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REVIEW

Antifungal Selection for the Treatment of Onychomycosis: Patient Considerations and Outcomes

& ORCID Icon
Pages 819-843 | Received 27 Nov 2023, Accepted 24 Feb 2024, Published online: 04 Mar 2024

References

  • Veiga FF, Gadelha MC, da Silva MRT, et al. Propolis extract for onychomycosis topical treatment: from bench to clinic. Front Microbiol. 2018;9:779. doi:10.3389/fmicb.2018.00779
  • Nickles MA, Lio PA, Mervak JE. Complementary and alternative therapies for onychomycosis: a systematic review of the clinical evidence. Skin Appendage Disorders. 2022;8(4):269–279. doi:10.1159/000521703
  • Lipner S, Scher RK. Onychomycosis: current and future therapies. Cutis. 2014;93(2):60–63.
  • Lipner SR, Scher RK. Onychomycosis: treatment and prevention of recurrence. J Am Acad Dermatol. 2019;80(4):853–867. doi:10.1016/j.jaad.2018.05.1260
  • Bodman MA, Krishnamurthy K. Onychomycosis. In: StatPearls. StatPearls Publishing LLC.; 2023.
  • Elewski BE. Onychomycosis: pathogenesis, diagnosis, and management. Clin Microbiol Rev. 1998;11(3):415–429. doi:10.1128/cmr.11.3.415
  • Gupta AK, Shear NHO. Going for cure. Can Fam Physician. 1997;43:299–305.
  • Aris P, Wei Y, Mohamadzadeh M, Xia X. Griseofulvin: an Updated Overview of Old and Current Knowledge. Molecules. 2022;27(20):7034. doi:10.3390/molecules27207034
  • Baran R, Gupta AK, Piérard GE. Pharmacotherapy of onychomycosis. Expert Opin Pharmacother. 2005;6(4):609–624. doi:10.1517/14656566.6.4.609
  • Falotico JM, Lipner SR. Updated perspectives on the diagnosis and management of onychomycosis. Clin Cosmet Invest Dermatol. 2022;15:1933–1957. doi:10.2147/ccid.S362635
  • Olson JM, Troxell T. Griseofulvin. In: StatPearls. StatPearls Publishing LLC; 2023.
  • Ameen M, Lear JT, Madan V, Mohd Mustapa MF, Richardson M. British Association of Dermatologists’ guidelines for the management of onychomycosis 2014. Br J Dermatol. 2014;171(5):937–958. doi:10.1111/bjd.13358
  • Piérard GE, Arrese-Estrada J, Piérard-Franchimont C. Treatment of onychomycosis: traditional approaches. J Am Acad Dermatol. 1993;29(1):S41–5. doi:10.1016/s0190-9622(08)81836-1
  • Davies RR, Everall JD, Hamilton E. Mycological and clinical evaluation of griseofulvin for chronic onychomycosis. Br Med J. 1967;3:5563):464–8. doi:10.1136/bmj.3.5563.464
  • Griseofulvin. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. National Institute of Diabetes and Digestive and Kidney Diseases; 2012.
  • Redeker AG, Sterling RE, Bronow RS. Effect of griseofulvin in acute intermittent porphyria. JAMA. 1964;188(5):466–468. doi:10.1001/jama.1964.03060310066017
  • Watsky MS, Lynfield YL. Lupus erythematosus exacerbated by griseofulvin. Cutis. 1976;17(2):361–363.
  • Madhok R, Zoma A, Capell H. Fatal exacerbation of systemic lupus erythematosus after treatment with griseofulvin. Br Med J Clin Res Ed. 1985;291:6490):249–50. doi:10.1136/bmj.291.6490.249
  • Rosa FW, Hernandez C, Carlo WA. Griseofulvin teratology, including two thoracopagus conjoined twins. Lancet. 1987;1(8525):171. doi:10.1016/s0140-6736(87)92015-0
  • Ko EM, Lowry RB, Martin RH. Analysis of sperm karyotypes in a patient treated with griseofulvin. Arch Androl. 2007;53(3):157–160. doi:10.1080/01485010701314024
  • Gupta AK, Paquet M. Systemic antifungals to treat onychomycosis in children: a systematic review. Pediatr Dermatol. 2013;30(3):294–302. doi:10.1111/pde.12048
  • Sajeed M, Wei L, Murdan S. What can GP data tell us about the treatment of onychomycosis in the UK? Skin Health Dis. 2022;2(1):e84. doi:10.1002/ski2.84
  • Okino K, Weibert RT. Warfarin-griseofulvin interaction. Drug Intell Clin Pharm. 1986;20(4):291–293. doi:10.1177/106002808602000417
  • Katz HI. Systemic antifungal agents used to treat onychomycosis. J Am Acad Dermatol. 1998;38(5):S48–52. doi:10.1016/s0190-9622(98)70484-0
  • De Beule K, Van Gestel J. Pharmacology of itraconazole. Drugs. 2001;61:27–37. doi:10.2165/00003495-200161001-00003
  • Ricardo JW, Lipner SR. Recommendations for treatment of nail lichen planus during the COVID-19 pandemic. Dermatol Ther. 2020;33(4):e13551. doi:10.1111/dth.13551
  • Slain D, Rogers PD, Cleary JD, Chapman SW. Intravenous itraconazole. Ann Pharmacother. 2001;35(6):720–729. doi:10.1345/aph.10262
  • Rodgers P, Bassler M. Treating onychomycosis. Am Fam Physician. 2001;63(4):663–72, 677–8.
