Terconazole

What is Terconazole?

Terconazole is a prescription antifungal medication that comes in cream and vaginal suppository form. It’s used to treat vaginal yeast infections, which can cause itching, burning especially when you urinate, and vaginal discharge that’s usually white and clumpy (often likened to cottage cheese).

Terconazole is highly effective and works quickly, with treatment usually lasting 3 to 7 days. U.S. studies found that the 0.4% cream cleared infections in 77% to 91% of cases. The 80mg suppository had similar success, clearing infections in 80% to 85% of users.^[1]

It also can help to lower the risk of reinfection, with most people staying infection-free for at least a month after treatment.^[1]

How does Terconazole work?

Terconazole works by stopping the growth of the yeast causing vaginal infections, most commonly Candida albicans. It does this by targeting sterol synthesis, a key component of the yeast’s cell membrane. More specifically, Terconazole inhibits an enzyme called 14-alpha-demethylase that’s needed for the production of sterols. Without enough of these molecules, the fungal cell membrane becomes unstable, its structure and functions are disrupted, and this ultimately stops the yeast from growing.^[2]

What forms does Terconazole come in?

Terconazole comes in two forms: a cream that contains either 0.4% or 0.8% terconazole, and a suppository that contains 80mg of terconazole. They’re both used once daily at bedtime and are typically applied intravaginally for three days in a row.

How to Use Terconazole

Terconazole is used once daily at bedtime for 3 or 7 days, as prescribed by your doctor.

As with any other medication, you should follow the instructions that come with your treatment, but typically you’ll use Terconazole in the ways described below.

If you’re using Terconazole vaginal cream:

• Wash your hands before and after each application.
• Remove the cap from the cream tube.
• Prepare the applicator that comes with the cream by attaching it to the tube, squeeze the tube to fill the applicator, and then remove the applicator from the tube.
• Lie on your back with your knees bent.
• Insert the applicator high into your vagina and push the plunger to release the cream.
• Remove the applicator gently.

If you’re using Terconazole vaginal suppository:

• Wash your hands.
• Unwrap the suppository.
• If you’re not using an applicator, lie on your back with your knees bent toward your upper body, and gently push the suppository with your fingertip into your vagina as far as you can.
• If you’re using the applicator, put the flat side of the suppository into the open end of the applicator. Lie on your back with your knees bent, gently insert the applicator deep into your vagina, and press the plunger to release the suppository. Gently remove the applicator afterward. 

After using the applicator, remove the plunger and clean both parts with warm water and soap.

If this treatment comes into contact with your eyes, rinse them well with cool tap water.

You may also want to consider wearing a mini-pad or sanitary napkin to avoid getting the medicine on your clothes. Tampons aren’t recommended, as they can absorb the medication.

Even if you start feeling better, make sure to finish the full course as prescribed. And don’t worry if your period starts during treatment. It won’t affect how the medication works, so you should keep going as usual.

How long does it take for Terconazole to work?

Terconazole starts working against the yeast that’s causing your infection pretty quickly and reaches its highest levels in your bloodstream five to 10 hours after using it.^[1] But you might not notice an improvement in your symptoms for one to two days.^[2] Even if you start feeling better before finishing the treatment, make sure to complete the entire prescribed course.

How long does Terconazole stay in your system?

It can vary from person to person. Most of the dose (over 60%) stays in the vagina, while only about 20% enters the bloodstream. However, it takes between 6.4 to 8.5 hours for the level of terconazole in the blood to drop by half.^[1]