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Canesten combi is a combination thrush treatment for women that includes a single dose vaginal tablet (pessary) and an external cream. Both contain the active ingredient clotrimazole, which is effective at killing the fungus that causes thrush and for relieving the external symptoms.
Between 70 to 75% of women of childbearing age will get thrush in their lifetime and may require treatment. You can request Canesten combi online for female thrush quickly and discreetly from ZAVA.
About Canesten combi
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Canesten combi is a combination treatment for female thrush that contains a pessary and an external cream. The active ingredient in Canesten combi is clotrimazole, a type of antifungal medication that belongs to a class of medications called imidazoles. This works to kill the fungus responsible for causing thrush, called Candida albicans.
Canesten combi contains a 500mg dissolvable tablet called a pessary that is inserted inside the vagina to clear the infection, and an external 2% clotrimazole cream to relieve symptoms such as itching, burning and soreness. By targeting the internal cause of thrush and treating the external symptoms caused by it, Canesten combi provides a complete thrush treatment for women.
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The active ingredient in Canesten combi is clotrimazole, an antifungal medication that kills the thrush-causing fungus, Candida albicans. It does this by stopping an important part of the fungal cell membrane, called ergosterol, from being produced.
Without ergosterol, the fungal cell membrane becomes damaged and unable to work properly. This causes the cellular contents to leak out, killing the fungus and helping clear the infection from the body.
How long does Canesten combi take to work?
Most people notice an improvement in their symptoms within 3 days of starting Canesten combi treatment. However, some people find it takes a little longer. If your symptoms have not improved after 7 days of starting treatment, contact your doctor for more advice.
How effective is Canesten combi?
Canesten combi is considered to be highly effective at treating vaginal thrush with most people noticing an improvement in their symptoms within 3 days of starting treatment.
Research shows that single doses of clotrimazole 500mg vaginal tablets cure thrush in 70 to 95% of cases within 1 or 2 weeks. While combined treatments like Canesten combi cure vaginal thrush in 80 to 95% of people within 2 weeks.
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Canesten combi is a combination treatment. The pessary is for internal use and directly targets the fungus causing the infection, while the external cream relieves common thrush symptoms like itching and burning. Each pack contains 1 pessary and applicator, and 1 tube of external cream.
If this is the first time you have gotten thrush, you must speak to a doctor or pharmacist before using any treatment.
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- Wash your hands thoroughly with soap and water before handling the applicator and foil blister pack.
- Remove the applicator from the packaging and pull the plunger with the red lock attached from the applicator.
- Remove the pessary (tablet) from the foil blister pack and place it into the open end of the applicator with the curved edge of the pessary facing down.
- Push the plunger and lock it into the applicator until you feel a click.
- Once you have felt the click, remove the lock from the plunger.
- Now, lying on your back with your knees bent up, carefully insert the applicator as deep as is comfortable into the vagina up to the patterned grip zone.
- Hold the applicator at the patterned grip zone.
- Carefully push the plunger all the way until it stops to dispense the vaginal pessary.
- Remove the applicator and dispose of it in a safe place out of reach of children.
You may find it useful to wear a panty liner as the pessary dissolves in the vagina because it may leave a chalky white residue, which is normal. However, if you notice pieces of undissolved pessary, you should contact your doctor or pharmacist.
How to apply the external cream:
- Wash your hands thoroughly with soap and water before applying the cream.
- The first time you use it, you’ll need to pierce the tube seal by inverting the cap over the end of the tube and pressing down.
- Apply a thin layer of cream around the entrance of the vagina, smoothing it in gently, 2 to 3 times a day.
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The full course of treatment usually lasts for 7 days, but can be extended to 2 weeks to stop the infection from coming back. If your symptoms have not improved after 7 days, you should speak to your doctor or pharmacist for further advice.
How often should I use Canesten combi?
The pessary is single-use and only needs to be applied once per course of treatment. However, the external 2% clotrimazole cream should be applied 2 to 3 times a day.
What if I miss a dose of Canesten combi?
If you forget to apply a dose of clotrimazole 2% cream, apply it as soon as you remember, and then continue the rest of your treatment as usual.
What if I take too much Canesten combi?
If you apply too much of the external cream, it can irritate your skin or cause redness. If this happens, apply less cream next time and consider washing it off and reapplying when your skin has settled. If irritation continues, stop using it and speak to your doctor or pharmacist for further advice.
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You can buy Canesten combi online from reputable online doctor services like ZAVA. These services are regulated and run by registered doctors who can make sure that the medication you request is suitable for you. Alternatively, you can buy Canesten combi over the counter from most UK pharmacies without a prescription.
Can I buy Canesten combi online?
Yes, you can buy Canesten combi online from ZAVA. You can request Canesten combi in 3 easy steps:
- Simply fill out a short online health questionnaire.
- One of our doctors will review your responses and confirm your suitability.
- Your medication will be discreetly delivered by Royal Mail to an address of your choice, or you can choose to collect it from your local Post Office.
Can I buy Canesten combi over the counter?
Yes, Canesten combi is available over the counter without a prescription. However, because the symptoms of thrush can be similar to other conditions, it’s recommended that you get advice from a doctor or pharmacist to make sure you are getting the correct treatment.
