Fluconazole (Diflucan) for Yeast Infections: How It Works, Side Effects and Cost

Written by Naurah Gaspard, DNP, FNP-C, FNP-BC · Medically reviewed by Cherlie Joseph, MSN, FNP-BC · Updated November 2026

Fluconazole (brand name Diflucan) is a prescription antifungal pill. For a typical vaginal yeast infection, the FDA-approved treatment is a single 150 mg tablet, and most people notice improvement within a few days. It is generally well tolerated, but it interacts with a number of common medicines and is not the preferred choice during pregnancy.

What fluconazole is and what it treats

Fluconazole belongs to the azole family of antifungals. It works by blocking an enzyme yeast needs to build its cell membrane, which stops the yeast from growing. According to MedlinePlus, it is used for yeast infections of the vagina, mouth, throat and esophagus, as well as more serious fungal infections of the blood, lungs and brain lining. In primary care, by far the most common use is vaginal yeast infection (vulvovaginal candidiasis).

How fluconazole works for a yeast infection

For an uncomplicated vaginal yeast infection, the label and CDC treatment guidelines list one 150 mg tablet taken by mouth, one time. Fluconazole stays in the body for days, so a single tablet keeps working after you take it. That also means symptoms do not vanish overnight; itching and burning usually ease over a few days.

Your provider may recommend a different plan in some situations:

• Severe symptoms (major swelling, redness or cracking): the CDC lists two doses given 72 hours apart, or a 7 to 14 day vaginal treatment.
• Recurrent infections (three or more a year): a longer starting course followed by weekly fluconazole for 6 months.
• Non-albicans yeast such as Candida glabrata: fluconazole often does not work well, and a different medicine is used.

Only take fluconazole exactly as prescribed. Taking extra tablets on your own will not speed things up.

Side effects

Most people have no side effects from a single tablet. When they happen, MedlinePlus lists these as the most common:

• Headache or dizziness
• Nausea, stomach pain, heartburn or diarrhea
• A change in how food tastes

Rare but serious reactions include liver injury (yellow skin or eyes, dark urine, pale stools, pain under the right ribs), severe skin reactions with blistering or peeling, allergic reactions, and seizures. Fluconazole can also affect heart rhythm (QT prolongation) in people who are already at risk. Get medical help right away for any of these.

Drug interactions and who should be careful

Fluconazole slows the liver enzymes that clear many other drugs, which can raise their levels. This is the most important safety issue with fluconazole, so share your full medication list, including supplements.

Medicine type	Examples	Possible concern
Blood thinners	Warfarin	Higher bleeding risk
Heart rhythm-affecting drugs	Erythromycin, some antipsychotics and antiarrhythmics	Dangerous heart rhythm changes
Some statins	Simvastatin, atorvastatin	Muscle pain or damage
Sulfonylureas	Glipizide, glyburide, glimepiride	Low blood sugar
Seizure medicines	Phenytoin	Higher drug levels

This list is not complete. People with liver disease, kidney disease, a heart rhythm problem, or low potassium or magnesium should also discuss fluconazole with their provider first.

Pregnancy and breastfeeding

The CDC recommends only vaginal (topical) treatment for 7 days during pregnancy, and oral fluconazole is not recommended. In 2016 the FDA reviewed a Danish study suggesting a possible link between oral fluconazole and miscarriage. In 2019 the FDA concluded the data were not conclusive for a single 150 mg dose, but high, long-term doses have been linked to birth defects. If you are pregnant, trying to conceive or breastfeeding, tell your provider before taking fluconazole.

Cost and how to get it

In the United States, fluconazole requires a prescription. Generic fluconazole is widely available and is usually inexpensive, especially with pharmacy discount programs, but prices vary by pharmacy and change over time, so check with your pharmacy before you pick it up. Over-the-counter vaginal creams are an alternative that do not need a prescription.

If this is your first yeast infection, or the symptoms are not typical, a visit helps confirm it really is yeast and not BV, trichomoniasis or a UTI, which need different treatment.

Frequently asked questions

How long does it take for fluconazole to work for a yeast infection?

Many people start to feel better within a day or two, but it can take several days for itching and burning to fully clear. If you are not better about a week after the dose, follow up with a provider.

Can I drink alcohol with fluconazole?

There is no known direct reaction between alcohol and fluconazole like there is with metronidazole. Alcohol can add to stomach upset and stress the liver, so keeping it light while you recover is reasonable.

Is Diflucan the same as fluconazole?

Yes. Diflucan is the brand name and fluconazole is the generic. FDA-approved generics contain the same active ingredient and work the same way.

Sources

• MedlinePlus: Fluconazole
• CDC: Vulvovaginal Candidiasis, STI Treatment Guidelines
• FDA: Drug safety communication on oral fluconazole in pregnancy

Keep reading

• Yeast infection treatment options: OTC creams vs fluconazole
• Recurrent yeast infections: why they keep coming back
• Yeast infection after antibiotics
• Browse all conditions and treatments A to Z

This article is for general education and is not a substitute for medical advice. Treatment, including any prescription, is decided by a licensed provider after reviewing your health history. OurTopClinic is not for emergencies; if you have a medical emergency, call 911. OurTopClinic serves adults located in Florida, New Mexico, Oregon and Washington. Learn more at ourtopclinic.com.