Vulvovaginal candidiasis (yeast infection)
Clinical basis & sources
- Primary source
- OCP Minor Ailments Prescribing
Sources used
- Ontario Regulation 256/24: GeneralGovernment of Ontario · 2026
- Minor Ailments: Drug Classes and Specified DrugsOntario College of Pharmacists · 2026
- Executive Officer Notice: Update to Funding for Minor Ailment Services in Ontario Pharmacies (Effective July 1, 2026)Government of Ontario · 2026-05-19
- Vulvovaginal Candidiasis - STI Treatment GuidelinesCenters for Disease Control and Prevention · 2021
- IDSA 2016 Clinical Practice Guideline Update for the Management of CandidiasisInfectious Diseases Society of America · 2016
- Pharmacist Assessment - Uncomplicated Vulvovaginal CandidiasismedSask, University of Saskatchewan · 2023-07
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Allowable drugs under Schedule 4 (4)
Drugs an Ontario pharmacist may prescribe for Vulvovaginal candidiasis (yeast infection) under O. Reg. 256/24, Schedule 4. Choice still depends on the assessment, contraindications, allergies, and product availability — this is the eligible list, not a recommendation.
- Clotrimazole
- Fluconazole
- Miconazole
- Terconazole
Symptoms this assessment screens
- Vulvar or vaginal itching, soreness, burning, redness, or swelling
- Thick white or curdy discharge without strong fishy odour
- External dysuria or discomfort with intercourse is consistent with vulvar irritation
- Sporadic or infrequent episode with mild to moderate symptoms
- Patient is not pregnant and pregnancy is not possible or is confidently excluded
- Medication safety screen completed for azole interactions, allergy, liver disease, QT risk, and latex-device counselling
Red flags — any positive means refer
- Pregnant, possibly pregnant, breastfeeding with uncertainty, age under 12, or first episode in a child/adolescent requiring diagnostic assessment
- Pelvic/lower abdominal pain, fever, abnormal bleeding, malodorous/fishy discharge, green/yellow/frothy discharge, genital ulcers/lesions, sexually transmitted infection exposure, or sexual assault concern
- Severe vulvar swelling, extensive fissures/excoriations, intense pain, immunocompromise, poorly controlled diabetes, or systemic illness
- Four or more episodes in 12 months, symptoms persisting after treatment, recent failed azole therapy, or suspected non-albicans Candida
- Symptoms are atypical, diagnosis is uncertain, urinary symptoms suggest UTI, or patient requests repeated empiric treatment without confirmation
- Azole allergy, clinically significant fluconazole interaction, serious liver disease, QT-risk concern, or another safety issue that cannot be managed
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