Candida medicine has come a long way since 1950 because of the enormous efforts of the pharmaceutical companies. There is now a considerable selection of anti-fungals for candida albicans with new medicines coming onto the market all the time. Each has its good points and bad points. Most target specific species of candida and fungi. They all work to some degree although not everyone achieves the same results do to different physiology and different levels of infection and health. Basically there is no one perfect candida albicans medicine on the market today. Many times it is best to use a few of these drugs at one time to achieve lasting results.
Candida Medicine in Use Today
Gentian violet was once the mainstay of candida treatment until Nystatin came into use in the 1950’s. Gentian violet can be bought without a doctor’s prescription and is often used for breast feeding and yeast infections of the skin. It is applied to the infected area of the skin infection and nipple and is generally considered safe for mother and child. It is also used on tampons for relief of candida vaginitis. One study did link heavy long-term use of gentian violet to cancer of the digestive tract and mouth. Its worst side effect is it stains skin and clothes purple. With the skin it wears off in a few days and Zout has been reported to take it out of clothes.
The Polyene Medicines for Candida Albicans
Although there are over 100 polyenes
that have been created or discovered, only four or so are in use today. The most popular are Nystatin, Candicidin, Natamycin, Amphotericin B and these are natural bi-products of the filamentous bacteria called Streptomyces and its sub-species. All of these candida albicans medicines work by damaging the cell wall of candida and altering its permeability, which effectively kills it.
Nystatin is the safest of the four and is commonly used in creams to treat yeast infections of the skin and in tablets to treat intestinal candida infections. Reported side effects have been trivial when compared to other anti-fungal medications. Candida glabrata and candida famata have been found to be resistant to Nystatin.
Candicidin is an extremely potent anti-candida agent but is very toxic so could never be used systemically. It is best used for vaginal candida and yeast infections of the skin as a cream.
Natamycin is a very weak anti-fungal that has been mostly used for candida vaginitis or candida infections of the skin. It has never really came into widespread use because of this fact but it is still available.
is the undisputed king of the candida albicans medicines when it comes to the polyenes. It is most often used systemically by injection with life threatening candida infections. Amphotericin B
can also be used orally because it is not readily absorbed into the blood stream just like the other polyenes. It has been successfully used as a topical agent as well.
This candida medicine is most often used with flucytosine with very good results for systemic candida. When used this way it has been found the doses can be lowered and you still achieve the same results. It has been effectively used against all types of candida infection with great results and is actually very under used today. The reason for its under use is because of its toxicity when injected. All polyenes have been found to be more effective when used with enzyme formulas like BioFase.
When used topically or orally Amphotericin B is relatively safe but when injected it can cause kidney damage, kidney failure and a lowering of blood potassium levels that can result in death. Blood urea nitrogen, creatinine clearance and serum potassium levels should be monitored twice weekly to correct these problems immediately if detected.
The Azole Drugs for Candida Albicans
The azole drugs
include Ketoconazole, Fluconazole, Itraconazole, Vibunazole and all can be taken by mouth. In smaller doses they work by inhibiting the growth of candida and can stop mycelial production in its tracks. In larger doses it permeates and disrupts ergosterol, which is a major part of the cell membrane like cholesterol is to our cell membranes. It works just like the polyene drugs and just like chemo drugs do when your being treated for cancer.
Ketoconazole was introduced in 1979 and was found to be effective for yeast infections of the skin and intestinal candida infections. It is hard on the liver and because of this fell out of widespread use. It is recommended that liver functions be monitored if taking this drug for more than a few days.
Miconazole has been used for the skin, vagina, intestinal candida in creams and pills and systemic candida by injection with pretty good results. It is very poorly absorbed by the body so its risks if not injected are minimal. Given intravenously it has been reported to cause skin rashes, blood disturbances and itching. All these symptoms subside when the patient stops taking the drug.
Fluconazole is readily absorbed into the blood stream and has come into wide spread use for candida vaginitis. It is weaker than the other azole drugs but because it is so well absorbed and does not degrade, it has fast become the candida albicans medicine of choice among most doctors today.
Doses of 200 to 400mgs a day are suggested for deep seated fungal infections. It should not be used for aspergillus, candida krusei or candida glabrata. It is most often used to contain Coccidiomycosis; a potently fatal fungi found in the environment of the southwest US.
Fluconazole has few side effects and most are associated with the gastrointestinal tract. When used in injectable form liver enzymes should be monitored for elevated levels and liver damage.
Itraconazole is worth mentioning because it does kill candida glabrata where fluconazole does not. It is readily absorbed into the blood stream like Diflucan. Its side effects are also very similar so it’s pretty safe.
Clotrimazole is used primarily on the skin and for vaginal yeast in creams. It has been shown to work very well for these types of infections and because it is so poorly absorbed by the body it is pretty safe.
The Encinocandins; Caspofungin, Micafungin, and Anidulafungin are administered by iv and work for most species of candida, especially candida glabrata. They inhibit the synthesis of glucan in the cell wall and disrupt the biofilm, especially when it comes to candida glabrata. The Enchinocandins should not be taken while pregnant and liver enzyme levels need to monitored for liver damage.
There are other candida medicines out there but those above are the most popular.