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Tioconazole vs Miconazole: What Is the Difference?

Tioconazole and Miconazole are two drugs commonly prescribed for vaginal infections, sometimes interchangeably. They have many things in common, but there are significant differences between them as well. 

Whether one of the two treatments was recommended to you by your doctor or you are looking for the best yeast infection treatment on your own, an in-depth tioconazole vs. miconazole comparison should help. 

We will provide it in the following lines, covering their presentation, potential uses, interactions, side effects, and, why not, alternative treatments. 

Treatments Presentation, Use, and Side Effects

What Is Tioconazole?

It is a synthetic derivative of imidazole, commonly used to treat yeast and fungal infections. According to Pubchem, it inhibits the synthesis of the cell walls by inhibiting the biosynthesis of sterols, thus damaging the membrane of the fungal cell, improving its permeability, and facilitating the loss of fundamental intracellular elements. 

Available over the counter in various ointment forms, tioconazole is commonly used for treating vaginal yeast infection. It alleviates symptoms like itching, burning, and vaginal discharges and stops the yeast responsible for the infection from growing. Tioconazole is best known for its effectiveness against Candida.  

The general usage recommendations involve one topical application daily, preferably before bedtime. Treatment should continue for up to seven days. 

What Is Miconazole?

It is a synthetic derivative of imidazole, commonly used as for treating candida infections. Miconazole affects the integrity of the fungal cell membrane as well. Available both with prescription and over the counter, it comes in several forms for topical use. 

The vaginal cream is used for vaginal yeast infections, reducing the most common symptoms, namely itching, burning, and vaginal discharges. The skin cream if often prescribes as a treatment for Cutaneous Candidiasis, Tinea Cruris, Tinea Corporis, Tinea Versicolor, and Tinea Pedis, and intertrigo. The tablets are most effective against Oral Thrush. 

Topical Use Instructions

Miconazole should be used once a day, preferably before bedtime, for up to seven days. Being available in table form as well, it allows more flexibility when it comes to timing and application. 

What Are the Side Effects of Miconazole and Tioconazole?

According to WebMD, both vaginal treatments have similar side effects. These include: 

  • Headaches
  • Urethral or vaginal burning, itching, or pain
  • Allergic reactions (rash, itching, swelling, trouble breathing, dizziness)

Possible Interactions of Miconazole and Tioconazole with Other Drugs 

Miconazole may interact with anisindione, dicumarol, and warfarin. It can also have additional side effects when used to treat skin and oral infections. 

Other Precautions

For safety purposes, both treatments should only be used at a doctor’s recommendation, and only after discussing possible interactions with other drugs and treatments. Patients diagnosed with severe conditions like diabetes or immune disorders should benefit from medical supervision. 

They should also warn their doctor about using either of the two treatments if they need to undergo surgery or begin treatment with other drugs. Pregnant women should avoid using both substances due to the lack of data regarding their safety.  

What Are the Main Differences between Tioconazole and Miconazole?

As the above presentations show, the two treatments are very similar. However, compared to tioconazole, miconazole is available in more forms, under more brand names, some only with a prescription, and treats more conditions. It also has a slightly higher risk of side effects.

A Drugs.com comparison gives tioconazole the upper hand. On a scale from 1 to 10, miconazole has an average rating of 2.8 out of over 3,000 user reviews. Tioconazole fairs a little better, its rating averaging at 4.2 based on over 1,500 reviews. It is generally more expensive than miconazole.

An older double-blind study on the efficacy of tioconazole vs. miconazole for treating fungal skin infection or erythrasma confirms tioconazole’s supremacy over miconazole. The former achieved a higher cure rate than the latter. 

The same conclusion was reached by another single-blinded study that reviewed the effectiveness of the two topical treatments in patients with pityriasis Versicolor and dermatophyte and yeast infections. It is important to note that different formulas using the same active substance often give different results. 

However, judging by the information available, neither of the two treatments seems a completely safe and definitive solution to vaginal yeast and fungal infections. Before settling for either of them, it may be a good idea to consider alternative treatments as well. 

Alternatives to Tioconazole and Miconazole

There are other topical treatments used to treat yeast and fungal infections. Most of them belong to the same azoles category. They include clotrimazole, terconazole, butoconazole, and fluconazole. They have similar action principles and use direction, and they are comparable to the two treatment options discussed above in terms of effectiveness as well. A comprehensive list of drugs used to treat a vaginal yeast infection is available here

An alternative to azoles would be holistic remedies. Two types of holistic treatments have been proven effective for vaginal yeast infections so far, namely probiotics and homeopathic remedies. 

Probiotics vs. Tioconazole and Miconazole for Yeast Infections

On one hand, yeast infections are associated with antibiotic use and imbalances in the gut and vaginal flora. Supplementation with probiotics is an easy way to restore the balance between good and bad bacteria and fight the yeast infection from within. 

Compared to the two treatment alternatives discussed above, probiotics are available in tablet and capsule form as well. They are easier and safer to take, and they have numerous and valuable health benefits. Some probiotic supplements, like DD Probiotic, are specifically formulated to improve vaginal health and widely recommended by gynecologists. 

Homeopathic Remedies vs. Tioconazole and Miconazole for Yeast Infections

 It is well known that many herbs and naturally occurring substances have antifungal, antimycotic, and antibacterial properties. Common examples include: 

  • Sodium borate and bicarbonate 
  • Stone root (Collinsonia Canadensis)
  • Barberry (Berberis Vulgaris)
  • Witch Hazel (Hamamelis Virginiana)
  • Oregano and tea tree essential oils, etc

The list could continue, but it should be easy to see that, for best results, these ingredients should be combined. Doing it at home would be inconvenient and uncomfortable. It also would not make sense, considering that there are readily available and safe formulas proven to provide yeast infection relief, such as The Eraser

Drawing the Line: Azoles vs. Alternatives

Now you know what your options are. Besides a comprehensive tioconazole vs. miconazole comparison, you also have safer, more effective, and easier to use alternatives. It is up to you and your doctor to decide which vaginal yeast treatment is best for you. 

Once you have reached a decision, do not hesitate to share it in a comment below and contribute to our tioconazole vs. miconazole vs. alternative yeast infection treatment review!