[5][1][7][6] Boric acid has shown comparable effectiveness to antifungals in the treatment of vaginal yeast infections.

[5] Side effects of vaginal boric acid may include watery discharge, burning, itching, redness, bleeding, and erosive changes.

[5] Boric acid can produce toxic effects, including death, if taken orally and/or at very high doses.

[18] Clinical studies of boric acid for treatment of vaginal infections began being published in the late 1900s and early 2000s.

[5] Despite not being a pharmaceutical drug, boric acid is widely used by women in the management of vaginal infections.

[5][20] It has been found to be similarly effective to azole antifungals like fluconazole and itraconazole in the treatment of vaginal Candida glabrata infections.

[5] The compound is one the only options available for treatment of azole-resistant vulvovaginal candidiasis and is considered a first-line therapy in this context.

[1] Boric acid is recommended at a dose of 600 mg vaginally once per day for acute or recurrent vulvovaginal candidiasis.

[5][22][10] Although it has been reported to be effective and is widely used for this purpose, clinical studies of boric acid for treatment of bacterial vaginosis are few and evidence is very limited.

[5] Based on unpublished data, boric acid by itself has been reported to be inadequate in the initial treatment of acute bacterial vaginosis[24][10] and is not recommended for this purpose.

[5] It is also suggested at a maintenance dose of 600 mg two to three times weekly for resistant or recurrent bacterial vaginosis suppression.

[5] Of six cases of boric acid monotherapy for recurrent trichomoniasis, three (50%) were cured after prolonged treatment.

[5] Vaginal boric acid may be useful in treating dysbiosis and malodorous discharge in those with neovaginas, for instance transgender women.

[29] Boric acid has been recommended for treatment of vaginal infections by multiple medical guidelines.

[5] Other side effects of vaginal boric acid have been found to include irritation, itching, redness, bleeding, and erosive changes in a small percentage of women (2.3%).

[5][1] Watery discharge appears to be a common and mild adverse effect of vaginal boric acid, but its frequency is unknown.

[1] More severe symptoms may include blue-green vomit, central nervous system depression, fever, headache, dermatitis or skin eruptions, a "boiled lobster" skin rash, reversible scalp hair loss, weakness, cyanosis, and kidney failure.

[1] Toxicity of boric acid has also been reported with large amounts applied topically to the skin.

[1][11][4] Vaginal boric acid is thought to have a low risk of interactions with systemic drugs.

[24][2][17] The compound is not an antibiotic or antifungal, and in contrast to these agents, has broad-spectrum antimicrobial activity and inhibits multiple different biological processes of microorganisms.

[1] Boric acid rapidly and completely absorbed from the gastrointestinal tract with oral administration.

[2][4] Following intravenous injection of 600 mg boric acid in healthy men, the elimination half-life was found to be 21 hours.

[2] On the basis of one woman in a study, the elimination half-life of boric acid with vaginal administration has been found to be 10.5 hours.

[13][14] The compound was first prepared, from borax, by the Dutch chemist William Homberg in 1702, and he is often incorrectly said to be the discoverer of boric acid.

[18] The compound was originally thought to be benign and non-toxic, but the toxicity of boric acid became more well-known with the publication of serious adverse effects in 1899.

[10][46] Boric acid has toxic effects in animals similarly to humans and can result in pet poisonings.