ONYCHOMYCOSIS


Treatment:

  • Terbinafine 250mg QD x 12-16 weeks
  • Better than griseofulvin and itraconazole in head-head trials for toenail onychomycosis (see review in J. Am. Board Fam. Pract. 13:268, 2000--AFP)
  • Has also ben used in "pulse" dosing: 500 QD x 1wk/mo x 4mos (associated with sig. lower incidence of both clinical and mycologic cure in one randomized study compared with 250mg QD x 3mos; Am. Acad. Dermatol. 53:578, 2005--JW)
  • May cause hepatotoxicity
  • Ketoconazole
  • Itraconazole 200mg QD x 12wks (has also been used in "pulse" dosing 200mg BID x 1wk/mo x 3mos)--May cause hepatotoxicity and have a negative inotropic effect
  • Fluconazole 150-300mg Qwk until infection clears (avg. 6mos)
  • Griseofulvin x 6-12mos or more
  • Topical treatments:

    See also under "Antifungals" for other info about these agents