment of cryptococcal meningitis may last for 10-12 weeks after cerebrospinal fluid cultures become negative.

Monistat 7

Miconazole vaginal cream and suppositories are for use only in the vagina. These products are not to be taken by mouth. The vaginal suppositories are inserted, one per dose, in an applicator. Alternatively, the tube containing the vaginal cream is screwed onto the end of a special applicator tube, and the tube is then squeezed to fill the applicator. The patient then lies on her back with bent knees, inserts the applicator containing either the suppository or cream so that the tip of the applicator is high in the vagina, and then pushes the plunger in to deposit the suppository or cream into the vagina. The applicator should be washed with warm soap and water after each use.

Miconazole usually is used once daily at bedtime. The 200 mg suppositories (Monistat 3) are inserted once nightly for 3 nights. The 100 mg suppositories (Monistat-7) and intravaginal cream are inserted once nightly for 7 nights. The 1200 mg formulation (Monistat 1) is applied once for one night.

For fungal skin infections, the topical cream is applied as a thin layer to cover the affected skin and surrounding area, usually once or twice daily for 2-4 weeks. The hands should be washed before and after application.

What drugs interact with Diflucan and Monistat 7?

Diflucan

Monistat 7

There are no known drug interactions with vaginal or topical miconazole.

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Are Diflucan and Monistat 7 safe to use while pregnant or breastfeeding?

Diflucan

  • There are no adequate studies of Diflucan in pregnant women. There are reports of harmful effects to the fetus when high dose fluconazole was administered to pregnant women for a few months. Use of fluconazole during pregnancy is not recommended.
  • Diflucan is secreted in breast milk at concentrations similar to the mother's blood level. However, fluconazole is used for treating neonates with fungal infections and for treating lactation associated Candida infections. Available evidence suggests that use of fluconazole during breastfeeding has little risk.

Monistat 7

  • There is very limited information on the use of miconazole during pregnancy. The physician must weigh the potential benefits against possible but unknown risks to the fetus.
  • It is not known if miconazole is secreted in breast milk in amounts that can affect the infant.

Summary

Diflucan (fluconazole) and Monistat 7 (miconazole) are anti-fungal medications used to treat vaginal fungal infections. Diflucan is also used to treat oral and esophageal fungal infections caused by Candida; urinary tract infections, peritonitis, pneumonia and disseminated infections caused by Candida; cryptococcal meningitis; and to prevent Candida infections in patients treated with chemotherapy or radiation after bone marrow transplantation. Monistat 7 is used to treat other infections (athlete's foot, ringworm) and severe fungal infections.

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Medically Reviewed on 1/24/2019
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