Ear, nose and throat

Medicines for Oral thrush

A fungal infection in the mouth that causes white patches and soreness, usually treated with an antifungal — and worth checking for an underlying cause when it keeps coming back.

Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.

Written by Meds Global Health Clinical Team · Clinically reviewed by Dr Muhammad Suffyan, MB BS, Founder & Clinical Director · Last reviewed · How we review

Quick answer

What is Oral thrush?

Oral thrush, or oral candidiasis, is a fungal infection of the mouth caused by an overgrowth of a yeast called Candida, which normally lives harmlessly in small amounts in the mouth. When something tips the balance, it can multiply and cause creamy-white patches on the tongue, inner cheeks or roof of the mouth, often with soreness, a burning feeling, redness underneath the patches, or a change in taste.

  • How it is treated: The aim is to clear the infection and, just as importantly, to deal with whatever allowed it to take hold.
  • Self-care: Rinsing your mouth with water after using a steroid inhaler, cleaning your teeth and tongue regularly, taking dentures out overnight and cleaning them well, staying well hydrated to ease a dry mouth, and keeping diabetes well controlled all reduce the chance of oral thrush developing or coming back.
  • When to seek help: See a GP or pharmacist if you have white patches or soreness in the mouth that do not clear, if oral thrush keeps coming back, or if it is hard to eat or drink.

What it is

Oral thrush, or oral candidiasis, is a fungal infection of the mouth caused by an overgrowth of a yeast called Candida, which normally lives harmlessly in small amounts in the mouth. When something tips the balance, it can multiply and cause creamy-white patches on the tongue, inner cheeks or roof of the mouth, often with soreness, a burning feeling, redness underneath the patches, or a change in taste. Several things make this more likely: using a steroid inhaler for asthma or COPD (especially without rinsing the mouth afterwards), wearing dentures, a recent course of antibiotics, a dry mouth, poorly controlled diabetes, a weakened immune system, and being very young or older. Babies can also develop oral thrush. It is usually easy to recognise and treat, but because it often points to one of these triggers, repeated or stubborn thrush is a reason to look for and address the underlying cause rather than simply treating each episode in isolation.

How it is treated

The aim is to clear the infection and, just as importantly, to deal with whatever allowed it to take hold. Treatment is with an antifungal medicine. For many people a treatment applied directly in the mouth — such as a gel or a liquid held in the mouth — works well and keeps the medicine where it is needed; an antifungal taken by mouth as a tablet or capsule may be used for more widespread infection, when local treatment is not suitable, or where the immune system is weakened. Alongside the medicine, the trigger is addressed: rinsing the mouth with water after using a steroid inhaler, cleaning and removing dentures overnight, keeping good mouth care, and improving control of conditions such as diabetes all help. When oral thrush keeps returning or does not clear, that is a prompt to check for an underlying reason rather than repeating the same treatment, since persistent thrush can be a sign that something else needs attention.

For this condition, these medicines

Medicine classes used for Oral thrush

Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.

Azole antifungals Anti-infective An oral antifungal such as fluconazole is used for more widespread infection, when treatment applied in the mouth is not suitable, or where the immune system is weakened. Topical antifungals Dermatology An antifungal applied directly in the mouth, such as miconazole gel or nystatin, is often the first choice as it keeps the medicine where the infection is. Tell your pharmacist or GP if you take warfarin (or another anticoagulant) before using miconazole, as it can increase the blood-thinning effect and bleeding risk, so nystatin is often preferred instead.

Symptom checker

Symptoms that can point to Oral thrush

Oral thrush can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:

Difficulty swallowingTrouble getting food or drink to go down, or a sense that it sticks or is painful on the w…Sore throatPain, scratchiness or rawness at the back of the throat that is usually caused by a passin…Mouth ulcersPainful sores on the lining of the mouth, lips or tongue that are usually harmless and hea…Dry mouthA persistent feeling that the mouth is dry and short of saliva — often a side effect of me…Burning or sore mouthA burning, scalded or sore sensation in the mouth, tongue or lips — which can come from th…Swollen tongue or lipsSwelling of the tongue, lips or mouth that can be a harmless reaction or a sign of an alle…Persistent bad breathAn unpleasant smell from the mouth that does not clear with brushing — most often caused b…Loss of tasteA reduced or altered sense of taste, where food tastes bland, odd or of nothing at all — u…Sore, cracked lips and mouth cornersDry, sore, cracked or split lips, often with painful cracks at the corners of the mouth — …

Beyond medication

Lifestyle and self-care

Rinsing your mouth with water after using a steroid inhaler, cleaning your teeth and tongue regularly, taking dentures out overnight and cleaning them well, staying well hydrated to ease a dry mouth, and keeping diabetes well controlled all reduce the chance of oral thrush developing or coming back.

When to get help

When to see a doctor

See a GP or pharmacist if you have white patches or soreness in the mouth that do not clear, if oral thrush keeps coming back, or if it is hard to eat or drink. Seek prompt medical advice if thrush spreads or is hard to shift in someone with a weakened immune system, poorly controlled diabetes, or who is unwell, as this may need closer assessment and a check for an underlying cause. A baby who is feeding poorly because of a sore mouth should also be reviewed.

999Emergency — call 999 or go to A&E
111Urgent advice — call NHS 111 or use 111 online
GPNon-urgent — see your GP or pharmacist

Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.

Answers

Oral thrush: frequently asked questions

What medicines are used for oral thrush?

Oral thrush is treated with antifungal medicine. Often the first choice is a treatment applied directly in the mouth — such as a gel or a liquid like miconazole or nystatin — which keeps the medicine where the infection is. An antifungal taken by mouth, such as fluconazole, may be used for more widespread infection, when a local treatment is not suitable, or where the immune system is weakened. A pharmacist or GP can advise which is most appropriate, and will also look at why the thrush developed.

Why do I keep getting oral thrush?

Repeated oral thrush usually means something is tipping the balance in the mouth. Common reasons include using a steroid inhaler without rinsing afterwards, wearing dentures, having a dry mouth, recent antibiotics, poorly controlled diabetes or a weakened immune system. Rather than just treating each episode, it is worth looking at the underlying trigger — addressing that is often what stops the thrush returning. If it keeps coming back, your GP can help work out the cause.

Can my asthma inhaler cause oral thrush?

Yes, steroid inhalers used for asthma or COPD can make oral thrush more likely, because some of the medicine can settle in the mouth and let the yeast overgrow. A simple and effective habit is to rinse your mouth with water (and spit it out) after each use, which washes away the residue. Using a spacer with your inhaler, where appropriate, can also help. If thrush keeps happening, mention it to your GP or asthma nurse, as your inhaler technique or device can be reviewed.

Is oral thrush serious?

For most people oral thrush is uncomfortable but not serious, and it clears with antifungal treatment. It matters more when it is persistent, widespread, or occurs in someone with a weakened immune system or poorly controlled diabetes, as it can be harder to treat and may point to an underlying problem that needs attention. Thrush that does not clear with treatment, keeps returning, or makes eating and drinking difficult should always be checked rather than left.

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Sources

Where this is drawn from

  • NICE CKS: Candida - oral.
  • NICE CKS: Oral thrush (mouth thrush).

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