The use of oral antifungal agents to treat onychomycosis.
Onychomycosis has been treated for years with oral antifungal agents, and more recently in the United States with a topical nail lacquer. Griseofulvin was the first significant oral agent available to manage onychomycosis. The introduction of the azoles (ketoconazole, itraconazole, and fluconazole) and the allylamine, terbinafine, led to improved cure rates and a broad spectrum of activity. Pharmacokinetic studies have shown that the newer oral agents penetrate the nail within approximately one to two weeks after the start of therapy and remain for several months after the end of treatment. This article reviews the oral antifungal agents used to treat onychomycosis.
Gupta
Aditya K
AK
Division of Dermatology, Department of Medicine, Sunnybrook and Women's College Health Science Center (Sunnybrook Site), University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada. agupta@execulink.com
Ryder
Jennifer E
JE
D000284:Administration, Oral; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004347:Drug Interactions; D015725:Fluconazole / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006118:Griseofulvin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007654:Ketoconazole / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D009281:Naphthalenes / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D014009:Onychomycosis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D000077291:Terbinafine
D000935:Antifungal Agents; D009281:Naphthalenes; D017964:Itraconazole; D006118:Griseofulvin; D015725:Fluconazole; D000077291:Terbinafine; D007654:Ketoconazole