  • Sigurgeirsson B, Olafsson JH, Steinsson JB, Paul C, Billstein S, Evans EG. Long-term effectiveness of treatment with terbinafine vs itraconazole in onychomycosis: a 5-year blinded prospective follow-up study. Arch Dermatol. 2002;138(3):353–357. doi:10.1001/archderm.138.3.353
  • Sigurgeirsson B, Billstein S, Rantanen T, et al. Study: efficacy and tolerability of continuous terbinafine (Lamisil) compared to intermittent itraconazole in the treatment of toenail onychomycosis. Lamisil vs. Itraconazole in Onychomycosis. Br J Dermatol. 1999;141(56):5–14. doi:10.1046/j.1365-2133.1999.00008.x
  • Gupta AK, Konnikov N, Lynde CW. Single-blind, randomized, prospective study on terbinafine and itraconazole for treatment of dermatophyte toenail onychomycosis in the elderly. J Am Acad Dermatol. 2001;44(3):479–484. doi:10.1067/mjd.2001.110874
  • De Backer M, De Keyser P, De Vroey C, Lesaffre E. A 12-week treatment for dermatophyte toe onychomycosis: terbinafine 250 mg/day vs. itraconazole 200 mg/day--a double-blind comparative trial. Br J Dermatol. 1996;134(46):16–17. doi:10.1111/j.1365-2133.1996.tb15653.x
  • Sigurgeirsson B, Elewski BE, Rich PA, et al. Intermittent versus continuous terbinafine in the treatment of toenail onychomycosis: a randomized, double-blind comparison. J DermatolTreat. 2006;17(1):38–44. doi:10.1080/09546630500504713
  • Bräutigam M. Terbinafine versus itraconazole: a controlled clinical comparison in onychomycosis of the toenails. J Am Acad Dermatol. 1998;38(5):S53–6. doi:10.1016/s0190-9622(98)70485-2
  • Ranawaka RR, Nagahawatte A, Gunasekara TA, Weerakoon HS, de Silva SH. Randomized, double-blind, comparative study on efficacy and safety of itraconazole pulse therapy and terbinafine pulse therapy on nondermatophyte mold onychomycosis: a study with 90 patients. J DermatolTreat. 2016;27(4):364–372. doi:10.3109/09546634.2015.1119781
  • Degreef H, Del Palacio A, Mygind S, Ginter G, Pinto Soares A, Zuluaga de Cadena A. Randomized double-blind comparison of short-term itraconazole and terbinafine therapy for toenail onychomycosis. Acta Derm Venereol. 1999;79(3):221–223. doi:10.1080/000155599750011020
  • Maddin S, Quiring J, Bulger L. Randomized, placebo-controlled, Phase 3 study of itraconazole for the treatment of onychomycosis. J Drugs Dermatol. 2013;12(7):758–763.
  • Odom RB, Aly R, Scher RK, et al. A multicenter, placebo-controlled, double-blind study of intermittent therapy with itraconazole for the treatment of onychomycosis of the fingernail. J Am Acad Dermatol. 1997;36(2):231–235. doi:10.1016/s0190-9622(97)70286-x
  • Zhang L, Xu H, Shi Y, Yu J, Tao Y, Li X. An exploration of the optimum dosage and number of cycles of itraconazole pulse therapy for severe onychomycosis. Mycoses. 2018;61(10):736–742. doi:10.1111/myc.12799
  • Havu V, Brandt H, Heikkilä H, et al. A double-blind, randomized study comparing itraconazole pulse therapy with continuous dosing for the treatment of toe-nail onychomycosis. Br J Dermatol. 1997;136(2):230–234.
  • Ricardo JW, Lipner SR. Safety of current therapies for onychomycosis. Expert Opin Drug Saf. 2020;19(11):1395–1408. doi:10.1080/14740338.2020.1829592
  • Haneke E, Abeck D, Ring J. Safety and efficacy of intermittent therapy with itraconazole in finger- and toenail onychomycosis: a multicentre trial. Mycoses. 1998;41(11–12):521–527. doi:10.1111/j.1439-0507.1998.tb00716.x
  • Ramos-e-Silva M, Marques SA, Gontijo B, Zaitz C, Campbell I, Veloso ST. Efficacy and safety of itraconazole pulse therapy: Brazilian multicentric study on toenail onychomycosis caused by dermatophytes. J Eur Acad Dermatol Venereol. 1998;11(2):109–116. doi:10.1111/j.1468-3083.1998.tb00762.x
  • Gupta AK, De Doncker P, Scher RK, et al. Itraconazole for the treatment of onychomycosis. Int J Dermatol. 1998;37(4):303–308. doi:10.1046/j.1365-4362.1998.00360.x
  • Sporanox (itraconazole) capsules. PriCara; 2023. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020083s040s041s044lbl.pdf. Accessed February 26, 2024.
  • Wang DL, Wang AP, Li RY, Wang R. Therapeutic efficacy and safety of one-week intermittent therapy with itraconazole for onychomycosis in a Chinese patient population. Dermatology. 1999;199(1):47–49. doi:10.1159/000018177
  • Ahmad SR, Singer SJ, Leissa BG. Congestive heart failure associated with itraconazole. Lancet. 2001;357(9270):1766–1767. doi:10.1016/s0140-6736(00)04891-1
  • MacKenzie-Wood AR, Whitfeld MJ, Ray JE. Itraconazole and HIV protease inhibitors: an important interaction. Med J Aust. 1999;170(1):46–47. doi:10.5694/j.1326-5377.1999.tb126872.x
  • Albreski DA, Gross EG. The safety of itraconazole in the diabetic population. J Am Podiatr Med Assoc. 1999;89(7):339–345. doi:10.7547/87507315-89-7-339
  • De Santis M, Di Gianantonio E, Cesari E, Ambrosini G, Straface G, Clementi M. First-trimester itraconazole exposure and pregnancy outcome: a prospective cohort study of women contacting teratology information services in Italy. Drug Saf. 2009;32(3):239–244. doi:10.2165/00002018-200932030-00006
  • Bar-Oz B, Moretti ME, Bishai R, et al. Pregnancy outcome after in utero exposure to itraconazole: a prospective cohort study. Am J Obstet Gynecol. 2000;183(3):617–620. doi:10.1067/mob.2000.105962
  • Ginter G. Mycoses in Children, Systemic Treatment. Acta Derm Venereol. 1998;7(98):3–4.
