Canesten Combi

Canesten Combi is a combined treatment for thrush. It contains a pessary, which is a dissolvable tablet that you insert into your vagina. This should be done before bed, to make sure it does not fall out. 

Canesten Combi also contains a cream, which can be used 2 to 3 times a day, to relieve symptoms of thrush.

Back to top

Canesten Combi contains a clotrimazole, which is an antifungal medication that treats the cause of the infection. This is because thrush is a yeast infection which is a type of fungal infection.

The pessary works by killing the fungus (yeast) inside the vagina which is causing the infection. The cream works by killing the yeast on the outside of the vagina, reducing soreness and itchiness.

How long does Canesten Combi last?

How long the cream lasts will depend on how often you use it, and how much you use. ​​Canesten Combi contains one pessary. The 10g tube of cream should contain enough to relieve symptoms until you feel better.You should try to use the cream sparingly

How long does Canesten Combi take to work?

Once you have used Canesten Combi, you should start to feel better within a few days. If you still have symptoms after a week, you must speak to your doctor. 

How effective is Canesten Combi?

Canesten Combi is very effective in treating thrush in women and should start relieving your symptoms within 2-3 days. This does not mean that you will not get thrush again, as some women are more likely to get thrush again.

Back to top

Canesten Combi comes in 2 parts, which is the pessary that is inserted into your vagina, and the cream which is applied to the outside. There is only one pessary per pack, and it should be inserted at night, before bed. The cream should be used 2 to 3 times a day to soothe itching and soreness and treat external thrush.

When to use Canesten Combi

You can use Canesten Combi when you get thrush symptoms. In women, these include irritation around the vagina, thick white discharge, and soreness or stinging when you pee, or have sex. If you think you have thrush, you should go to your GP, or a sexual health clinic if you:

• are under 16 years old
• have thrush more than 4 times in a year
• have taken oral treatment and it has not worked
• have a weakened immune system, such as patients with HIV, diabetes, or cancer
• bleeding or deep pain during or after sex
• bleeding between your periods
• pelvic pain
• green or yellow discharge

You can take Canesten Combi without seeing a doctor if you think you have thrush and none of the above apply to you. If you are pregnant or breastfeeding you should speak to a doctor or your midwife before using Canesten combi. Do not use the vaginal applicator if you are pregnant.

How to apply Canesten Combi cream

Before using the cream, pierce the seal. Be sure to wash your hands before and after using the cream. To apply, use a thin and even layer of cream around the entrance of your vagina, 2 to 3 times a day. Gently smooth the cream into your vagina, so you do not cause more irritation. If you still have external symptoms after 7 days of using the cream, you must speak to your doctor. 

How to use the Canesten Combi pessary

The pessary should be inserted as high in your vagina as comfortable, unless your doctor has given you other instructions. 

Insert the pessary before bed, when you are ready to go to sleep. This is so the tablet can dissolve in your vagina overnight. To use the pessary, follow these steps.

1. Wash your hands and remove the applicator. Pull out the plunger and put the pessary into the place on the applicator. There are pictures included in the patient information leaflet to help you with this.
2. The pessary should be inserted tightly into the holder. 
3. Put the applicator as deep as you can into your vagina. Do this by lying back, with your knees bent up. 
4. When it is in place, slowly press the plunger until the pessary is inserted into your vagina.
5. Remove the applicator slowly and dispose of it. Do not flush it down the toilet. 

Some women like to wear a panty liner after using the pessary, as it can cause a chalky residue in your underwear. This is because the tablet dissolves in your vagina. This is normal and does not mean the treatment has not worked. 

If you notice large chunks of the pessary has not dissolved then speak to your doctor or pharmacist, as this may mean the treatment has not worked.

How often do I need to use Canesten Combi?

You should only need to use Canesten Combi once to treat your thrush. If you get thrush often, you can use Canesten Combi whenever you first get symptoms. If you get thrush more than 4 times in a year, speak to your doctor.

Back to top

Canesten Combi is available online, from trusted and regulated sellers like Superdrug Online Doctor. You can also get Canesten Combi over the counter, as it does not need a prescription. If you visit your GP or sexual health clinic, you may be prescribed Canesten Combi, or an unbranded alternative on the NHS though this will depend on local prescribing guidelines. 

