Fluconazole (Diflucan) is the oral antifungal used to treat vaginal yeast infections. One 150 mg pill is the standard regimen for uncomplicated cases — symptoms typically start improving within 24 hours and resolve in 2–3 days. Bidwell's licensed nurse practitioner reviews your intake the same day and sends the prescription to your pharmacy for $45 flat. Generic fluconazole runs $10–$20 cash per dose.
Fluconazole is a triazole antifungal that works by inhibiting lanosterol 14-alpha-demethylase — the fungal cytochrome P-450 enzyme responsible for producing ergosterol, a key component of the fungal cell membrane. Without functional ergosterol, the fungal cell membrane becomes leaky and the organism can't survive. Fluconazole is highly selective for fungal over mammalian CYP enzymes, which is why it's generally well tolerated at therapeutic doses. The FDA DailyMed label is the authoritative reference.
Pfizer marketed fluconazole as Diflucan starting in 1990. It's one of the most-used antifungals in medicine because of its excellent oral bioavailability (>90%), long half-life (~30 hours — so you can dose once daily, or even once weekly), and broad tissue distribution (including the CSF, which is why it's used for cryptococcal meningitis). The CDC STI Treatment Guidelines list fluconazole 150 mg oral as first-line for uncomplicated vaginal candidiasis. The IDSA Candidiasis Guidelines provide broader indications.
Bidwell's yeast intake is designed to screen for uncomplicated vaginal candidiasis in non-pregnant adult women. You can be prescribed fluconazole through Bidwell if you:
Symptoms suggestive of bacterial vaginosis (thin grayish discharge with fishy odor) are not yeast — see our metronidazole page. If you're unsure which you have, the intake walks you through both symptom patterns.
Use caution — not absolute avoidance — if you have kidney impairment (dose adjustment needed for CrCl <50), take drugs metabolized by CYP3A4 or CYP2C9 (see interactions), or have a history of cardiac arrhythmia. The NIH StatPearls monograph is a useful clinical reference.
| Indication | Regimen | Notes |
|---|---|---|
| Uncomplicated vaginal yeast | 150 mg orally × 1 dose | CDC first-line. Single pill. Symptoms improve in 24 hours. |
| Complicated or severe vaginal yeast | 150 mg every 72 hours × 2–3 doses | Typically requires in-person evaluation. |
| Recurrent vaginal yeast (≥4/year) — maintenance | 150 mg weekly × 6 months | After initial induction; manage in person. |
| Oropharyngeal thrush | 200 mg loading dose, then 100 mg daily × 7–14 days | IDSA regimen for mild-moderate oral candidiasis. |
| Esophageal candidiasis | 200–400 mg daily × 14–21 days | Typically in immunocompromised patients; in-person care. |
For Bidwell's yeast intake, the standard regimen is a single 150 mg tablet. Take it by mouth with or without food. Most women feel significant symptom improvement within 24 hours. If symptoms haven't meaningfully improved by 3 days, or if they recur within a few weeks, contact us — you may need a second dose or an in-person workup.
Fluconazole is very well tolerated at the 150 mg single-dose used for yeast infections. The most common side effects reported in the FDA label:
Most women who take one 150 mg dose experience no side effects. Longer courses or higher doses can cause more frequent side effects, including elevated liver enzymes that are usually reversible. For more detail, see our fluconazole guide.
Rare but serious: hepatotoxicity (mostly with prolonged use), severe allergic reactions, Stevens-Johnson syndrome (very rare), QT prolongation leading to arrhythmia (especially with drug interactions), and adrenal insufficiency (very rare, with chronic high-dose use). Stop the medication and seek urgent care for severe rash with mucosal involvement, jaundice, fainting, or severe allergic reaction.
Fluconazole inhibits CYP3A4 and CYP2C9, so it affects many drugs. Interactions are dose-dependent — a single 150 mg dose produces less interaction than chronic daily dosing, but significant interactions are still possible. Tell your provider and pharmacist all medications before starting.
| Formulation | Quantity | Typical cash + discount |
|---|---|---|
| Fluconazole 150 mg (generic Diflucan) | 1 tablet (single dose) | ~$10–$20 |
| Fluconazole 100 mg (generic) | 14 tablets (thrush course) | ~$15–$30 |
| Fluconazole 150 mg (generic) | 6 tablets (6-month weekly maintenance) | ~$25–$50 |
| Diflucan (brand) | 1 tablet | $30–$50 |
Generic fluconazole is the obvious choice — therapeutically equivalent to brand Diflucan at a small fraction of the price. Compare current prices at GoodRx. Most commercial insurance plans cover generic fluconazole at a low copay. Your $45 Bidwell visit covers the clinical review and prescription; the pharmacy fill is separate.
You must be physically located in one of these states at the time of your visit.
Yes. Uncomplicated vaginal yeast in non-pregnant women is routinely treated via telehealth. Bidwell reviews intakes same-day for $45 flat.
Single 150 mg oral tablet for uncomplicated vaginal candidiasis — one pill, one time. Complicated cases get longer regimens.
Symptom improvement in 24 hours, full resolution in 2–3 days for most women. 30-hour half-life means a single dose covers the infection.
Similar cure rates (~80–90%). Oral is convenient (one pill) and doesn't affect condoms/diaphragms. Topical azoles are OTC and avoid drug interactions. Pregnant women should use topical.
People on QT-prolonging drugs, significant liver disease, hypersensitivity to azoles, and pregnancy (use topical instead).
No — CDC recommends topical azoles (miconazole, clotrimazole 7 days) over oral fluconazole in pregnancy. Bidwell does not prescribe fluconazole to pregnant patients.
Warfarin, statins (especially simvastatin), certain heart meds, tacrolimus, phenytoin, some benzodiazepines. Disclose all medications.
Generic 150 mg tablet: $10–$20 with GoodRx. The $45 Bidwell visit is separate from the pharmacy fill.
4+ infections per year is "complicated" candidiasis — warrants in-person evaluation for underlying factors (diabetes, immunosuppression) and may need longer induction and maintenance dosing.
Yes — candidal balanitis in men is treated with topical antifungal cream or a single 150 mg oral dose.