| Antifungal Medication | How to Prescribe |
|---|---|
| Nystatin 100,000 U/mL a | Dispense 300 mL; swish and spit out (or swallow) 5 mL 3–4 times a day for 7–10 days |
| Nystatin pastilles 200,000 U/pastille | Dissolve 1–2 pastilles in mouth 3–4 times a day for 7–10 days |
| Amphotericin B suspension 100 mg/mL | Dispense 300 mL; swish and spit out 5 mL 3–4 times a day for 7–10 days |
| Amphotericin 10-mg lozenges | Dissolve 1–2 tablets in mouth 3–4 times a day for 7–10 days |
| Clotrimazole 10-mg troches a | Suck on one troche 3–5 times a day for 7–10 days (troches do not dissolve if there is prominent hyposalivation) |
| Ketoconazole 200–400 mg daily | Take 1 or 2 tablets twice a day for 7–10 days |
| Miconazole 50 mg dissolving tablets daily | Dissolve in mouth once a day for 7–10 days |
| Fluconazole 100–200 mg daily Itraconazole 100–200 mg daily Voriconazole 200 mg twice a day Posaconazole 100 mg daily |
Fluconazole: Use as directed for 3–4 days (depending on the severity of the infection); long-term therapy may lead to resistance to fluconazole. Culture and sensitivity should be performed, and itraconazole, voriconazole, and posaconazole are alternatives; may be taken 1–2 times a week for prophylaxis if on long-term immunosuppressive therapy. |
| Mycostatin/triamcinolone cream Clotrimazole/betamethasone cream Iodoquinol/hydrocortisone 1% cream Miconazole 2% gel Miconazole/hydrocortisone |
Apply to corners of mouth 3–4 times a day or for angular cheilitis Paint onto denture base 3 times a day and wear denture; add erythromycin gel if there is residual lesion, because Staphylococcus aureus may be involved. |
| Denture soaks: Nystatin 100,000 U/mL Chlorhexidine digluconate 0.12–2% 3% sodium hypochlorite diluted in water (1 : 10) 2% sodium benzoate |
Soak denture in solution overnight. Dentures should never be worn overnight. |
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