Recurrent Vaginal Yeast Infection Support
SuppositoryVaginalNon sterile Rx only

Boric Acid Vaginal Suppository

Suppository Base

A compounded boric acid vaginal suppository, prepared in Chino, CA to a prescriber's order for recurrent or azole resistant vaginal yeast infections.

Reviewed by Linda Pungpravat, Compounding Pharmacist, RPh Mixwell Compounding Pharmacy, Chino, CA

  • USP <795> compliant
  • USP <800> hazardous drug lab
  • PCCA member

Clinical Advantages

  • Custom strength available
  • Rectal or vaginal route
  • Dye free option
  • Non sterile preparation

How It Works

What is Boric Acid Vaginal Suppository?

Boric Acid Vaginal Suppository is a compounded preparation of boric acid for vaginal use, prepared by prescription for recurrent vaginal yeast infections. Guidelines name it for infections caused by Candida glabrata and other species that have not responded to azole antifungals such as fluconazole.

How it works

  1. Boric acid is an antiseptic that acts locally against yeast in the vagina.
  2. It works differently from azole antifungals, which is why guidelines turn to it when azoles have not worked [1][2].
  3. The guideline regimens place 600 mg in the vagina once daily, in a gelatin capsule [1][2].
  4. A suppository base or capsule holds the measured dose for vaginal insertion.

When prescribers choose it

  • Gynecologists managing recurrent vaginal yeast infection
  • Prescribers treating C. glabrata or other species that have not responded to azoles
  • Vulvovaginal specialty clinics following CDC or IDSA recommendations
  • Prescribers who want a dose prepared to prescription rather than a product bought over the counter

Clinical Details

What does the evidence show?
  • The CDC 2021 STI treatment guidelines recommend 600 mg of boric acid in a gelatin capsule, given vaginally once daily for 3 weeks, when non albicans yeast infection recurs, with clinical and mycologic eradication rates of about 70% [1].
  • For C. glabrata vaginitis that does not respond to oral azoles, the IDSA 2016 candidiasis guideline lists intravaginal boric acid 600 mg daily for 14 days, a strong recommendation based on low quality evidence [2].
  • A 2011 systematic review in the Journal of Women's Health identified 14 studies of vaginal boric acid, including 2 randomized trials, 9 case series, and 4 case reports. Mycologic cure rates ranged from 40% to 100%, and no study showed a significant difference in recurrence rates [3].
  • Sobel and colleagues (2003, American Journal of Obstetrics and Gynecology) reviewed 141 women with C. glabrata vaginal cultures. Boric acid 600 mg daily for 2 to 3 weeks achieved clinical and mycologic success in 64% of symptomatic women at one site and 71% at the other, with no advantage from extending therapy beyond 14 days [4].

Findings come from the cited studies and do not promise any individual outcome.

Why is it compounded, and how is it typically used?

Why it is compounded

Boric acid vaginal products are sold over the counter, and none has been approved by the FDA as a drug for yeast infection. A prescriber who wants boric acid as part of a treatment plan can order it compounded to a prescription, at the dose and in the form they specify.

Dosage forms and strengths

  • 600 mg per dose, the strength used in CDC and IDSA regimens, or another strength the prescriber sets [1][2]
  • Gelatin capsule or suppository base, as the prescriber orders
  • Dye free versions on request
  • Duration set by the prescriber, commonly 14 days to 3 weeks in guidelines [1][2]

Frequency, duration, and any maintenance plan are the prescriber's decision.

How Mixwell prepares it

Mixwell compounds these suppositories in Chino, California under USP 795 standards for non sterile preparations [6]. Our pharmacist confirms the dose and the form with the prescriber before compounding, and the label carries storage instructions and a warning that the preparation is for vaginal use only. Batch records document every preparation, and finished preparations ship across California.

Safety information

Boric acid is for vaginal use only and must never be swallowed. Store it away from children and pets. An expert consensus advises avoiding vaginal boric acid during pregnancy [5].

Side effects reported in the clinical studies were mainly local, including vaginal burning in fewer than 10% of cases, watery discharge, and redness [3]. Recurrent symptoms warrant culture to identify the yeast, since boric acid does not replace a diagnosis [1]. Patient selection, dosing, monitoring, and duration are the prescriber's responsibility.

References
  1. Centers for Disease Control and Prevention. Vulvovaginal candidiasis. Sexually transmitted infections treatment guidelines, 2021. CDC guidelines
  2. Pappas PG, Kauffman CA, Andes DR, et al. Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):e1 to e50. doi:10.1093/cid/civ933
  3. Iavazzo C, Gkegkes ID, Zarkada IM, Falagas ME. Boric acid for recurrent vulvovaginal candidiasis: the clinical evidence. J Womens Health. 2011;20(8):1245 to 1255. doi:10.1089/jwh.2010.2708
  4. Sobel JD, Chaim W, Nagappan V, Leaman D. Treatment of vaginitis caused by Candida glabrata: use of topical boric acid and flucytosine. Am J Obstet Gynecol. 2003;189(5):1297 to 1300. PubMed 14634557
  5. Phillips NA, Bachmann G, Haefner H, Martens M, Stockdale C. Topical treatment of recurrent vulvovaginal candidiasis: an expert consensus. Womens Health Rep. 2022;3(1):38 to 42. doi:10.1089/whr.2021.0065
  6. United States Pharmacopeia. General Chapter 795, Pharmaceutical Compounding: Nonsterile Preparations. USP NF. Official November 1, 2023.

What to include on the prescription

  • APIs and strengths
  • Base or vehicle
  • Quantity
  • Directions for use
  • Refills
  • Allergies or dye free needs
Call (909) 378-7301 Fax (909) 378-7071

Related Solutions

Nystatin Vaginal Cream (Ellage®)CREAM Amphotericin B Vaginal SuppositorySUPPOSITORY Progesterone Vaginal SuppositoriesCompounded vaginal suppositories — progesterone at custom... Commonly prescribed for Recurrent Vaginal Yeast Infection Support Commonly prescribed for Vaginal Dryness After Menopause (GSM) Support

Compounded in Chino, CA. Delivered across California.

  • Chino
  • Chino Hills
  • Ontario
  • Pomona
  • Diamond Bar
  • Rancho Cucamonga
  • Eastvale
Mixwell Compounding Pharmacy 13788 Roswell Ave, Ste 158, Chino, CA 91710
(909) 378-7301

Compounded medications are not reviewed or approved by the FDA. Dispensed only with a valid prescription. Mixwell is a non sterile pharmacy and does not prepare sterile products or injectables. Compounded preparations are not presented as superior to commercially available products, and nothing here promises a specific result. Mixwell does not accept insurance. Call for pricing.

Call pharmacist Send Rx

Want to learn more about Boric Acid Vaginal Suppository

Are you a healthcare provider or patient in Chino, Chino Hills, Ontario, Eastvale, Rancho Cucamonga, or Upland? Mixwell Pharmacy provides specialized pharmaceutical support throughout San Bernardino, Los Angeles, and Orange Counties. Contact our Chino laboratory to learn how we facilitate customized Boric Acid Vaginal Suppositoryfor practitioners across Southern California.

(909) 378-7301

Serving Los Angeles County, Orange County, San Bernardino County, Riverside County, Ventura County, and the Inland Empire