  • Huang PH, Paller AS. Itraconazole pulse therapy for dermatophyte onychomycosis in children. Arch Pediatr Adolesc Med. 2000;154(6):614–618. doi:10.1001/archpedi.154.6.614
  • Gupta AK, Cooper EA, Ginter G. Efficacy and safety of itraconazole use in children. Dermatol Clin. 2003;21(3):521–535. doi:10.1016/s0733-8635(03)00030-5
  • Wang Y, Lipner SR. Retrospective analysis of adverse events with systemic onychomycosis medications reported to the United States food and drug administration. J DermatolTreat. 2021;32(7):783–787. doi:10.1080/09546634.2019.1708242
  • Salem M, Reichlin T, Fasel D, Leuppi-Taegtmeyer A. Torsade de pointes and systemic azole antifungal agents: analysis of global spontaneous safety reports. Glob Cardiol Sci Pract. 2017;2017(2):11. doi:10.21542/gcsp.2017.11
  • Lipner SR, Joseph WS, Vlahovic TC, et al. Therapeutic recommendations for the treatment of toenail onychomycosis in the US. J Drugs Dermatol. 2021;20(10):1076–1084. doi:10.36849/jdd.6291
  • Bhatia A, Kanish B, Badyal DK, Kate P, Choudhary S. Efficacy of oral terbinafine versus itraconazole in treatment of dermatophytic infection of skin - A prospective, randomized comparative study. Indian J Pharmacol. 2019;51(2):116–119. doi:10.4103/ijp.IJP_578_17
  • Garcia-Effron G, Gomez-Lopez A, Mellado E, Monzon A, Rodriguez-Tudela JL, Cuenca-Estrella M. In vitro activity of terbinafine against medically important non-dermatophyte species of filamentous fungi. J Antimicrob Chemother. 2004;53(6):1086–1089. doi:10.1093/jac/dkh228
  • LAMISIL (terbinafine hydrochloride) tablets. Novartis pharmaceuticals corporation; 2023.
  • Tavakkol A, Fellman S, Kianifard F. Safety and efficacy of oral terbinafine in the treatment of onychomycosis: analysis of the elderly subgroup in improving results in onychomycosis-concomitant lamisil and debridement (IRON-CLAD), an open-label, randomized trial. Am J Geriatr Pharmacother. 2006;4(1):1–13. doi:10.1016/j.amjopharm.2005.12.012
  • Evans EG, Sigurgeirsson B. Double blind, randomised study of continuous terbinafine compared with intermittent itraconazole in treatment of toenail onychomycosis. The LION Study Group. BMJ. 1999;318(7190):1031–1035. doi:10.1136/bmj.318.7190.1031
  • Warshaw EM, Fett DD, Bloomfield HE, et al. Pulse versus continuous terbinafine for onychomycosis: a randomized, double-blind, controlled trial. J Am Acad Dermatol. 2005;53(4):578–584. doi:10.1016/j.jaad.2005.04.055
  • Billstein S, Kianifard F, Justice A. Terbinafine vs. placebo for onychomycosis in black patients. Int J Dermatol. 1999;38(5):377–379. doi:10.1046/j.1365-4362.1999.00713.x
  • Svejgaard EL, Brandrup F, Kragballe K, et al. Oral terbinafine in toenail dermatophytosis. A double-blind, placebo-controlled multicenter study with 12 months’ follow-up. Acta Derm Venereol. 1997;77(1):66–69. doi:10.2340/0001555555776669
  • Bräutigam M, Nolting S, Schopf RE, Weidinger G. German randomized double-blind multicentre comparison of terbinafine and itraconazole for the treatment of toenail tinea infection. Br J Dermatol. 1996;134(46):18–21. doi:10.1111/j.1365-2133.1996.tb15654.x
  • Gupta AK, Stec N, Summerbell RC, et al. Onychomycosis: a review. J Eur Acad Dermatol Venereol. 2020;34(9):1972–1990. doi:10.1111/jdv.16394
  • Jennings MB, Pollak R, Harkless LB, Kianifard F, Tavakkol A. Treatment of toenail onychomycosis with oral terbinafine plus aggressive debridement: IRON-CLAD, a large, randomized, open-label, multicenter trial. J Am Podiatr Med Assoc. 2006;96(6):465–473. doi:10.7547/0960465
  • Kreijkamp-Kaspers S, Hawke K, Guo L, et al. Oral antifungal medication for toenail onychomycosis. Cochrane Database Syst Rev. 2017;7(7):Cd010031. doi:10.1002/14651858.CD010031.pub2
  • Gupta AK, Ryder JE, Johnson AM. Cumulative meta-analysis of systemic antifungal agents for the treatment of onychomycosis. Br J Dermatol. 2004;150(3):537–544. doi:10.1046/j.1365-2133.2003.05728.x
  • Trivedi NA, Shah PC. A meta-analysis comparing efficacy of continuous terbinafine with intermittent itraconazole for toenail onychomycosis. Indian J Dermatol. 2010;55(2):198–199. doi:10.4103/0019-5154.62746
  • Doty RL, Haxel BR. Objective assessment of terbinafine-induced taste loss. Laryngoscope. 2005;115(11):2035–2037. doi:10.1097/01.Mlg.0000181462.08683.0c
  • Doty RL, Bromley SM. Effects of drugs on olfaction and taste. Otolaryngol Clin North Am. 2004;37(6):1229–1254. doi:10.1016/j.otc.2004.05.002
  • Duxbury AJ, Oliver RJ, Pemberton MN. Persistent impairment of taste associated with terbinafine. Br Dent J. 2000;188(6):295–296. doi:10.1038/sj.bdj.4800461
  • O’Sullivan DP, Needham CA, Bangs A, Atkin K, Kendall FD. Postmarketing surveillance of oral terbinafine in the UK: report of a large cohort study. Br J Clin Pharmacol. 1996;42(5):559–565. doi:10.1111/j.1365-2125.1996.tb00110.x
