Vagisil vs. Monistat: Differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ | Prevention | Alternatives

If you’re suffering from a vaginal yeast infection, you’re not alone— about 75% of women will experience a yeast infection at least once. Yeast infections are most commonly caused by a fungus called Candida albicans and cause pesky symptoms such as itching, burning, and discharge. Vagisil and Monistat are two popular over-the-counter (OTC) medications commonly chosen by women for yeast infection treatment. 

Vagisil contains benzocaine and resorcinol, which work as external analgesics, relieving symptoms of burning and itching. Monistat contains miconazole, which is an antifungal that stops the growth of the fungus that is causing yeast infection. While both medications are used for vaginal symptoms, such as itching and discomfort, they are very different medications in terms of ingredients and how they work. 

What are the main differences between Vagisil and Monistat?

Vagisil is an OTC local anesthetic cream containing benzocaine 5% and resorcinol 2%. There is also a Vagisil maximum strength formulation which contains benzocaine 20% and resorcinol 3%, as well as a Vagisil sensitive anti-itch cream which contains hydrocortisone 1%, a steroid that helps with external itching. Although Vagisil is often thought of as a yeast infection treatment, it does not actually cure yeast infections.

Monistat is an OTC antifungal cream that contains the active ingredient miconazole nitrate. Monistat is available in a variety of formulations: a one-day (Monistat 1), three-day (Monistat 3), or seven-day (Monistat 7) treatment. You can buy Monistat as an internal vaginal cream or suppository. Some types of Monistat are available as a combination pack, with a tube of miconazole 2% cream that you can use externally to relieve symptoms. 

RELATED: Vagisil details | Monistat details | Miconazole details

Differences between Vagisil and Monistat
	Vagisil	Monistat
Drug class	Local anesthetic	Antifungal
Brand/generic availability	Brand	Brand and generic
What is the generic name?	Benzocaine and resorcinol	Miconazole
What form(s) does the drug come in?	External cream	Internal cream Vaginal suppository (ovule) External cream
What is the standard dosage?	Adults & children 12 years and older: Apply a fingertip amount (1-inch strip) to affected area 3 to 4 times daily	Adults & children 12 years and older: Insert 1 applicator (or suppository) vaginally at bedtime daily as directed on package
How long is the typical treatment?	As needed up to 7 days (consult a doctor if symptoms have not improved after 7 days)	1, 3, or 7 days depending on which formulation you select
Who typically uses the medication?	Adults & children 12 years and older	Adults & children 12 years and older

Conditions treated by Vagisil vs. Monistat

Vagisil contains benzocaine and resorcinol, which are local anesthetics used externally to relieve itching and irritation. Vagisil does not contain an antifungal, so while it may relieve symptoms externally, it will not treat the source of the yeast infection. 

Monistat contains the antifungal miconazole and is used vaginally, both internally and externally, to treat yeast infections. 

Is Vagisil or Monistat more effective?

It is difficult to compare the two drugs because they work differently. Vagisil can help with external itching, but will not cure a yeast infection. Therefore, if the itching is due to a yeast infection, Vagisil may help relieve symptoms temporarily, but will not cure the yeast infection that is causing the symptoms. If you are experiencing itching due to local irritation not associated with a yeast infection, Vagisil may be helpful, while Monistat would not be an effective treatment. 

Monistat has been shown to be effective as an antifungal and will help cure a yeast infection. Using the external cream in the combination pack (in addition to using the internal cream at bedtime) can help relieve symptoms while you wait for the infection to be cured.

You can always check with your doctor to see if Vagisil or Monistat is an appropriate choice for you because he or she should be familiar with your medical condition(s) and history.

Coverage and cost comparison of Vagisil vs. Monistat

Because Vagisil and Monistat are available OTC, they are typically not covered by insurance. Occasionally, an insurance plan may cover the generic form of Monistat. You can use a SingleCare card to save on Vagisil or Monistat, but you’ll need your doctor to write a prescription in order to process the SingleCare savings. Even though the drugs are both OTC, the SingleCare card will only work with a prescription. 

Cost comparison	Vagisil	Monistat
Typically covered by insurance?	No	No
Typically covered by Medicare Part D?	No	No
Typical Medicare Part D copay	N/A	N/A
SingleCare cost	$5-10 per tube	$10-17 per package

Prescription drug prices often change. These are the most accurate medication prices at the time of publishing.

Common side effects of Vagisil vs. Monistat

The most common side effects of Vagisil include local skin irritation or inflammation and skin peeling. Other, less common side effects that may occur include itching or redness, hives, stinging, and an allergic reaction. 