Can I buy Canesten Combi online? 

Yes, you can get Canesten Combi online through Superdrug Online Doctor. Ordering is simple and starts with a short, medical questionnaire. One of our doctors will review the questionnaire and your symptoms, to make sure Canesten Combi is the right treatment for you.

If it is, Canesten Combi can be bought online and delivered straight to your door. You can also order it for collection at your local Superdrug store. 

Can I buy Canesten Combi over the counter?

Yes, Canesten Combi can be bought over the counter and does not need to be prescribed to you. It is still best to get advice from a doctor or pharmacist, to make sure that you have thrush. 

Can I get Canesten Combi on the NHS?

Yes, you can be prescribed Canesten Combi on the NHS, or you may be offered an unbranded alternative. In some areas your GP may ask you to buy Canesten Combi over the counter instead.

Back to top

Canesten Combi may cause some side effects but not everyone will get them. A potential serious side effect is  an allergic reaction to the pessary or cream, but this is unlikely. If you get signs of a serious allergic reaction such as difficulty breathing, facial swelling, dizziness and/ or a rash, you must call 999 or go to A&E straight away. 

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

If you get any of the above side effects of either treatment, you must speak to your doctor straight away. 

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 after stopping or finishing the treatment, speak to your doctor. 

What to do if you get Canesten Combi side effects

If you get any side effects listed above, speak to your doctor straight away. Do not use the cream if it causes severe side effects. If you get a severe allergic reaction, you must go to A&E straight away.

Back to top

Some conditions or medications can interact with Canesten Combi, which make it less effective, or potentially unsafe. You should never use Canesten Combi if you are:

• allergic to any of the ingredients in the pessary or cream
• on your period, as it may be less effective

Contraindications

As Canesten Combi is used inside and around your vagina, it can make condoms and other forms of rubber contraceptives less effective. You should use other forms of contraception during treatment and for at least 5 days after. Do not use tampons, vaginal douches, or other vaginal products whilst using this treatment.

You should also avoid having sex while you have thrush and whilst using treatment, as you could infect your sexual partner, which means you could catch thrush again. If you are pregnant or breastfeeding, speak to your doctor before use. 

Medications that interact with Canesten Combi 

There are some medications that can interact with Canesten Combi, so speak to your doctor if you take any medications, especially:

• sirolimus
• tacrolimus
• any other medication or herbal remedy that you use in or around your vagina

Back to top

There are other thrush treatments available if Canesten Combi is not suitable for you, or you do not want to use a pessary. Superdrug Online Doctor can also provide Canesten Cream on its own, or Canesten Duo, which is a similar treatment to Canesten Combi. 

Are there any alternatives to Canesten Combi? 

Yes, there are a few alternatives to Canesten Combi depending on which you prefer. 

Canesten Cream can be used on its own, to relieve the external symptoms and treat thrush. 

Canesten Duo is another combined treatment for female thrush, which contains an external cream for your vagina, and a tablet that you take by mouth. To see all the thrush treatment for women that we offer, click here. Which treatment is most suitable will depend on your medical history and whether you take any medications. 

We offer clotrimazole cream for men, if a male thinks he has thrush and needs treatment. 

How is Canesten Combi different from Canesten Duo?

Canesten Combi contains the pessary and cream, which both contain the active ingredient clotrimazole. Canesten Duo works the same but contains a cream and an oral tablet. The tablet should be taken by mouth and contains the active ingredient fluconazole, which is another antifungal medication. This may be a more suitable treatment if you cannot use the pessary or would rather take an oral tablet. The cream works the same in both treatments.

Back to top

Canesten Combi Pessary & External Cream 500mg / 2% w/w pessary & cream (2017) EMC (accessed 29 October 2021) 

Clotrimazole (2019) NHS (accessed 29 October 2021)

CLOTRIMAZOLE (2021) BNF (accessed 29 October 2021)

Fluconazole (2020) NHS (accessed 29 October 2021)

Thrush in men and women (2020) NHS (accessed 29 October 2021)

Candida: female genital CKS (accessed 29 October 2021)

British Association for Sexual Health and HIV national guideline for the management of vulvovaginal candidiasis (2019) BASHH CEG (accessed 29 October 2021)

Back to top