  • Stricker BH, Van Riemsdijk MM, Sturkenboom MC, Ottervanger JP. Taste loss to terbinafine: a case-control study of potential risk factors. Br J Clin Pharmacol. 1996;42(3):313–318. doi:10.1046/j.1365-2125.1996.04105.x
  • Kyriakidis I, Tragiannidis A, Munchen S, Groll AH. Clinical hepatotoxicity associated with antifungal agents. Expert Opin Drug Saf. 2017;16(2):149–165. doi:10.1080/14740338.2017.1270264
  • Reuben A, Koch DG, Lee WM. Drug-induced acute liver failure: results of a U.S. multicenter, prospective study. Hepatology. 2010;52(6):2065–2076. doi:10.1002/hep.23937
  • Stolmeier DA, Stratman HB, McIntee TJ, Stratman EJ. Utility of laboratory test result monitoring in patients taking oral terbinafine or griseofulvin for dermatophyte infections. JAMA Dermatol. 2018;154(12):1409–1416. doi:10.1001/jamadermatol.2018.3578
  • National Institute of Diabetes and Digestive and Kidney Diseases. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. National Institute of Diabetes and Digestive and Kidney Diseases; 2012.
  • Vanderweil SG, Yang C, Pagani K, Chuprin J, Bernhard J, Harris JE. Assessing risk amid uncertainty inside and outside the dermatology clinic. J Am Acad Dermatol. 2023;89:864–866. doi:10.1016/j.jaad.2023.06.038
  • Ishack S, Miller RC, Lipner SR. Insights into the ”fear factor” regarding terbinafine-associated hepatoxicity in an assessment of online information. J Am Acad Dermatol. 2022;86(6):e269–e271. doi:10.1016/j.jaad.2022.02.006
  • Kang R, Lipner S. Evaluation of onychomycosis information on the internet. J Drugs Dermatol. 2019;18(5):484–487.
  • Gupta AK, Konnikov N, MacDonald P, et al. Prevalence and epidemiology of toenail onychomycosis in diabetic subjects: a multicentre survey. Br J Dermatol. 1998;139(4):665–671. doi:10.1046/j.1365-2133.1998.02464.x
  • Gupta AK, Gover MD, Lynde CW. Pulse itraconazole vs. continuous terbinafine for the treatment of dermatophyte toenail onychomycosis in patients with diabetes mellitus. J Eur Acad Dermatol Venereol. 2006;20(10):1188–1193. doi:10.1111/j.1468-3083.2006.01698.x
  • Cribier BJ, Bakshi R. Terbinafine in the treatment of onychomycosis: a review of its efficacy in high-risk populations and in patients with nondermatophyte infections. Br J Dermatol. 2004;150(3):414–420. doi:10.1046/j.1365-2133.2003.05726.x
  • Gupta AK, Ryder JE, Lynch LE, Tavakkol A. The use of terbinafine in the treatment of onychomycosis in adults and special populations: a review of the evidence. J Drugs Dermatol. 2005;4(3):302–308.
  • Nandwani R, Parnell A, Youle M, et al. Use of terbinafine in HIV-positive subjects: pilot studies in onychomycosis and oral candidiasis. Br J Dermatol. 1996;134(46):22–24. doi:10.1111/j.1365-2133.1996.tb15655.x
  • Herranz P, García J, De Lucas R, et al. Toenail onychomycosis in patients with acquired immune deficiency syndrome: treatment with terbinafine. Br J Dermatol. 1997;137(4):577–580. doi:10.1111/j.1365-2133.1997.tb03789.x
  • Andersson NW, Thomsen SF, Andersen JT. Exposure to terbinafine in pregnancy and risk of preterm birth, small for gestational age, low birth weight, and stillbirth: a nationwide cohort study. J Am Acad Dermatol. 2021;84(3):763–767. doi:10.1016/j.jaad.2020.10.034
  • Patel VM, Schwartz RA, Lambert WC. Topical antiviral and antifungal medications in pregnancy: a review of safety profiles. J Eur Acad Dermatol Venereol. 2017;31(9):1440–1446. doi:10.1111/jdv.14297
  • Gupta AK, Chang P, Del Rosso JQ, Adam P, Hofstader SL. Onychomycosis in children: prevalence and management. Pediatr Dermatol. 1998;15(6):464–471. doi:10.1046/j.1525-1470.1998.1998015464.x
  • Tosti A, Piraccini BM, Iorizzo M. Management of onychomycosis in children. Dermatol Clin. 2003;21(3):507–509. doi:10.1016/s0733-8635(03)00034-2
  • Feldstein S, Totri C, Friedlander SF. Antifungal therapy for onychomycosis in children. Clin Dermatol. 2015;33(3):333–339. doi:10.1016/j.clindermatol.2014.12.010
  • Wang Y, Lipner SR. Retrospective analysis of abnormal laboratory test results in pediatric patients prescribed terbinafine for superficial fungal infections. J Am Acad Dermatol. 2021;85(4):1042–1044. doi:10.1016/j.jaad.2021.01.073
  • Jensen P, Lehne G, Fauchald P, Simonsen S. Effect of oral terbinafine treatment on cyclosporin pharmacokinetics in organ transplant recipients with dermatophyte nail infection. Acta Derm Venereol. 1996;76(4):280–281. doi:10.2340/0001555576280281
  • Lee KH, Kim YS, Kim MS, Chung HS, Park K. Study of the efficacy and tolerability of oral terbinafine in the treatment of onychomycosis in renal transplant patients. Transplant Proc. 1996;28(3):1488–1489.