The most common side effects of Monistat include headache, local burning sensation or irritation, and lower stomach cramping. An allergic reaction is very rare, but you should seek immediate medical attention if symptoms occur. Symptoms can include swelling of the face, tongue, or throat, trouble breathing, dizziness, and/or rash.

Other side effects may occur. Consult your gynecologist for a full list of side effects. 

Drug interactions of Vagisil vs. Monistat

Both drugs have very few drug interactions since they are used topically. Vagisil should not be used with retinoids, such as adapalene or tretinoin, because the combination could be too irritating to the skin. 

Monistat should not be used in combination with Coumadin (warfarin), an anticoagulant that is also known as a blood thinner. The combination could lead to increased levels of warfarin in the body, which could lead to bleeding. 

Consult your healthcare provider for more information on drug interactions of Vagisil or Monistat. 

Warnings of Vagisil and Monistat

Vagisil warnings: 

• Vagisil is intended for external use only and applied to the affected area. Do not apply to large areas of the body.
• Avoid contact with the eyes.
• Keep out of reach of children.
• If symptoms do not improve within 7 days, consult your doctor. 

Monistat warnings:

• Consult a doctor if you have never been diagnosed with a yeast infection. Do not use Monistat unless you have previously been diagnosed with a vaginal yeast infection. A yeast infection can have similar symptoms to bacterial vaginosis, so if this is the first time you are experiencing symptoms, it is best to get evaluated by a doctor. 
• Check with your doctor before using Monistat if:
  • Your symptoms are accompanied by lower abdominal, back, or shoulder pain, fever, chills, nausea, vomiting, or foul-smelling vaginal discharge. These symptoms may indicate a more serious condition. 
  • You have vaginal yeast infections often.
  • You have been exposed to HIV.
• Ask your doctor before using Monistat if you take Coumadin (warfarin).
• While using Monistat:
  • Avoid tampons, douches, spermicides, and other vaginal products. Monistat may damage condoms or diaphragms, which could expose you to pregnancy or sexually transmitted disease (STDs). 
  • Do not have vaginal sexual intercourse.
  • You may experience local burning, itching, or irritation.
• Consult your healthcare professional if your symptoms do not improve. 
• Keep out of the reach of children.

If you are pregnant, consult your doctor about the appropriate treatment for a yeast infection and/or vaginal itching. 

Frequently asked questions about Vagisil vs. Monistat

What is Vagisil?

Vagisil is an OTC cream that contains local anesthetics called benzocaine and resorcinol. It can help relieve vaginal itching and irritation, but will not cure an underlying infection. 

What is Monistat?

Monistat contains miconazole, an antifungal used to treat vaginal yeast infections. It is available OTC in a variety of formulations as a one-day, three-day, or seven-day treatment. The internal cream comes with disposable applicators and is used at bedtime. Some formulations of Monistat also contain a tube of miconazole cream to be used externally. 

Does Monistat burn if you don’t have a yeast infection? 

Monistat may cause a mild increase of vaginal burning, itching, and irritation when used, even without a yeast infection. The vaginal area is sensitive in general and prone to these side effects when applying any type of medication there. However, burning may be worse if you already have a yeast infection present. This is because Monistat may worsen vaginal discomfort that is caused by a yeast infection. Additionally, the shorter the duration of treatment, the more potent the medication is. Therefore, if you are prone to vaginal irritation from vaginal products in general, it may be better to try the three-day or seven-day treatment instead of the one-day treatment. 

Can Monistat cause burning?: How to stop monistat burning

One way to reduce the risk of irritation with Monistat is to use the combination pack that comes with external itch relief cream. To reduce the chances of side effects, use the ovule insert as directed, apply the external cream to the outside of the vagina only, and dry the genital area thoroughly after a shower, bath, or swim. Another important thing to remember is to not scratch the area, no matter how tempting it may be. Scratching can break the skin, potentially worsening irritation and increasing the risk of infection. Overall, it is normal to feel a mild increase of burning when taking Monistat, but if it becomes worse or intolerable, it is important to stop taking it and seek medical help.  

Are Vagisil and Monistat the same?

No. Vagisil helps relieve itching but does not cure infections. Monistat contains an antifungal, so it can help cure a yeast infection. 

Which is the best vaginal itch cream?: Vagisil vs. Monistat

If you have local itching that is not associated with a yeast infection, Vagisil may be sufficient to relieve symptoms. However, if your symptoms are due to a yeast infection, you need treatment with an antifungal, such as Monistat, to cure the infection. 

