From the Guidelines
Fingernail fungus can be effectively treated with oral terbinafine, which is considered the first-line treatment for this condition. The typical regimen is terbinafine 250 mg taken once daily for 6 weeks for fingernail infections, as recommended by the British Association of Dermatologists' guidelines for the management of onychomycosis 2014 1. This medication has been shown to be more effective than alternatives like itraconazole, with higher efficacy rates and better tolerability, making it the optimum choice of treatment unless there are contraindications 1.
Some key points to consider when treating fingernail fungus with oral terbinafine include:
- The importance of confirming the diagnosis with a nail sample to ensure the infection is fungal
- The need for patients to be aware that complete nail clearing takes time, as the healthy nail needs to grow out, which can take several months even after completing the medication course
- Potential side effects, such as headache, gastrointestinal upset, and rarely liver problems, which may require liver function tests before and during treatment
- The possibility of drug interactions in patients with liver disease or those taking certain medications, which may necessitate alternative treatments
According to the guidelines, terbinafine has been shown to have higher efficacy rates compared to itraconazole, with complete cure rates of 55% compared to 26% for pulsed itraconazole at follow-up at 72 weeks 1. Additionally, long-term effectiveness studies have demonstrated that mycological cure without a second therapeutic intervention was found in 46% of terbinafine-treated patients, compared to 13% of itraconazole-treated patients 1. Overall, oral terbinafine is a highly effective treatment for fingernail fungus, with a favorable safety profile and high cure rates, making it the recommended first-line treatment for this condition.
From the FDA Drug Label
Patients taking terbinafine tablets should receive the following information and instructions: Patients should take one 250 mg tablet once daily for 6 weeks for treatment of fingernail onychomycosis or once daily for 12 weeks for treatment of toenail onychomycosis Terbinafine is a prescription antifungal medicine used to treat fungal infections of the fingernails and toenails (onychomycosis).
Fingernail fungus treatment: Terbinafine can be used to treat fingernail fungus. The recommended dosage is 250 mg once daily for 6 weeks.
- Key points:
- Terbinafine is an antifungal medication
- It is used to treat fungal infections of the fingernails and toenails
- The treatment duration for fingernail fungus is 6 weeks 2
From the Research
Fingernail Fungus Treatment with Oral Terbinafine
- Oral terbinafine is an effective treatment for fingernail fungus, particularly for dermatophyte onychomycosis 3, 4, 5, 6.
- The drug works by inhibiting the biosynthesis of ergosterol, a principal sterol in fungi, resulting in a fungistatic and fungicidal effect 3.
- Studies have shown that oral terbinafine has a higher mycologic and complete cure rate compared to other antifungal agents such as itraconazole, fluconazole, and griseofulvin 3, 4, 6.
- The recommended treatment duration for oral terbinafine is typically 12 weeks, although some studies have shown that shorter treatment durations may be effective 4, 5.
- Oral terbinafine is generally well-tolerated, with common side effects including gastrointestinal disturbances and minor skin rashes 3, 5, 7.
- Regular laboratory monitoring for liver toxicity is recommended when using oral terbinafine, as it can cause elevated liver enzymes in some patients 7.
Efficacy and Safety of Oral Terbinafine
- Multiple studies have demonstrated the efficacy and safety of oral terbinafine in the treatment of onychomycosis in adults and special populations, including children, the elderly, and immunocompromised patients 3, 4, 5, 6.
- Oral terbinafine has been shown to be more cost-effective than other antifungal agents, making it a preferred treatment option for many patients 3, 6.
- The drug has a low potential for drug interactions, making it a safe choice for patients with multiple medical conditions or taking other medications 3, 6.