Antifungals

Itraconazole (Sporanox)

• Indications: onychomycosis, Tinea pedis
• Active against Dermatophytes, and Candida
• 100mg PO bid x 12 weeks for fungal toenails
  • 6 weeks therapy for fungal finger nails
  • “Pulse therapy”: 200mg PO bid for 1 week of the month x 3 months
• Do not use in pts with CHF
• Possible hepatotoxicity, get hepatic function labs pre-treatment and again at 1 month

 

Ketoconazole (Nizoral)

• Indications: dermatophytes, Candida, some G+, and has some antiviral properties
• 200-400mg PO qd
• Can cause hepatotoxicity

 

Terbinafine (Lamisil)

• Indications: Onychomycosis
• 250 mg qd x 3 months
• Pulse: 250 mg qd x 7d for 2 months
• Inhibits CYP 450 2D6

 

Fluconazole (Diflucan)

• Pulse: 300 mg/week

 

Griseofulvin (Gris-PEG)

• Write “Gris-PEG (DAW)”
• Indications: dermatophytes (Chronic Tinea pedis)
• 250 mg tid (4-8 weeks) for onychomycosis
• Drug interactions:
  • Oral contraceptives
  • Barbituates