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Oral thrush in adults

Oral thrush is a fungal infection of the mouth. It’s not contagious and is usually successfully treated with antifungal medication.

It’s also called oral candidosis (or candiasis) because it’s caused by a group of yeasts called Candida.

Non-urgent advice: Contact your GP practice if:

You develop symptoms of oral thrush, which can include:

white patches (plaques) in the mouth that can often be wiped off, leaving behind red areas that may bleed slightly
loss of taste or an unpleasant taste in the mouth
redness inside the mouth and throat
cracks at the corners of the mouth
a painful, burning sensation in the mouth

In some cases, the symptoms of oral thrush can make eating and drinking difficult.

If left untreated, the symptoms will often persist and your mouth will continue to feel uncomfortable.

In severe cases that are left untreated, there is also a risk of the infection spreading further into your body, which can be serious.

Your GP will usually be able to diagnose oral thrush simply by examining your mouth. Sometimes they may also recommend blood tests to look for certain conditions associated with oral thrush, such as diabetes and nutritional deficiencies.

What causes oral thrush?

Low numbers of the fungus Candida are naturally found in the mouth and digestive system of most people. They don’t usually cause any problems, but can lead to oral thrush if they multiply.

There are a number of reasons why this may happen, including:

taking a course of antibiotics, particularly over a long period or at a high dose
taking inhaled corticosteroid medication for asthma
wearing dentures (false teeth), particularly if they don’t fit properly
having poor oral hygiene
having a dry mouth, either because of a medical condition or a medication you are taking
smoking
having chemotherapy or radiotherapy to treat cancer

Babies, young children and elderly people are at a particularly high risk of developing oral thrush, as are people with certain underlying conditions, including diabetes, an iron deficiency or vitamin B12 deficiency, an underactive thyroid (hypothyroidism) and HIV.

As most people already have Candida fungi living in their mouth, oral thrush is not contagious. This means it cannot be passed to others.

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Treating oral thrush

Oral thrush can usually be successfully treated with antifungal medicines. These usually come in the form of gels or liquid that you apply directly inside your mouth (topical medication), although tablets or capsules are sometimes used.

Topical medication will usually need to be used several times a day for around 7 to 14 days. Tablet or capsules are usually taken once daily.

These medications don’t often have side effects, although some can cause nausea (feeling sick), vomiting, bloating, abdominal (tummy) pain and diarrhoea.

If antibiotics or corticosteroids are thought to be causing your oral thrush, the medicine – or the way it is delivered – may need to be changed or the dosage reduced.

Preventing oral thrush

There are a number of things you can do to reduce your chances of developing oral thrush.

Antifungal medicines

You can get some antifungal medicines from a pharmacy without needing a GP prescription.

Infections antifungals can treat

Fungal infections commonly treated with antifungals include:

ringworm
athlete’s foot
fungal nail infection
vaginal thrush
some types of severe dandruff

Some fungal infections can grow inside the body and need to be treated in hospital.

aspergillosis, which affects the lungs
fungal meningitis, which affects the brain

You’re more at risk of getting one of these more serious fungal infections if you have a weakened immune system – for example, if you’re taking medicines to suppress your immune system.

Types of antifungal medicines

You can get antifungal medicines as:

a cream, gel, ointment or spray
a capsule, tablet or liquid
an injection
a pessary: a small and soft tablet you put inside the vagina

Common names for antifungal medicines include:

clotrimazole (Canesten)
econazole
miconazole
terbinafine (Lamisil)
fluconazole (Diflucan)
ketoconazole (Daktarin)
nystatin (Nystan)
amphotericin

How antifungal medicines work

Antifungal medicines work by either:

killing the fungus
preventing the fungus from growing

When to see a pharmacist or GP

See a pharmacist or GP if you think you have a fungal infection. They can advise you on which antifungal medicine is best for you.

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If you take too much antifungal medicine, call 111 or speak to a pharmacist or GP.

If you’re advised to go to hospital, take the medicine’s packaging with you so the healthcare professionals who treat you know what you’ve taken.

Things to consider when using antifungal medicines

Before taking antifungal medicines, speak to a pharmacist or GP about:

any existing conditions or allergies that may affect your treatment for fungal infection
the possible side effects of antifungal medicines
whether the antifungal medicine may interact with other medicines you may already be taking
whether your antifungal medicine is suitable to take during pregnancy or while breastfeeding – many are not suitable

You can also check the patient information leaflet that comes with your antifungal medicine for more information.

Side effects of antifungal medicines

Antifungal medicines may cause side effects. These are usually mild and do not last long.

They can include:

itching or burning
redness
feeling sick
tummy (abdominal) pain
diarrhoea
a rash

Occasionally, antifungal medicines may cause a more severe reaction, such as:

an allergic reaction – your face, neck or tongue may swell and you may have difficulty breathing
a severe skin reaction – such as peeling or blistering skin
liver damage (very rarely) – you may have loss of appetite, vomiting, nausea, jaundice, dark pee or pale poo, tiredness or weakness

Stop using the medicine if you have these severe side effects, and see a GP or pharmacist to find an alternative.

If you’re having difficulty breathing, go to A&E or call 999.

Reporting side effects

If you think a medicine has made you unwell, you can report this side effect through the Yellow Card Scheme.

Antifungal medicines for children

Some antifungal medicines can be used to treat children and babies – for example, miconazole oral gel can be used for oral thrush in babies.

But different doses are usually needed for children of different ages. Speak to a pharmacist or GP for more advice.