  • Moreno-Sabater A, Ouali N, Chasset F, et al. Severe onychomycosis management with oral terbinafine in a kidney transplantation setting: clinical follow-up by image analysis. Mycoses. 2021;64(3):309–315. doi:10.1111/myc.13220
  • Saarikoski T, Saari TI, Hagelberg NM, et al. Effects of terbinafine and itraconazole on the pharmacokinetics of orally administered tramadol. Eur J Clin Pharmacol. 2015;71(3):321–327. doi:10.1007/s00228-014-1799-2
  • Mikami A, Hori S, Ohtani H, Sawada Y. Analysis of the mechanism of prolonged persistence of drug interaction between terbinafine and amitriptyline or nortriptyline. Biol Pharm Bull. 2017;40(7):1010–1020. doi:10.1248/bpb.b16-01004
  • Park YM. Prolonged Drug-Drug Interaction between Terbinafine and Perphenazine. Psychiatry Invest. 2012;9(4):422–424. doi:10.4306/pi.2012.9.4.422
  • Bebawi E, Jouni SS, Tessier AA, Frenette AJ, Brindamour D, Doré M. A metoprolol-terbinafine combination induced bradycardia. Eur J Drug Metab Pharmacokinet. 2015;40(3):295–299. doi:10.1007/s13318-014-0205-x
  • Brown SJ. Efficacy of fluconazole for the treatment of onychomycosis. Ann Pharmacother. 2009;43(10):1684–1691. doi:10.1345/aph.1M165
  • Leung AKC, Lam JM, Leong KF, et al. Onychomycosis: an Updated Review. Recent Pat Inflamm Allergy Drug Discov. 2020;14(1):32–45. doi:10.2174/1872213x13666191026090713
  • Pakshir K, Kamali M, Nouraei H, Zomorodian K, Motamedi M, Mahmoodi M. Molecular characterization and antifungal activity against non-dermatophyte molds causing onychomycosis. Sci Rep. 2021;11(1):20736. doi:10.1038/s41598-021-00104-0
  • Gupta AK, Scher RK, Rich P. Fluconazole for the treatment of onychomycosis: an update. Int J Dermatol. 1998;37(11):815–820. doi:10.1046/j.1365-4632.1998.00564.x
  • Gupta AK, Drummond-Main C, Paquet M. Evidence-based optimal fluconazole dosing regimen for onychomycosis treatment. J DermatolTreat. 2013;24(1):75–80. doi:10.3109/09546634.2012.703308
  • Montero-Gei F, Robles-Soto ME, Schlager H. Fluconazole in the treatment of severe onychomycosis. Int J Dermatol. 1996;35(8):587–588. doi:10.1111/j.1365-4362.1996.tb03666.x
  • Smith SW, Sealy DP, Schneider E, Lackland D. An evaluation of the safety and efficacy of fluconazole in the treatment of onychomycosis. South Med J. 1995;88(12):1217–1220. doi:10.1097/00007611-199512000-00006
  • Assaf RR, Elewski BE. Intermittent fluconazole dosing in patients with onychomycosis: results of a pilot study. J Am Acad Dermatol. 1996;35(2):216–219. doi:10.1016/s0190-9622(96)90327-8
  • Diflucan (fluconazole) tablets. Pfizer Inc; 2023. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/020083s062lbl.pdf. Accessed February 26, 2024.
  • Zhang Z, Zhang X, Zhou YY, Jiang CM, Jiang HY. The safety of oral fluconazole during the first trimester of pregnancy: a systematic review and meta-analysis. Bjog. 2019;126(13):1546–1552. doi:10.1111/1471-0528.15913
  • Kaplan YC, Koren G, Bozzo P. Fluconazole exposure during pregnancy. Can Fam Physician. 2015;61(8):685–686.