Can I use Vagisil with Monistat? 

While Vagisil and Monistat do not interact, it may be best to not use them together. Monistat’s product insert says that it should not be used with any other vaginal products because they may interfere with its effectiveness. Another thing to note is that using Vagisil with Monistat may make it difficult to see if Monistat is working to treat a yeast infection. Vagisil could cover up yeast infection side effects. If Monistat is ineffective and it is hard to tell, it could delay seeking medical care. However, it is best to consult a healthcare provider to see if it is okay to use these two products together based on individual circumstances. 

Can I use Vagisil or Monistat while pregnant?

Yeast infections can be common in pregnancy. According to the American Pregnancy Association, treatment with a vaginal suppository or cream is recommended under the care of your doctor. Ask your OB/GYN if it is safe for you to use Monistat. The manufacturer of Vagisil states that you should contact your doctor before using Vagisil if you are pregnant.

Can I use Vagisil or Monistat with alcohol?

The manufacturers of Vagisil and Monistat do not list any contraindications with alcohol. However, alcohol can increase the risk of yeast infections, so if you are experiencing a yeast infection or are prone to recurrent yeast infections, you may want to skip the alcohol.

Does Vagisil work for yeast infections?

No. Vagisil will help relieve itching but does not contain an antifungal to help the source of the infection. There is a product called Vagistat, from the manufacturers of Vagisil, which contains miconazole in an internal and external cream, similar to Monistat 3. If you are looking to cure a yeast infection, you will want to choose a product that contains an antifungal agent (such as Vagistat or Monistat), but not Vagisil. 

Which Monistat is most effective?

All three formulations of Monistat are similarly effective in treating yeast infections in approximately the same amount of time. If you are not feeling better in three days, or you have symptoms for more than seven days, see your doctor. 

How long does it take for Monistat to work?

Regardless of which product you choose, it can take up to seven days until you are fully cured.

What cures a yeast infection fast?

Using an antifungal medication as directed can be very helpful for fast relief. Studies have shown that creams and oral pills work in more than 90% of cases. 

How do I treat recurring yeast infections? 

You should talk to your doctor if you get four or more yeast infections per year because you may need to take prescription antifungal medicine for a few weeks or longer. This occurs in less than 5% of women. However, being immunocompromised increases the risk of recurrent yeast infections. You should also see your doctor if you do not have improvement within three days or if you have symptoms for more than seven days after starting a treatment. If you experience serious side effects, such as developing a rash, hives, abdominal pain, fever, chills, nausea vomiting, foul smelling vaginal discharge, or severe vaginal burning, stop the treatment and seek medical help. 

Yeast infection Prevention

The following lifestyle tips promote vaginal health and may help to prevent yeast infections:

• Wear cotton clothing and underwear.
• Wash with an unscented hypoallergenic soap, and dry thoroughly.
• Wipe from front to back.
• Change out of your swimsuit or any damp clothing (such as workout clothing) as soon as possible.
• Avoid the use of douches (such as Summer’s Eve), feminine hygiene sprays, sanitary products that contain deodorant, scented soaps, bubble baths, and perfumed toilet paper. 
• Eat yogurt with live and active cultures and/or take probiotics, especially if you are taking antibiotics.
• Limit sugar in your diet.
• Drink more water and stay hydrated.

Yeast infection alternatives to Monistat and Vagisil

There are some alternatives to Monistat and Vagisil for treating and alleviating the symptoms of a yeast infection. They should never be used internally without consulting a doctor. These alternatives include:

• Apple cider vinegar: Drinking one spoonful mixed into a glass of water daily can inhibit the growth of Candida albicans.
• Cranberry juice or pills: These can help prevent the formation of Candida albicans in the urine. 
• Tea tree oil suppositories: Tea tree oil has antimicrobial and antifungal properties. It has been found to be effective against Candida albicans.
• Garlic: Garlic has antifungal properties and consuming it can help prevent or speed up treatment of yeast infections.
• Boric acid vaginal suppositories: These have been shown to treat recurrent or hard-to-treat yeast infections because of their potency. Milder treatments should be used first. Remember, if you are having difficulty treating a yeast infection, it is best to consult a doctor.
• Prescriptions: No matter what treatment you try, if there is no improvement within three days or if a yeast infection is still present after seven days, it may be time to get a prescription. You will most likely be prescribed an antifungal, such as fluconazole (oral tablets) or terconazole (vaginal cream).