Canesten Combi

Order a Canesten combi pack for fast-acting thrush relief for both internal and external infection.

The Canesten Combi packs include medications to treat both the internal infection (with either a  vaginal pessary, or intravaginal cream) and a supply of topical cream (clotrimazole). Using this combo is a highly effective method to quickly defeat thrush.

Our prices

Strength Quantity Price Stock
500mg / 2%1 pack£15.25In Stock
500mg / 2%2 packs£23.95In Stock
Prices exclude a prescription fee. This treatment requires a quick online consultation,
which a doctor will review to determine if a prescription is appropriate.

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Information

Dr Samantha Miller

Reviewed by Dr Samantha Miller MB ChB
(2017, University of Glasgow)
GMC number: 7561464

Information last reviewed 10/04/2021

About

What is the Canesten Combi?

The Canesten Combi packs consist of an intravaginal (internal) treatment, and also an external cream. Canesten Combi is a complete antifungal treatment for vulvovaginal thrush as it targets both the internal and external symptoms.

What is thrush?

Thrush is a common type of yeast infection characterized by vaginal inflammation, intense itching, soreness, and swelling of the vagina and vulva, accompanied by a white, lumpy discharge.

What is the Canesten Combi used for?

This Canesten Combi is a comprehensive and proven remedy for treating vulvovaginal candidiasis (thrush) in females. It contains two components so it will treat both thrush inside the vagina and thrush on the skin of the external genitalia. 

How does the Canesten Combi work?

Canesten Combi is used to treat both the cause and symptoms of vaginal thrush. It contains two components – either a pessary or cream which is inserted inside the vagina using the included applicator; and soothing cream to relieve the uncomfortable external symptoms such as itching, burning, redness, and swelling. 

The pessary option contains 500mg of clotrimazole which acts to attack the cell membrane of the yeast and prevent growth and reproduction. The internal cream option contains 5g of 10% clotrimazole cream. 

The 2% clotrimazole cream acts to remove excess yeast cells residing on the skin of the genitalia. Together these two components eradicate your symptoms quickly and effectively.

How long does the Canesten Combi take to work?

The amount of time it takes for Canesten to take effect varies in each individual. The medication can begin to work in as little as a few hours of its first use, but typically, the external symptoms would start to improve within 3 days. It can take up to a week for the internal infection to clear away completely. It is important that the treatment is used continually until the symptoms of the infection have fully disappeared.

Where can I buy the Canesten Combi?

Dr Felix is able to offer Canesten on prescription. Through the online consultation service, our doctors will assess your symptoms and subsequently advise you on the most suitable treatment and dosage for you.

Ingredients

Active ingredients

The active ingredient in the Canesten pessary is 500mg of clotrimazole.
The active ingredient in the Canesten intravaginal cream is 5g of 10% clotrimazole.
The active ingredient in the Canesten cream is 2% clotrimazole.

Inactive ingredients

The inactive ingredients in the Canesten pessary are lactose monohydrate, cellulose, microcrystalline, lactic acid, maize starch, crospovidone, calcium lactate pentahydrate, magnesium stearate, silica, colloidal anhydrous and hypromellose

The inactive ingredients in the Canesten internal cream are sorbitan stearate, polysorbate 60, cetyl palmitate, cetostearyl alcohol, isopropyl myristate, benzyl alcohol and purified water.

The inactive ingredients in the Canesten external cream are sorbitan stearate, polysorbate 60, cetyl palmitate, cetostearyl alcohol, octyldodecanol, benzyl alcohol, and purified water.

Which ingredients can cause an allergic reaction?

If you are allergic to any of the active or inactive ingredients in this medication, you should avoid taking this medication and let your prescribing doctor know. A severe allergic reaction will present as hives, difficulty breathing, facial swelling, severe dizziness, and chest tightness. Get medical help right away if you experience any of these symptoms shortly after using the cream.  The cream might cause some local irritation to the applied areas as it does contain cetostearyl alcohol and benzyl alcohol.

Dosage

How to use the Canesten pessary?

