Common Side Effects of Griseofulvin
The most common side effects of griseofulvin include gastrointestinal disturbances and skin rashes, occurring in approximately 8-15% of patients. 1, 2
Primary Side Effect Profile
Gastrointestinal Effects
- Nausea
- Vomiting
- Epigastric distress
- Diarrhea
- Oral thrush
Dermatological Effects
- Skin rashes
- Urticaria (hives)
- Rarely, more severe reactions such as:
- Angioneurotic edema
- Erythema multiforme
- Stevens-Johnson syndrome
- Toxic epidermal necrolysis 1
Neurological Effects
- Headache
- Fatigue
- Dizziness
- Insomnia
- Mental confusion
- Impairment of routine activities
- Peripheral neuropathy and paresthesias (particularly with treatment duration exceeding 6 months) 1
Less Common but Serious Side Effects
Hepatic Effects
- Hepatitis
- Elevated liver enzymes
- Hyperbilirubinemia
- Jaundice 1
Hematological Effects
- Leukopenia
- Coagulopathy 1
Renal Effects
- Proteinuria
- Nephrosis (sometimes associated with existing systemic lupus erythematosus) 1
Monitoring and Management
When to Discontinue Therapy
- If granulocytopenia occurs
- If severe skin reactions develop
- If signs of hepatotoxicity appear 1
Drug Interactions
- Plasma concentration decreased by rifampicin
- Plasma concentration increased by cimetidine
- May reduce effectiveness of oral contraceptives 2
- Interactions with anticoagulants 3
Special Considerations
Contraindications
- Lupus erythematosus
- Porphyria
- Severe liver disease 2
Pregnancy Concerns
- Contraindicated in pregnancy
- Manufacturers caution against men fathering a child for 6 months after therapy 2
Clinical Context
While griseofulvin has been used for over 50 years and remains the only licensed product for tinea capitis in children in some countries, newer antifungal agents like terbinafine are now preferred for many fungal infections due to griseofulvin's side effect profile, long treatment duration, and lower efficacy rates 2.
For proper management, patients should be informed about potential side effects before starting treatment, and appropriate monitoring should be implemented, especially for those on long-term therapy or with pre-existing conditions that might increase risk of adverse effects.