  • Mølgaard-Nielsen D, Svanström H, Melbye M, Hviid A, Pasternak B. Association between use of oral fluconazole during pregnancy and risk of spontaneous abortion and stillbirth. JAMA. 2016;315(1):58–67. doi:10.1001/jama.2015.17844
  • Paquette VC, Elwood C. The safety of oral fluconazole therapy in pregnancy. Cmaj. 2019;191(7):E177–e178. doi:10.1503/cmaj.190079
  • Seaton TL, Celum CL, Black DJ. Possible potentiation of warfarin by fluconazole. Dicp. 1990;24(12):1177–1178. doi:10.1177/106002809002401207
  • Nofal A, Fawzy MM, El-Hawary EE. Successful treatment of resistant onychomycosis with voriconazole in a liver transplant patient. Dermatol Ther. 2020;33(6):e14014. doi:10.1111/dth.14014
  • Gupta AK, Talukder M, Venkataraman M. Review of the alternative therapies for onychomycosis and superficial fungal infections: posaconazole, fosravuconazole, voriconazole, oteseconazole. Int J Dermatol. 2022;61(12):1431–1441. doi:10.1111/ijd.15999
  • Scott LJ, Simpson D. Voriconazole: a review of its use in the management of invasive fungal infections. Drugs. 2007;67(2):269–298. doi:10.2165/00003495-200767020-00009
  • Perea S, Fothergill AW, Sutton DA, Rinaldi MG. Comparison of in vitro activities of voriconazole and five established antifungal agents against different species of dermatophytes using a broth macrodilution method. J Clin Microbiol. 2001;39(1):385–388. doi:10.1128/jcm.39.1.385-388.2001
  • Spriet I, Lambrecht C, Lagrou K, Verhamme B. Successful eradication of Scytalidium dimidiatum-induced ungual and cutaneous infection with voriconazole. Eur J Dermatol. 2012;22(2):197–199. doi:10.1684/ejd.2011.1616
  • Levine MT, Chandrasekar PH. Adverse effects of voriconazole: over a decade of use. Clin Transplant. 2016;30(11):1377–1386. doi:10.1111/ctr.12834
  • Wang JL, Chang CH, Young-Xu Y, Chan KA. Systematic review and meta-analysis of the tolerability and hepatotoxicity of antifungals in empirical and definitive therapy for invasive fungal infection. Antimicrob Agents Chemother. 2010;54(6):2409–2419. doi:10.1128/aac.01657-09
  • Johnson LB, Kauffman CA. Voriconazole: a new triazole antifungal agent. Clin Infect Dis. 2003;36(5):630–637. doi:10.1086/367933
  • Shoai Tehrani M, de Fontbrune F S, Roth P, et al. Case report of exposure to voriconazole in the second and third trimesters of pregnancy. Antimicrob Agents Chemother. 2013;57(2):1094–1095. doi:10.1128/aac.00899-12
  • VFEND (voriconazole) oral suspension. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021266s032lbl.pdf. Accessed 28 February 2024.
  • Gupta AK, Tomas E. New antifungal agents. Dermatol Clin. 2003;21(3):565–576. doi:10.1016/s0733-8635(03)00024-x
  • Elewski B, Pollak R, Ashton S, Rich P, Schlessinger J, Tavakkol A. A randomized, placebo- and active-controlled, parallel-group, multicentre, investigator-blinded study of four treatment regimens of posaconazole in adults with toenail onychomycosis. Br J Dermatol. 2012;166(2):389–398. doi:10.1111/j.1365-2133.2011.10660.x
  • Jachiet M, Lanternier F, Rybojad M, et al. Posaconazole treatment of extensive skin and nail dermatophytosis due to autosomal recessive deficiency of CARD9. JAMA Dermatol. 2015;151(2):192–194. doi:10.1001/jamadermatol.2014.2154
  • Noxafil (posaconazole) Label. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/022003s018s020,0205053s002s004,0205596s001s003lbl.pdfAccessed February 26, 2024.
  • Gupta AK, Venkataraman M, Bamimore MA. Relative impact of traditional vs. newer oral antifungals for dermatophyte toenail onychomycosis: a network meta-analysis study. Br J Dermatol. 2023;189(1):12–22. doi:10.1093/bjd/ljad070
  • Lavigne S, Fisher BT, Ellis D, Zaoutis TE, Downes KJ. Posaconazole Administration in Hospitalized Children in the United States. J Pediatric Infect Dis Soc. 2019;8(5):481–484. doi:10.1093/jpids/piy119
  • Al-Hatmi AM, Bonifaz A, Calderón L, et al. Proximal subungual onychomycosis caused by Fusarium falciforme successfully cured with posaconazole. Br J Dermatol. 2015;173(1):253–255. doi:10.1111/bjd.13589
  • Noguchi H, Matsumoto T, Kimura U, et al. Fosravuconazole to treat severe onychomycosis in the elderly. J Dermatol. 2021;48(2):228–231. doi:10.1111/1346-8138.15651
  • Shimoyama H, Yo A, Sei Y, Kuwano Y. Treatment Outcome with Fosravuconazole for Onychomycosis. Mycopathologia. 2021;186(2):259–267. doi:10.1007/s11046-021-00540-6
  • Watanabe S, Tsubouchi I, Okubo A. Efficacy and safety of fosravuconazole L-lysine ethanolate, a novel oral triazole antifungal agent, for the treatment of onychomycosis: a multicenter, double-blind, randomized phase III study. J Dermatol. 2018;45(10):1151–1159. doi:10.1111/1346-8138.14607
  • Nakano M, Aoki Y, Yamaguchi H. Drug properties of fosravuconazole L-lysine ethanolate (NAILIN(®) Capsules 100 mg), a new oral azole therapeutic for onychomycosis: an analysis based on non-clinical and clinical trial data. Nihon Yakurigaku Zasshi. 2019;153(2):79–87. doi:10.1254/fpj.153.79
  • Inoue T, Watabe D, Tsunemi Y, Amano H. Outcome of fosravuconazole treatment for onychomycosis refractory to topical antifungal agents. J Dermatol. 2023;50(8):1014–1019. doi:10.1111/1346-8138.16824
  • Gupta AK, Ryder JE, Baran R. The use of topical therapies to treat onychomycosis. Dermatol Clin. 2003;21(3):481–489. doi:10.1016/s0733-8635(03)00025-1
  • Tabara K, Szewczyk AE, Bienias W, et al. Amorolfine vs. ciclopirox - lacquers for the treatment of onychomycosis. Postepy Dermatol Alergol. 2015;32(1):40–45. doi:10.5114/pdia.2014.40968
  • Bunyaratavej S, Leeyaphan C, Rujitharanawong C, Surawan TM, Muanprasat C, Matthapan L. Efficacy of 5% amorolfine nail lacquer in Neoscytalidium dimidiatum onychomycosis. J DermatolTreat. 2016;27(4):359–363. doi:10.3109/09546634.2015.1109029
  • Reinel D. Topical treatment of onychomycosis with amorolfine 5% nail lacquer: comparative efficacy and tolerability of once and twice weekly use. Dermatology. 2009;184(Suppl. 1):21–24. doi:10.1159/000247612
  • Reinel D, Clarke C. Comparative efficacy and safety of amorolfine nail lacquer 5% in onychomycosis, once-weekly versus twice-weekly. Clin Exp Dermatol. 1992;17 Suppl 1:44–49. doi:10.1111/j.1365-2230.1992.tb00278.x
  • Amorolfine 5% Medicated nail lacquer, package leaflet: information for the user. Available from: https://www.medicines.org.uk/emc/files/pil.7414.pdf. Accessed February 26, 2024.
