Tioconazole vs. Miconazole: What Are the Differences?

Tioconazole and miconazole are both anti-fungal medications. They both help treat certain fungal infections by breaking down the fungi structure. Without the basic fungal structure, the fungi can not survive on its own.

Both tioconazole and miconazole help treat vaginal yeast infections. However, miconazole can also be used for other types of fungal infections, such as oral thrush, athlete’s foot, ringworm, or jock itch.

This article will help you understand the similarities and differences between tioconazole and miconazole. 

What Are Tioconazole and Miconazole?

Tioconazole and miconazole are medications belonging to a drug class called imidazole antifungals. They are used to treat different types of fungal infections.

Both of these medications can fight fungal infections by inhibiting a protein that creates ergosterol, which is an essential substance needed for fungal structure and protection. Without ergosterol, the fungi structure is weakened and vulnerable to your body’s immune system. As a result, the fungus cannot survive, and the infection is cleared.

Miconazole is approved to treat the following:

• Vaginal yeast infections in people 12 years and older
• Oral thrush in people 2 and older
• Tinea or fungal infections that result in athlete’s foot, ringworm, or jock itch in people 2 and older

Tioconazole is only approved to treat vaginal yeast infections in those 12 and older.

Available Brands and Formulations

Based on the brand and formulation, tioconazole and miconazole are available over-the-counter (OTC) or by prescription.

Tioconazole is only formulated as an ointment for vaginal use. Miconazole has many different formulations based on the infection site:

• For oral thrush, miconazole is available as a dissolvable tablet that is placed between the gums and the cheek. This formulation is prescription only.
• For vaginal yeast infections, miconazole is available OTC as a suppository or an ointment placed in the vagina.
• For tinea-related infections, miconazole is available OTC as a cream, powder, or spray. 

The comparison of the different brands of tioconazole and miconazole is provided below.

Tioconazole vs. Miconazole: Main Differences

The main difference between tioconazole and miconazole is the type of fungal infections they treat.

Tioconazole is only available to treat vaginal yeast infections. Whereas miconazole is used to treat many other types of fungal infections, too, such as oral thrush, athlete’s foot, ringworm, or jock itch.

The following table summarizes the primary differences between tioconazole and miconazole.

Dosing: Tioconazole vs. Miconazole

Tioconazole is available as a 6.5% ointment. To administer it, you use an applicator filled with the ointment to place it in the vagina at bedtime.

The vaginal applicator is already pre-filled with the ointment, so all you have to do is push the medicine into the vagina, similar to a tampon. Once the medication is applied, dispose of the applicator.

You can still use tioconazole if you are menstruating; however, avoid using tampons during this time. Instead, opt for sanitary napkins. Using tampons can prevent the medication from working properly since the tampon will absorb the ointment. Even if you're not on your period, it is recommended to wear a sanitary napkin as the ointment can leak out.

Miconazole comes as a cream or suppository for inserting into the vagina.

The duration of treatment using a suppository is based on the doses listed below:

• 1200 milligram (mg) one-time dose
• 200 mg dose for three days 
• 100 mg dose for seven days

The duration of treatment using the cream is based on the doses listed below:

• 4% cream: Insert one applicatorful daily for three days
• 2% cream: Insert one applicatorful daily for seven days

If you are using miconazole for oral thrush, apply a 50 mg tablet to the upper gum region in your mouth in the morning after brushing your teeth once a day for seven to 14 days.

What Are the Side Effects?

Some common side effects that both tioconazole and miconazole share include:

• Vaginal irritation
• Itching 

Less commonly, vaginal miconazole may cause pelvic cramps.

Rarely, topical use in the form of a cream has caused localized allergic reactions at the application site.

Which Is More Effective?

There are limited studies comparing the effectiveness of tioconazole and miconazole. Both agents can work well in treating vaginal yeast infections. However, miconazole has a broader spectrum of uses. It can also help treat other fungal infections.

The Infectious Diseases Society of America recommends topical anti-fungal agents for these infections, with no preference as to which medication is best.

Other Treatment Options for Yeast Infections

Tioconazole and miconazole are not the only options available for treating vaginal yeast infections. 

Other treatment options available OTC for vaginal yeast infections include:

• Clotrimazole 1% cream 
• Clotrimazole 2% cream 

Prescription treatments for vaginal yeast infections include:

• Butoconazole 2% cream
• Terconazole 0.4% or 0.8% cream
• Terconazole 80 mg vaginal suppository
• Fluconazole 150 mg tablet

Summary

Tioconazole and miconazole are both imidazole anti-fungal medications used to treat vaginal yeast infections. However, miconazole has a broader spectrum of antifungal activity, allowing its use in other fungal infections, such as oral thrush and athlete's foot.

Because of miconazole's wider variety of uses, it has several different dosages and administration forms. For vaginal yeast infections, tioconazole only needs to be used once, whereas miconazole comes in three- and seven-day regimens.

The author would like to recognize and thank Alexya Rosas for contributing to this article.