Page last reviewed: 03 April 2023
Next review due: 03 April 2026

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Fluconazole

Fluconazole is used to treat fungal infections, including yeast infections of the vagina, mouth, throat, esophagus (tube leading from the mouth to the stomach), abdomen (area between the chest and waist), lungs, blood, and other organs. Fluconazole is also used to treat meningitis (infection of the membranes covering the brain and spine) caused by fungus. Fluconazole is also used to prevent yeast infections in patients who are likely to become infected because they are being treated with chemotherapy or radiation therapy before a bone marrow transplant (replacement of unhealthy spongy tissue inside the bones with healthy tissue). Fluconazole is in a class of antifungals called triazoles. It works by slowing the growth of fungi that cause infection.

How should this medicine be used?

Fluconazole comes as a tablet and a suspension (liquid) to take by mouth. It is usually taken once a day, with or without food. You may need to take only one dose of fluconazole, or you may need to take fluconazole for several weeks or longer. The length of your treatment depends on your condition and on how well you respond to fluconazole. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take fluconazole exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may tell you to take a double dose of fluconazole on the first day of your treatment. Follow these directions carefully.

Shake the liquid well before each use to mix the medication evenly.

You should begin to feel better during the first few days of treatment with fluconazole. If your symptoms do not improve or get worse, call your doctor.

Continue to take fluconazole until your doctor tells you that you should stop, even if you feel better. Do not stop taking fluconazole without talking to your doctor. If you stop taking fluconazole too soon, your infection may come back after a short time.

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Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

Other uses for this medicine

Fluconazole is also sometimes used to treat serious fungal infections that begin in the lungs and can spread through the body and fungal infections of the eye, skin and nails. Fluconazole is also sometimes used to prevent fungal infections in people who are likely to become infected because they have human immunodeficiency virus (HIV) or cancer or have had a transplant operation (surgery to remove an organ and replace it with a donor or artificial organ). Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking fluconazole,

tell your doctor and pharmacist if you are allergic to fluconazole, other antifungal medications such as itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), or voriconazole (Vfend), any other medications, or any of the ingredients in fluconazole tablets or suspension. Ask your pharmacist for a list of the ingredients.
tell your doctor if you are taking astemizole (Hismanal) (not available in the US), cisapride (Propulsid) (not available in the US), erythromycin (E.E.S., E-Mycin, Erythrocin); pimozide (Orap), quinidine (Quinidex), or terfenadine (Seldane) (not available in the US). Your doctor will probably tell you not to take fluconazole if you are taking any of these medications.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking, or plan to take. Also you should tell your doctor you have taken fluconazole before starting to take any new medications within 7 days of receiving fluconazole. Be sure to mention any of the following: amitriptyline; amphotericin B (Abelcet, AmBisome); anticoagulants (‘blood thinners’) such as warfarin (Coumadin, Jantoven); calcium channel blockers such as amlodipine (Norvasc, in Caduet, in Lotrel, others), felodipine , isradipine , and nifedipine (Adalat, Afeditab, Procardia); carbamazepine (Carbatrol, Epitol, Equetro, Tegretol); celecoxib (Celebrex, in Consensi); cholesterol-lowering medications (statins) such as atorvastatin (Lipitor, in Caduet), fluvastatin (Lescol), and simvastatin (Zocor, in Vytorin); cyclophosphamide; cyclosporine (Gengraf, Neoral, Sandimmune); diuretics (‘water pills’) such as hydrochlorothiazide ( Microzide, in Diovan HCT, in Tribenzor, others ); fentanyl (Actiq, Duragesic, Fentora, Sublimaze, Subsys, others); isoniazid (Laniazid, in Rifamate,in Rifater); losartan (Cozaar, in Hyzaar); methadone (Methadose); midazolam (Seizalam); nevirapine (Viramune); nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Anaprox, Naprelan, in Treximet, in Vimovo); oral contraceptives (birth control pills); oral medication for diabetes such as glipizide (Glucotrol), glyburide (Diabeta, Glynase), and tolbutamide; nortriptyline (Pamelor); phenytoin (Dilantin, Phenytek); prednisone (Rayos); rifabutin (Mycobutin); rifampin (Rifadin, Rimactane, in Rifamate, in Rifater); saquinavir (Invirase); sirolimus (Rapamune); tacrolimus (Astagraf, Prograf); theophylline (Elixophyllin, Theo-24, Theochron); tofacitinib (Xeljanz); triazolam (Halcion); valproic acid (Depakene, Depakote); vinblastine; vincristine (Marqibo); vitamin A; voriconazole (Vfend); and zidovudine (Retrovir, in Combivir, in Trizivir). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with fluconazole, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
tell your doctor if you have or have ever had cancer; acquired immunodeficiency syndrome (AIDS); an irregular heartbeat; a low level of calcium, sodium, magnesium, or potassium in your blood; rare, inherited conditions where the body is not able to tolerate lactose or sucrose;or heart, kidney, or liver disease.
tell your doctor if you are pregnant, especially if you are in the first 3 months of your pregnancy, plan to become pregnant, or are breastfeeding. Your doctor may tell you to use birth control to prevent pregnancy during your treatment and for 1 week after your final dose. If you become pregnant while taking fluconazole, call your doctor. Fluconazole may harm the fetus.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking fluconazole.
you should know that fluconazole may make you dizzy or cause seizures. Do not drive a car or operate machinery until you know how this medication affects you.