Can I get Canesten combi on the NHS?
Yes, you can get Canesten combi prescribed on the NHS, or you may be offered an unbranded alternative. In some areas of the UK, your GP may advise you to buy Canesten combi over the counter instead.
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Like all medications, Canesten combi can cause side effects, but not everyone will get them. Speak to your doctor or pharmacist if your side effects are severe or persistent.
The main side effects of the pessary include:
- rash
- swelling
- itching
- redness
- discomfort
- irritation
- burning
- vaginal peeling
- vaginal bleeding
- pain in your stomach or pelvic area
The main side effects of the cream include:
- itching
- rash
- burning
- discomfort
- blisters
- swelling
- redness
- irritation
- peeling of your skin on the outside of your vagina
How long do Canesten combi side effects last?
Canesten combi side effects should only last a few days. If you get any side effects that do not go away when you stop or finish treatment, speak to your doctor or pharmacist for advice.
What to do if you get Canesten combi side effects
Most mild Canesten combi side effects will go away once you have stopped using it. However, if your symptoms persist, you should contact your doctor for advice.
If you experience an allergic reaction or the redness, burning, pain, or swelling gets worse, you should stop using Canesten combi. Signs of an allergic reaction include:
- rash
- breathing or swallowing problems
- swelling of the lips, face, throat, or tongue
- weakness, dizziness, or fainting
- feeling sick (nausea)
In an emergency, such as if you’re struggling to breathe, become confused, or lose consciousness, call 999 or get someone to take you to A&E.
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Canesten combi may not be suitable for everyone, which is why it is important to discuss your symptoms and medical history with a doctor or pharmacist before starting treatment. They will make sure that Canesten combi is safe and suitable for you to take.
Do not use Canesten combi:
- if you are allergic to clotrimazole or any other ingredients, including cetostearyl alcohol or benzyl alcohol, listed in the Canesten combi pessary and external cream
- during your period
- to treat fungal scalp or nail infections
Before using Canesten combi to treat female thrush, you should tell your doctor or pharmacist if you:
- are not sure if you have thrush, or this is the first time you have had these symptoms
- have had more than 2 thrush infections in the last 6 months
- or your partner have ever had a sexually transmitted infection (STI)
- are under 16 or over 60
- have ever had an allergic reaction to Canesten or any other vaginal antifungal medication
You should also speak to a doctor if you have any of the following symptoms because Canesten combi may not be the right treatment for you:
- irregular vaginal bleeding
- abnormal vaginal bleeding or blood-stained discharge
- ulcers, blisters, or sores of the vagina or vulva
- lower abdominal pain
- pain or difficulty passing urine
- fever or chills
- feeling or being sick
- diarrhoea
- foul smelling vaginal discharge
Canesten combi and other medications
Tell your doctor or pharmacist if you are taking or plan to take any prescribed, over-the-counter, or herbal medications while using Canesten combi, especially tacrolimus or sirolimus, which are given to reduce the immune response after an organ transplant.
Clotrimazole can reduce the effectiveness of latex contraceptives, like condoms and diaphragms. You will need to use extra protection for at least 5 days after using this product.
Canesten combi and pregnancy and breastfeeding
Canesten combi can be used during pregnancy and breastfeeding. However, you should let your doctor or midwife know before using Canesten combi. They may advise using the pessary without an applicator, and you should use Canesten combi exactly as they have told you to.
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Canesten combi may not be suitable for everyone, so at ZAVA, we offer a range of female thrush treatments to suit your preferences, needs, and symptoms. The female thrush alternative treatments we offer are:
This is the same external cream that is supplied in Canesten combi and can be used on its own without the pessary to relieve the external symptoms and treat thrush.
Another combined treatment that contains an external cream for your vagina and a single dose oral tablet containing 150mg of fluconazole, another type of antifungal medication.
Clotrimazole 1% cream
A lower strength external cream that is applied around the entrance of the vagina to treat thrush symptoms and kill the infection.
Fluconazole
An oral antifungal tablet that is taken by mouth to help clear the thrush infection from the body and relieve the irritating external symptoms.
➤ We can also provide clotrimazole 1% cream for thrush in men if your partner thinks he has thrush and requires treatment.
After completing her first degree, she went on to study graduate-entry medicine at Warwick University. After graduating as a doctor, she worked within the West Midlands in Urology, Respiratory Medicine, Infectious Disease, and Psychiatry before transitioning into a full-time medical communications role.
Meet our doctorsLast reviewed: 08 Jun 2025
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A clinical multicenter study comparing efficacy and tolerability of topical combination therapy with clotrimazole (Canesten, two formats) with oral single dose fluconazole (Diflucan) in vulvovaginal mycoses, National Library of Medicine [accessed 28 April 2025]
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About clotrimazole cream, spray and solution, NHS [accessed 28 April 2025]
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Canesten Thrush Combi Pessary & External Cream 500mg / 2% w/w pessary & cream, emc [accessed 28 April 2025]
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Clotrimazole, NICE [accessed 28 April 2025]
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Clotrimazole, National Library of Medicine [accessed 28 April 2025]