Systemic antifungals

  • For information on oral fluconazole, itraconazole and terbinafine refer to Antifungal drugs and to guidance on the management of skin/soft tissue infections.
  • Only start systemic antifungal agents once positive cultures have been obtained. It is worthwhile advising patients that their nail will not appear normal for some months. Consider reinvestigation before a second course of treatment. Repeated sampling may be required.

AMOROLFINE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Nail lacquerOTC 5%

Dosage:

Dermatophyte infection: apply to infected nails once or twice weekly for 6 months (fingers) or 12 months (toes).

CLOTRIMAZOLE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

CreamOTC 1%

Dosage:

Apply 2 to 3 times daily, continuing for 14 days after lesions have healed.

Important: Formulation and dosage details

Formulation:

Solution 1%

Dosage:

Apply 2 to 3 times daily, continuing for 14 days after lesions have healed.

TERBINAFINE

Important: Therapy notes

  • Inappropriate oral terbinafine use is not only expensive but has a severe side-effect profile. Idiosyncratic liver reactions occur rarely with terbinfine.
  • Not recommended for children.

Important: Formulation and dosage details

Formulation:

CreamOTC 1%

Dosage:

Tinea pedis: apply thinly once or twice daily for up to 1 week.
Tinea corporis and tinea cruris: apply thinly once or twice daily for 1 to 2 weeks .
Cutaneous candidiasis and pityriasis versicolor: apply thinly once or twice daily for 2 weeks and then review.

MICONAZOLE NITRATE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Spray powder 0·16%

Dosage:

Interdigital tinea pedis: apply twice daily, continuing for 10 days after lesions have healed.

Editorial Information

Document Id: F112