Isoconazole (pessary)

Isoconazole (pessary) is used to treat vaginal thrush. Learn how to use the medication, its common side effects, precautions to watch out for, and more.

What is this medication for?

Isoconazole pessaries are used to treat vaginal thrush (also known as vulvovaginal candidiasis). Vaginal thrush is caused by an overgrowth of a fungus known as Candida albicans. This infection causes symptoms such as itching, swelling and thick, white odourless discharge. This medication will prevent the growth of the fungus and clear the infection.

How should I take or use this medication?

  • Insert one pessary into your vagina as deeply as possible, in a lying position in the evening, just before bedtime.
  • Usually, only a single dose is required for treatment.
  • Avoid vaginal intercourse during the period of treatment.
  • You may consider using a panty liner during the treatment to absorb any discharge.
  • Do not use tampons, intravaginal douches, spermicides or other products to be used in the vagina when you are using this medication.
  • The treatment is not to be carried out during menstruation, as it may be less effective.

What should I do if I forget to take or use this medication?

If you miss a dose, use it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue normally. Do not use two doses or extra medication to make up for the missed dose.

What precautions should I take when taking or using this medication?

  • Wash your hands before and after handling the pessary
  • Inform your healthcare professional if:
    • You are allergic to isoconazole or any other ingredients used in the medication
    • You are pregnant, planning to become pregnant or breastfeeding
    • You are taking any other medications, including supplements, traditional medications and herbal remedies

What are some common side effects of this medication?

Mild stinging, itching and redness may occur at the affected area. 

  • These side effects are usually mild and go away after some time. However, if the symptoms are bothersome, do not go away or become worse, stop the medication and consult your healthcare professional.

What are some rare but serious side effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following:

  • Swollen face/eyes/lips/tongue
  • Difficulty in breathing
  • Itchy skin rashes over your whole body

Signs that you may require further medical attention include:

  • Abnormal vaginal bleeding
  • Vaginal discharge that is either green, yellow, or has a fishy smell
  • Symptoms differ from previous vaginal thrush infections
  • You had 4 or more cases of vaginal thrush within the last year
  • Symptoms reappear in less than 2 months
  • You previously had a sexually transmitted infection
  • You have a weakened immune system
  • You have diabetes 
  • You continue to have symptoms 3 days after your last dose of the medication

If you experience any of these symptoms, you should stop the medication and see your doctor immediately.

What food or medication should I avoid when I take or use this medication?

Check with your healthcare professional if other topical medications may be applied together with this medication.

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children.

How do I throw away this medication safely?

Pack this medication into a black trash bag and seal it tightly before throwing it into the rubbish chute or bin.




Please take note that the above is not a complete list of all possible side effects. If you have any concerns about your medication or if you have other side effects that you think are caused by this medication, please consult your doctor or pharmacist. 

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information. 

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

Last updated on June 2024

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