Each Canesten pessary comes in a foil package with an applicator to help insert it into the vagina. The pessary is not for oral use, and you must ensure that the packaging is not damaged or broken before use. It’s best to insert this at night, and it’s important to insert it as high up into the vagina as comfortably possible. You should wash your hands before insertion. 

The following steps demonstrate how to correctly insert the pessary:

  • Remove the application from its packaging and pull out the plunger until you feel it stop.
  • Remove the pessary from its foil blister pack and place it into the applicator, as shown in the leaflet diagram.
  • Fix the pessary into the designated holding part of the applicator, by using a gentle twisting motion. 
  • Find a comfortable position, this might be lying on your back with your knees bent, or standing with one fit propped up
  • Carefully insert the applicator as deep as is comfortable into the vagina
  • Holding the applicator in place, slowly press the plunger until it stops so that the pessary is deposited into the vagina.
  • Remove the applicator and dispose of it safely – do not flush it down the toilet.

You should avoid using tampons while the pessary is in place, and it works best if you are not on your period. 

How to use the Canesten internal cream?

The internal cream should ideally be inserted high into the vagina, preferably being going to sleep at night for the most convenient treatment.

Follow these steps after washing your hands to administer the internal cream correctly:

  • Take the applicator from the packaging and assemble the applicator by inserting the tip of plunger A into applicator B, approximately 1cm.
  • Twist and remove the cap (C) being careful not to press the plunger in any further to avoid wasting cream.
  • Insert the applicator as deep as is comfortable into the vagina (you might want to lie on your back with your knees bent, or stand up and bend your knees slightly). Holding the applicator, press the applicator plunger in until it stops. This will deposit the dose of cream into the vagina.
  • Dispose of the applicator in your waste, don’t flush it down the toilet. 
  • It’s common to notice a slight white discharge after using the cream and therefore it may be helpful to wear a panty liner.

How to use Canesten external cream?

To treat the external symptoms of vaginal thrush with Canesten cream, follow the steps below:

  • Thoroughly wash and dry your hands.
  • Apply a thin and even layer to the area around the entrance of the vagina and rub it in gently.
  • Spread the cream onto the affected area 2 to 3 times a day until the symptoms have completely disappeared.
     

How long should I use the pessary for?

This Canesten pessary is used as a one-off treatment. The pessary itself will dissolve inside your vagina and does not require removal at any time. If you feel your symptoms have not resolved after 1 week, you should see your doctor to check if a further pessary or alternative treatment is indicated.

Side Effects

What are the side-effects of Canesten Combi?

As with all medications, some users may experience side-effects from clotrimazole, although not everyone will get them. The most common side-effects from the cream include:

  • Redness
  • Swelling
  • Rash
  • Itching
  • Irritation

The most common side-effects from the pessary include:

  • Discomfort/swelling
  • Pain/burning after inserting the pessary
  • Pain in the lower stomach or pelvic area
  • Vaginal bleeding

These effects may occur as your body adjusts to the medication, but if they continue after 7 days, try using a smaller amount of the cream. If the problems persist, discontinue use and contact your doctor or pharmacist.

The above is not a comprehensive list of the side-effects. For full details, refer to the patient information leaflet inside the medication package.
 

Precautions

For those experiencing vaginal thrush for the first time, you should consult your doctor or pharmacist before treating with Canesten.
Intercourse should ideally be avoided during treatment as the infection could be transmitted to your partner, and then subsequently back to you!

If you do have sex, it is important to note that clotrimazole may damage latex condoms and diaphragms, and reduce the efficacy of spermicides, so these should not be relied upon as a method of contraception during your treatment. 

Before using the pessary, seek medical advice if any of the following are applicable:

  • You have had two or more instances of vaginal thrush in the last six months.
  • You or your partner have a history of sexually-transmitted diseases.
  • You are, or suspect that you may be pregnant.
  • You are aged under 16 or over 60 years.
  • You have any of the following symptoms
    • Abnormal vaginal bleeding
    • Ulcers, blisters, or sores on the genitals
    • Lower abdominal pain
    • Pain or difficulty passing urine
    • Fever
    • Feeling generally unwell
    • Nausea, vomiting or diarrhoea
    • Foul-smelling or discoloured vaginal discharge. 

