Dosage and strength
Clotrimazole for thrush comes as a pessary and cream that you use internally, or externally.
Clotrimazole pessaries contain 100mg, 200mg or 500mg.
The pessary dose to treat thrush is:
- 100mg – use 1 pessary every night for 6 nights in a row or 2 pessaries for 3 nights in a row.
- 200mg – use 1 pessary (or 2 100mg pessaries) every night for 3 nights in a row
- 500mg – use 1 pessary for 1 night only
Clotrimazole internal cream contains 500mg of clotrimazole in every 5g of cream. It comes as a single application that you use once.
Clotrimazole external cream is used 2 or 3 times a day for at least 2 weeks.
How to use it
Canesten sometimes comes as a pessary and external cream combined in 1 pack. This treats your thrush internally and your external symptoms.
How to use external cream
- Wash your hands before you start.
- Put a strip of cream onto your fingertip. A 1cm strip is enough to treat an area the size of the hand. Apply it in a thin layer to the affected area and rub it in gently.
- Wash your hands when you’ve finished.
Do this 2 or 3 times a day for at least 2 weeks. The cream will work better if you can use it 3 times a day.
How to use pessaries
Pessaries are made to go into your vagina only. Do not swallow them.
Pessaries need moisture in the vagina to dissolve completely. If they do not dissolve, pieces of the pessary may crumble and fall out of the vagina. You may notice this if you have vaginal dryness.
To help the pessary dissolve, insert it as far as possible into your vagina at bedtime. Each pessary comes in a foil blister pack, together with an applicator to help you insert it. Make sure the foil is not broken before you use it.
- Wash your hands before you start.
- Remove the applicator from the packet.
- Pull the plunger (the thinner end of the applicator) out as far as it will go.
- Take the pessary out of the blister pack.
- Gently squeeze the holder (the wider end of the applicator) to open it.
- Push the pessary into the application following the instructions that come in the medicine packet.
- Lie on your back, bend your knees then let your knees fall to each side.
- Gently put the applicator into your vagina and push it in as far as you can comfortably.
- Holding the applicator in place, slowly press the plunger in until it stops moving.
- Remove the applicator.
- Throw the applicator away safely, out of the reach of children. Do not flush it down the toilet.
- Wash your hands thoroughly when you've finished.If you have a 100mg pessary, you can insert 2 pessaries at a time.
Do not use tampons or other vaginal products while you're using the pessary. Do not use pessaries during your period – wait until your period has finished.
How to use internal cream
- Wash your hands before you start.
- Remove the applicator from the packet.
- The internal vaginal cream is already in the applicator. You will need to put the plunger into the applicator.
- Carefully twist and pull off the cap following the instructions that come in the medicine packet.
- Lie on your back, bend your knees then let your knees fall to each side.
- Gently put the applicator into your vagina and push it in as far as you can comfortably.
- Holding the applicator in place, slowly press the plunger in until it stops moving.
- Remove the applicator. Throw the applicator away safely, out of the reach of children. Do not flush it down the toilet.
- Wash your hands thoroughly when you've finished.
For some internal creams, you will also need to take a capsule of fluconazole to complete your treatment.
It's quite common to notice a slight discharge after using the cream so it may help to wear a panty liner. This does not mean that the treatment has not worked.
If you forget to use it
If you forget to use a pessary or internal cream at bedtime, use it during the night if you remember. If you only remember the next day, wait until bedtime for your next dose. Pessaries and internal cream work best at night.
If you’re using the external cream and you forget to put it on, use it as soon as possible and continue putting it on 2 to 3 times a day as usual.
If you have forgotten for more than 1 day, your infection may not be treated properly. If you still have symptoms after you finish your course, speak to a doctor.
If you use too much
If you use too much external clotrimazole cream or use it more often than you need to, it may make your skin irritated, or red. Use less cream the next time if this happens.
If you insert too many pessaries at the same time, you may feel discomfort or irritation. Stop using the pessaries and see a doctor if the discomfort or irritation does not go away.