  • Chen S, Ran Y-P, Dai Y-L, Lama J, Hu W-Y. Case of infantile onychomycosis successfully cured by 5% amorolfine nail lacquer. J Paediatr Child Health. 2014;50(11):933–934. doi:10.1111/jpc.12740
  • Bohn M, Kraemer KT. Dermatopharmacology of ciclopirox nail lacquer topical solution 8% in the treatment of onychomycosis. J Am Acad Dermatol. 2000;43(4 Suppl):S57–69. doi:10.1067/mjd.2000.109072
  • Geizhals S, Lipner SR. A timeline of onychomycosis therapy and future directions. Skinmed. 2020;18(6):367–371.
  • Bohn M, Kraemer K. The dermatopharmacologic profile of ciclopirox 8% nail lacquer. J Am Podiatr Med Assoc. 2000;90(10):491–494. doi:10.7547/87507315-90-10-491
  • Gupta AK, Baran R. Ciclopirox nail lacquer solution 8% in the 21st century. J Am Acad Dermatol. 2000;43(4 Suppl):S96–102. doi:10.1067/mjd.2000.109068
  • Gupta AK, Fleckman P, Baran R. Ciclopirox nail lacquer topical solution 8% in the treatment of toenail onychomycosis. J Am Acad Dermatol. 2000;43(4 Suppl):S70–80. doi:10.1067/mjd.2000.109071
  • Shemer A, Nathansohn N, Trau H, Amichai B, Grunwald MH. Ciclopirox nail lacquer for the treatment of onychomycosis: an open non-comparative study. J Dermatol. 2010;37(2):137–139. doi:10.1111/j.1346-8138.2009.00773.x
  • Avner S, Nir N, Henri T. Combination of oral terbinafine and topical ciclopirox compared to oral terbinafine for the treatment of onychomycosis. J DermatolTreat. 2005;16(5–6):327–330. doi:10.1080/09546630500420183
  • Wang Y, Lipner SR. Retrospective analysis of adverse events with topical onychomycosis medications reported to the United States food and drug administration. Arch Dermatol Res. 2020;312(8):581–586. doi:10.1007/s00403-020-02044-7
  • Seebacher C, Nietsch KH, Ulbricht HM. A multicenter, open-label study of the efficacy and safety of ciclopirox nail lacquer solution 8% for the treatment of onychomycosis in patients with diabetes. Cutis. 2001;68(2 Suppl):1.
  • Brenner MA, Harkless LB, Mendicino RW, Page JC. Ciclopirox 8% nail lacquer topical solution for the treatment of onychomycosis in patients with diabetes: a multicenter, open-label study. J Am Podiatr Med Assoc. 2007;97(3):195–202. doi:10.7547/0970195
  • Friedlander SF, Chan YC, Chan YH, Eichenfield LF. Onychomycosis does not always require systemic treatment for cure: a trial using topical therapy. Pediatr Dermatol. 2013;30(3):316–322. doi:10.1111/pde.12064
  • Tatsumi Y, Nagashima M, Shibanushi T, et al. Mechanism of action of efinaconazole, a novel triazole antifungal agent. Antimicrob Agents Chemother. 2013;57(5):2405–2409. doi:10.1128/aac.02063-12
  • Sugiura K, Sugimoto N, Hosaka S, et al. The low keratin affinity of efinaconazole contributes to its nail penetration and fungicidal activity in topical onychomycosis treatment. Antimicrob Agents Chemother. 2014;58(7):3837–3842. doi:10.1128/aac.00111-14
  • Lipner SR, Scher RK. Efinaconazole in the treatment of onychomycosis. Infect Drug Resist. 2015;8:163–172. doi:10.2147/idr.S69596
  • Iozumi K, Abe M, Ito Y, et al. Efficacy of long-term treatment with efinaconazole 10% solution in patients with onychomycosis, including severe cases: a multicenter, single-arm study. J Dermatol. 2019;46(8):641–651. doi:10.1111/1346-8138.14935
  • Elewski BE, Rich P, Pollak R, et al. Efinaconazole 10% solution in the treatment of toenail onychomycosis: two phase III multicenter, randomized, double-blind studies. J Am Acad Dermatol. 2013;68(4):600–608. doi:10.1016/j.jaad.2012.10.013
  • Gupta AK, Cernea M. How effective is efinaconazole in the management of onychomycosis? Expert Opin Pharmacother. 2016;17(4):611–618. doi:10.1517/14656566.2016.1146687
  • Wang C, Cantrell W, Canavan T, Elewski B. Successful treatment of dermatophytomas in 19 patients using efinaconazole 10% solution. Skin Appendage Disord. 2019;5(5):304–308. doi:10.1159/000495042
  • Gupta AK, Venkataraman M, Shear NH, Piguet V. Labeled use of efinaconazole topical solution 10% in treating onychomycosis in children and a review of the management of pediatric onychomycosis. Dermatol Ther. 2020;33(4):e13613. doi:10.1111/dth.13613
  • Fujimoto K, Yamaguchi H, Otsuka Y, Mayumi N, Saeki H. Contact dermatitis caused by efinaconazole and luliconazole. J Nippon Med Sch. 2021;88(3):253–257. doi:10.1272/jnms.JNMS.2021_88-312
  • Hirohata A, Hanafusa T, Mabuchi-Kiyohara E, Ikegami R. Contact dermatitis caused by efinaconazole solution for treatment of onychomycosis. Contact Dermatitis. 2015;73(3):190–192. doi:10.1111/cod.12414
  • Oiso N, Tatebayashi M, Kawada A. Allergic contact dermatitis caused by efinaconazole: positive patch test reactions up to 0.1% pet. Contact Dermatitis. 2017;76(1):53–54. doi:10.1111/cod.12643
  • Jublia (efinaconazole) topical solution, 10%. Valent Pharmaceuticals; 2023. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/203567s009lbl.pdf. Accessed February 26, 2024.
