OTC Availability—With Warnings

Until 1990, drugs used to treat vaginal yeast infections were available only by prescription. In December 1990, the FDA gave the go-ahead to market and sell over-the-counter (OTC) antifungal medications. The products are supplied in one of two ways: as vaginal inserts or suppositories or as a cream with a special applicator. Both formulations are for use at bedtime every night for seven nights.

While most women note improvement within just a few days, it's important to finish the seven-day treatment to make sure all of the troublemaking fungus has been disabled. Women who don't see rapid improvement of their symptoms are likely to have a problem other than a vaginal yeast infection.

"The benefit (of OTC sale of these products) is that they are readily available for women to purchase without having to go to a physician," says Joseph Winfield, M.D., a medical officer in the FDA's anti-infective drugs division. Ready availability of OTC treatments means that women no longer have to suffer while waiting for an appointment or have to rearrange work and family life to find time to go to the doctor's office for a recurring infection.

"Vaginal candidiasis is a rather common occurrence," says Dr. Winfield. "It doesn't present any life-threatening condition to the individual with an infection, and it's okay to treat over the counter—but only for women who have had an infection previously diagnosed by a physician. As those same symptoms recur, they then should be able to treat themselves."