If you experience abdominal pain, fever, and foul-smelling vaginal discharge, or if your condition does not improve after treatment, then your symptoms may be due to a health issue other than a yeast infection. If so, you should seek medical advice.

Contraindications

Do not use Canesten Combi if you are allergic to clotrimazole, other antifungal agents, or any of the inactive ingredients in the products.

The pessary is not recommended for those under the age of 16 without medical supervision.

Drug interactions

Clotrimazole is not known to have any adverse interactions with other medications. However, before using Canesten Combi, you must inform your doctor of any medications or vitamin or herbal supplements you may be taking, specifically:

  • Amphotericin, or any other antifungal medication.
  • Tacrolimus or sirolimus, given to transplant patients or those with psoriasis or rheumatism.

Treatment Options

There are two Canesten Combi options from Dr Felix

  • Canesten Combi Internal & External Creams
  • Canesten Combi Pessary & External Cream

Thrush can also be treated with oral fluconazole as a one-off tablet, which can be purchased alone, or in combination with an external cream that is available in a handy Canesten Duo pack. 

Canesten pessary vs. internal cream

While both pessaries and internal (intravaginal) creams have the same efficacy, some people prefer to use a cream rather than a pessary if they feel uncomfortable using a pessary. Others prefer to use a pessary as this might be less messy and easier to use. It’s up to personal preference.

Q&A

What if Canesten Combi doesn't work for me?

If your thrush does not improve within 7 days of treatment with Canesten Combi, you must talk to your doctor. You may need a longer course of treatment or stronger prescription medication to relieve the symptoms and address the root cause.

Is Canesten Combi safe for long term use?

You should not use clotrimazole or other antifungal medications for longer than 7 days at a time unless specifically instructed by your doctor; this is because the infection may eventually become resistant to the medication, making it ineffective.

If you find no improvements in your condition from using Canesten Combi for the prescribed period, then you may need to consider using an alternative treatment option – speak with your doctor, who will advise you accordingly.

What should I do if my thrush keeps coming back?

If your vaginal thrush improves within 7 days of treating with Canesten Combi but then returns after 7 days or more, you may begin treatment again with another pessary or cream.

However, if you experience frequent bouts of thrush throughout the year, speak with your doctor who may run some tests to diagnose the underlying cause of your symptoms and prescribe you an alternative, more appropriate treatment to address the problem.

Is thrush a sexually transmitted infection?

Vaginal thrush is not generally considered an STI, and you can get thrush without ever having had sex. However, if you have thrush, there is a risk of it being passed on to your partner during sexual intercourse. For this reason, it is best to avoid having sex until the infection has completely cleared.

Will Canesten Combi affect my fertility?

There is currently no clinical evidence to suggest that clotrimazole will affect fertility in men or women.

Can you use Canesten Combi when pregnant?

You should speak to your doctor prior to using Canesten Combi if you are pregnant, planning pregnancy, or breastfeeding. 

Are there any lifestyle changes to avoid thrush?

Once you have effectively treated vulvovaginal thrush with Canesten Combi, there are several lifestyle habits you can adopt to reduce the risk of the infection returning:

  • Wash and thoroughly dry the affected area on a daily basis using clean water
  • Avoid douching, using perfumed soaps, or deodorants
  • Avoid hot baths or perfumed oil baths
  • Wear breathable, loose-fitting cotton underwear
     

Can Canesten Combi be used by men?

Canesten Combi is only suitable for women, as it contains an intravaginal component. Options available to treat thrush in men include oral fluconazole or clotrimazole cream.

How do I know if the Canesten pessary is working?

Your symptoms should be starting to resolve within 3 days of using Canesten Combi. If your symptoms have not improved within a week, it’s time to speak to your doctor.

How long does it take for the Canesten pessary to dissolve?

Canesten pessaries dissolve within a matter of hours, however, this will depend a little on the moisture content of your vagina. It’s recommended to insert a pessary at night before you go to bed so that it will be dissolved by morning.

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