  • Eichenfield LF, Elewski B, Sugarman JL, et al. Efinaconazole 10% topical solution for the treatment of onychomycosis in pediatric patients: open-label Phase 4 study. J Am Acad Dermatol. 2021;84(4):1140–1142. doi:10.1016/j.jaad.2020.06.1004
  • Shofler D, Hamedani E, Seun J, Navarrete R, Thamby R, Harkless L. Efficacy and safety of efinaconazole 10% solution in the treatment of onychomycosis in diabetic patients. Clin Podiatr Med Surg. 2020;37(2):401–407. doi:10.1016/j.cpm.2019.12.015
  • Vlahovic TC, Joseph WS. Efinaconazole topical, 10% for the treatment of toenail onychomycosis in patients with diabetes. J Drugs Dermatol. 2014;13(10):1186–1190.
  • Elewski BE, Tosti A. Tavaborole for the treatment of onychomycosis. Expert Opin Pharmacother. 2014;15(10):1439–1448. doi:10.1517/14656566.2014.921158
  • Jinna S, Finch J. Spotlight on tavaborole for the treatment of onychomycosis. Drug Des Devel Ther. 2015;9:6185–6190. doi:10.2147/dddt.S81944
  • Hui X, Baker SJ, Wester RC, et al. In Vitro penetration of a novel oxaborole antifungal (AN2690) into the human nail plate. J Pharm Sci. 2007;96(10):2622–2631. doi:10.1002/jps.20901
  • Elewski BE, Aly R, Baldwin SL, et al. Efficacy and safety of tavaborole topical solution, 5%, a novel boron-based antifungal agent, for the treatment of toenail onychomycosis: results from 2 randomized phase-III studies. J Am Acad Dermatol. 2015;73(1):62–69. doi:10.1016/j.jaad.2015.04.010
  • Aly R, Winter T, Hall S, Vlahovic T. Topical tavaborole in the treatment of onychomycosis complicated by dermatophytoma: a post-hoc assessment of phase II subjects. J Drugs Dermatol. 2018;17(3):347–354.
  • Foley K, Gupta AK, Versteeg S, Mays R, Villanueva E, John D. Topical and device-based treatments for fungal infections of the toenails. Cochrane Database Syst Rev. 2020;1(1):Cd012093. doi:10.1002/14651858.CD012093.pub2
  • Gupta AK, Foley KA, Mays RR, Shear NH, Piguet V. Monotherapy for toenail onychomycosis: a systematic review and network meta-analysis. Br J Dermatol. 2020;182(2):287–299. doi:10.1111/bjd.18155
  • Rich P, Spellman M, Purohit V, Zang C, Crook TJ. Tavaborole 5% topical solution for the treatment of toenail onychomycosis in pediatric patients: results from a phase 4 open-label study. J Drugs Dermatol. 2019;18(2):190–195.
  • Khanna D, Bharti S. Luliconazole for the treatment of fungal infections: an evidence-based review. Core Evid. 2014;9:113–124. doi:10.2147/ce.S49629
  • Gregoriou S, Kyriazopoulou M, Tsiogka A, Rigopoulos D. Novel and investigational treatments for onychomycosis. J Fungi. 2022;8:1.
  • Scher RK, Nakamura N, Tavakkol A. Luliconazole: a review of a new antifungal agent for the topical treatment of onychomycosis. Mycoses. 2014;57(7):389–393. doi:10.1111/myc.12168
  • Watanabe S, Kishida H, Okubo A. Efficacy and safety of luliconazole 5% nail solution for the treatment of onychomycosis: a multicenter, double-blind, randomized phase III study. J Dermatol. 2017;44(7):753–759. doi:10.1111/1346-8138.13816
  • Jones T, Tavakkol A. Safety and tolerability of luliconazole solution 10-percent in patients with moderate to severe distal subungual onychomycosis. Antimicrob Agents Chemother. 2013;57(6):2684–2689. doi:10.1128/aac.02370-12
  • Shono M. Allergic contact dermatitis from luliconazole. Contact Dermatitis. 2007;56(5):296–297. doi:10.1111/j.1600-0536.2006.01023.x