Oral Medications

Medical prescription treatments for onychomycosis (any kind of nail fungus infection) are often given orally.  The decision on which form of treatment to use to battle yellow toenails and other nail fungus infections is dependent on several factors.  Sometimes, if the fungal agents are heavily entrenched or has been in place for many years, it may be that an oral medication is the only way to fully eliminate the infection.  Patient preference factors into the decision, too.  In some cases, a combination of oral and topical treatments is prescribed because this can lead to a more rapid clearance of the infection and full eradication of the onychomycosis.

[Editor’s Note] – Due to certain restrictions placed on websites such as ours, we are not permitted to reference the actual names of these medications and their active ingredient.  So we ask our readers to conduct their own research and figure out which of the specific medications we are reviewing and discussing on this page.  We have included the first letter of each of the medications in order to give you a reasonable start.

Because of the potential psychological and physical discomforts, patients must be very cautious when considering oral prescriptions as a toenail fungus treatment.  All oral antimycotic (antifungal) treatments used for onychomycosis have the potential to damage the liver.  In fact, if the patient has any history of liver disease whatsoever, oral medications for nail fungus should not be used and will not be allowed by a physician.  Even without a history of liver disease, it is usually recommended that the treating physician check liver enzymes before starting oral antifungal onychomycosis treatment.  For some treatments, liver function should be checked again after four weeks.  Also, any sign of liver disease such as jaundice (yellow skin or whites of the eyes), dark urine, pale colored stools, upper abdominal pain, fatigue or malaise should be reported to the doctor immediately.

Historically, “G” was the only oral treatment for onychomycosis.  While it worked reasonably well, it was associated with a lot of side effects especially at moderately high doses.  “G” also required long treatment courses and the nail fungal infection would often come back once the drug was stopped.  Fortunately there are newer, more effective oral antifungal onychomycosis treatments.  In fact, there are three main medications in use today and they are listed from top to bottom by popularity below:

1)  “T”

Has become the most popular of the oral treatments.  “T” is given as a 250 mg pill once a day for six weeks if treating fingernails and twelve weeks if treating toenails.  Pulse therapy has been effective in some cases.  Pulse therapy delivers a higher overall dose but is separated by times when no drug is administered. A complete blood count and liver function tests should be performed before treatment is started and after four weeks of therapy.

2)  “I”

Usually administered in pulse dosing. The most common treatment schedule is 200 mg orally, once a day for one week per month over three months.  “I” can interact with a number of other medications so you must tell your doctor about all other medications you are currently taking.  Liver function tests should be performed before treatment is started and after four weeks of therapy.

3)  “F”

Administered once per week (150 or 300 mg) until the symptoms resolve.  Treatment times may be six to nine months long before results are seen.  This antifungal may interact with several other medications and must be used judiciously.  Fortunately no blood tests are required when using “F” (though they may be performed anyway).

We found that topical toenail fungus treatments are extremely effective when application is regular and the infection is not a multiple year, severely entrenched condition.  Some of the leading treatments found on the internet proved to have high efficacy when used properly and often.