How will oral thrush be treated if I have HIV or AIDS?

If you have HIV or AIDS and develop oral thrush, you’ll be treated with an antifungal medicine called fluconazole.

Oral thrush, also known as oral candidiasis, is a yeast infection usually caused by a type of fungus called Candida albicans.

Seek medical attention

Always see your GP or HIV healthcare team if you have HIV or AIDS and develop oral thrush. You should also tell them if you have repeated oral thrush infections.

Assessing your oral thrush infection

Your healthcare professional will assess how severe your condition is and ask:

  • if you've had any type of thrush before
  • if so, how the infection was treated

If you have a widespread infection – for example, if it’s spread to your oesophagus (gullet) – you may be admitted to hospital. If your infection is severe, or previous treatment with fluconazole didn’t work, your GP may seek specialist advice before treating you.

Antifungal medicines

The usual treatment for oral thrush in people with HIV is an antifungal medicine called fluconazole. Fluconazole will be prescribed if:

  • you’re otherwise well
  • the infection is mild 
  • you aren't already taking antifungal medicines to stop thrush developing (prophylactic antimycotic treatment)

If you don’t meet this criteria, your healthcare professional may seek specialist advice about your treatment. 

You’ll need to take two fluconazole capsules a day for seven days. You should then return to your GP or HIV clinic. If your condition hasn't improved, they may prescribe fluconazole for another seven days.

Side effects of fluconazole

Fluconazole can cause side effects. These include:

  • feeling sick
  • tummy pain
  • diarrhoea
  • headaches

Fluconazole may not be prescribed for people who:

  • have problems with their liver or kidneys 
  • are taking certain medicines, such as warfarin (medicine that stops the blood clotting) or statins (cholesterol-lowering medicine)

For more information, see our fluconazole medicine guide.

If fluconazole doesn’t work

If treatment with fluconazole does not clear up your oral thrush infection after two weeks, you should see your healthcare professional again.

The fungus causing your thrush may be resistant to fluconazole, which means that the medicine no longer works. Several different types of candida fungi can cause oral thrush and some, such as Candida krusei, are resistant to fluconazole.

Your healthcare professional may collect a sample of cells from inside your mouth using a swab (small cotton bud) to find out what fungus is causing your infection. They may also seek specialist advice about prescribing a different antifungal medicine.

Repeated oral thrush infections

If you have repeated oral thrush infections, you should tell the staff at your HIV clinic. For more information, see Why am I at risk of oral thrush if I have HIV? 

Read the answers to more questions about infections.

Further information:

Page last reviewed: 03/12/2014

Next review due: 02/12/2016