Griseofulvin Tablet Indications
Griseofulvin is primarily indicated for the treatment of dermatophyte infections of the skin, hair, and nails that cannot be adequately treated with topical therapy. 1
Specific Indications
Griseofulvin is FDA-approved for the following dermatophyte infections:
- Tinea capitis (ringworm of the scalp)
- Tinea corporis (ringworm of the body)
- Tinea pedis (athlete's foot)
- Tinea cruris (jock itch)
- Tinea barbae (ringworm of the beard)
- Tinea unguium (onychomycosis/nail infections) 1
These infections must be caused by susceptible dermatophyte species including:
- Epidermophyton floccosum
- Microsporum species (audouinii, canis, gypseum)
- Trichophyton species (crateriform, gallinae, interdigitalis, megnini, mentagrophytes, rubrum, schoenleini, sulphureum, tonsurans, verrucosum) 1
Mechanism of Action
Griseofulvin is fungistatic and works by:
- Binding to microtubular proteins required for fungal cell mitosis
- Inhibiting nucleic acid synthesis
- Arresting cell division at metaphase
- Impairing cell wall synthesis 2, 1
Clinical Applications and Efficacy
Tinea Capitis
- Considered the treatment of choice for tinea capitis, particularly for Microsporum infections 2
- Standard treatment protocol: 20 mg/kg daily for 6-8 weeks in children weighing <50 kg 2
- Higher efficacy against Microsporum species (88.5%) compared to Trichophyton species (67.9%) 2
Onychomycosis
- While historically used for nail infections, griseofulvin has been largely superseded by newer antifungals due to:
Important Considerations
Administration
- Should be taken with fatty food to increase absorption and improve bioavailability 2, 4
- Prior to initiating treatment, appropriate laboratory testing (KOH preparation, fungal culture, or nail biopsy) should confirm the diagnosis 1
Contraindications
- Not effective for bacterial infections, candidiasis, or other fungal infections not caused by dermatophytes 1
- Contraindicated in lupus erythematosus, porphyria, and severe liver disease 5
- Contraindicated in pregnancy 5
- Men should avoid fathering a child for 6 months after therapy 5
Side Effects
- Generally well-tolerated, especially in children 4
- Common side effects (8-15% of patients) include:
Drug Interactions
- May interact with:
Current Treatment Landscape
While griseofulvin has been used for over 40 years, newer antifungal agents like terbinafine, itraconazole, and fluconazole are now often preferred for many fungal infections due to:
- Shorter treatment durations
- Better efficacy profiles, particularly for Trichophyton infections
- Lower relapse rates 2, 3
However, griseofulvin remains valuable for: