What are the most effective treatments for toenail fungus. How long does it take to cure toenail fungus with Lamisil. What are the potential side effects of using Lamisil for nail fungus. How can you prevent toenail fungus from recurring.

Understanding Toenail Fungus: Causes, Symptoms, and Prevalence

Toenail fungus, medically known as onychomycosis, is a common condition that affects millions of people worldwide. It’s caused by various types of fungi, including yeasts and molds, that thrive in warm, moist environments. The fungus typically enters through small cracks in the nail or the surrounding skin, leading to infection.

The most common symptoms of toenail fungus include:

• Thickened nails
• Discoloration (often yellow or brown)
• Brittle or crumbly nails
• Distorted nail shape
• Foul odor

Toenail fungus is particularly prevalent among older adults and individuals with compromised immune systems, such as those with diabetes. The condition affects approximately 10% of the general population but can be as high as 50% in people over 70 years old.

Risk Factors for Developing Toenail Fungus

Several factors can increase your risk of developing toenail fungus:

• Advanced age
• Reduced blood circulation
• Excessive sweating
• Walking barefoot in public areas like locker rooms or swimming pools
• Wearing tight-fitting shoes or non-breathable footwear
• Having a weakened immune system
• Suffering from conditions like psoriasis or diabetes

Lamisil: The Gold Standard in Toenail Fungus Treatment

Lamisil, known generically as terbinafine, is an oral antifungal medication widely regarded as one of the most effective treatments for toenail fungus. It works by inhibiting the growth of fungi, eventually leading to their death and allowing healthy nails to grow.

How Effective is Lamisil for Treating Toenail Fungus?

Clinical studies have shown that Lamisil is highly effective in treating toenail fungus, with success rates ranging from 80% to 85%. This makes it one of the most reliable options available for combating stubborn fungal infections.

Is Lamisil the fastest way to cure toenail fungus? While no treatment for toenail fungus is truly “fast,” Lamisil is considered the quickest and most effective oral medication for this condition. However, it’s important to note that even with Lamisil, it can take 9 to 12 months for infected nails to be fully replaced by healthy ones.

Dosage and Treatment Duration

The typical dosage for Lamisil in treating toenail fungus is:

• 250 mg once daily for 6 weeks (fingernail infections)
• 250 mg once daily for 12 weeks (toenail infections)

It’s crucial to complete the full course of treatment as prescribed by your healthcare provider, even if symptoms improve before the end of the treatment period.

Side Effects and Precautions When Using Lamisil

While Lamisil is generally well-tolerated, like all medications, it can cause side effects in some individuals. Common side effects may include:

• Headache
• Diarrhea
• Nausea
• Skin rash
• Altered taste sensation

More serious side effects, although rare, can include liver problems. For this reason, healthcare providers typically require blood tests to check liver function before starting treatment and again after 6 weeks of therapy.

Interactions and Contraindications

Lamisil can interact with certain medications, potentially altering their effectiveness or increasing the risk of side effects. It’s important to inform your healthcare provider about all medications you’re taking, including over-the-counter drugs and supplements.

Lamisil is contraindicated in individuals with:

• Chronic or active liver disease
• History of allergic reactions to terbinafine
• Severe kidney disease

Alternative Treatment Options for Toenail Fungus

While Lamisil is highly effective, it’s not the only treatment available for toenail fungus. Other options include:

Topical Treatments

Prescription topical medications like Jublia (efinaconazole) can be effective, especially for mild to moderate cases. However, they often require longer treatment periods and may be less effective than oral medications for severe infections.

Home Remedies

Some people find success with home remedies such as:

• Vicks VapoRub (shown to have about 20% effectiveness in studies)
• Apple cider vinegar soaks
• Tea tree oil applications

While these methods may provide some benefit, they are generally less effective than prescription treatments.

Laser Treatment

Laser therapy is a newer treatment option that uses focused light to target and destroy the fungi causing the infection. While it shows promise, multiple treatments are often required, and its long-term effectiveness is still being studied.

Preventing Toenail Fungus Recurrence

After successfully treating toenail fungus, taking steps to prevent its recurrence is crucial. Here are some effective prevention strategies:

1. Keep feet clean and dry, especially between toes
2. Wear breathable footwear and moisture-wicking socks
3. Use antifungal sprays or powders in shoes
4. Avoid walking barefoot in public areas like locker rooms and swimming pools
5. Trim nails regularly and keep them short
6. Disinfect nail clippers and other pedicure tools after each use
7. Avoid sharing shoes or socks with others

The Importance of Professional Diagnosis and Treatment

While toenail fungus may seem like a cosmetic issue, it’s important to seek professional medical advice for proper diagnosis and treatment. A healthcare provider can:

• Confirm the presence of fungal infection through nail clippings and laboratory analysis
• Rule out other conditions that may mimic fungal infections
• Prescribe the most appropriate treatment based on the severity of the infection and your overall health
• Monitor for potential side effects during treatment

Is professional treatment always necessary for toenail fungus? While mild cases might respond to over-the-counter treatments, persistent or severe infections often require prescription medications like Lamisil for effective eradication.

Living with Toenail Fungus: Social and Emotional Impact

Toenail fungus can have significant social and emotional effects on those affected. Many individuals feel embarrassed about the appearance of their nails, leading to:

• Avoidance of activities that expose feet, such as swimming or wearing open-toed shoes
• Decreased self-esteem and confidence
• Social anxiety in situations where feet might be visible
• Reluctance to seek intimate relationships

Addressing these psychological aspects is an important part of comprehensive toenail fungus treatment. Support from healthcare providers, friends, and family can be crucial in managing the emotional impact of the condition.

Coping Strategies

While undergoing treatment, individuals can employ several strategies to cope with the appearance of affected nails:

• Using nail polish (after consulting with a healthcare provider)
• Keeping nails trimmed and filed to minimize visible damage
• Focusing on overall foot health and hygiene
• Joining support groups or online communities for individuals with similar conditions

The Future of Toenail Fungus Treatment

Research into more effective and convenient treatments for toenail fungus is ongoing. Some promising areas of development include:

Novel Antifungal Compounds

Scientists are working on developing new antifungal medications that may be more effective against resistant strains of fungi or have fewer side effects than current treatments.

Improved Delivery Methods

Research is being conducted on innovative ways to deliver antifungal medications directly to the infected nail bed, potentially increasing effectiveness and reducing treatment duration.

Combination Therapies

Studies are exploring the potential benefits of combining different treatment modalities, such as oral medications with topical treatments or laser therapy, to enhance overall efficacy.

How might future treatments improve upon current options like Lamisil? Future treatments may offer shorter treatment durations, higher cure rates, or reduced side effect profiles, making toenail fungus treatment more accessible and tolerable for patients.

Frequently Asked Questions About Lamisil and Toenail Fungus

To address common concerns and provide additional clarity, here are answers to some frequently asked questions about Lamisil and toenail fungus treatment:

Can Lamisil cure all types of toenail fungus?

Lamisil is effective against many types of fungi that cause nail infections, including dermatophytes (the most common cause). However, some strains may be resistant, and infections caused by non-dermatophyte molds or yeasts might respond differently to treatment.

How long after starting Lamisil will I see improvement?

While Lamisil starts working quickly to kill the fungus, visible improvement in nail appearance may not be noticeable for several months. This is because it takes time for the infected portion of the nail to grow out and be replaced by healthy nail.

Can I use nail polish while taking Lamisil?

It’s generally recommended to avoid nail polish during treatment, as it can trap moisture and potentially interfere with the medication’s effectiveness. However, you should consult your healthcare provider for personalized advice.

Is Lamisil safe for diabetics?

Lamisil can be used in diabetic patients, but close monitoring may be required due to the increased risk of foot complications in diabetes. Always consult with your healthcare provider before starting any new medication.

Can children use Lamisil for toenail fungus?

Lamisil is approved for use in children over 4 years old for certain fungal infections, but its use for nail infections in children should be carefully considered and monitored by a pediatrician.

What should I do if I miss a dose of Lamisil?

If you miss a dose, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and continue with your regular schedule. Don’t double up on doses to make up for a missed one.

Can toenail fungus spread to other parts of the body?

While toenail fungus primarily affects the nails, it can potentially spread to surrounding skin or other nails if left untreated. In rare cases, severe infections might affect more distant parts of the body, especially in individuals with weakened immune systems.

By addressing these common questions, patients can gain a better understanding of Lamisil treatment and manage their expectations throughout the treatment process. Remember, while Lamisil is highly effective, patience and adherence to the prescribed regimen are key to achieving the best possible outcomes in treating toenail fungus.

What to do about toe fungus

If you have toe fungus, you may be keeping your toes under cover, avoiding open-toe shoes.

Maybe you’re cringing when you climb out of the pool and look down at your yellow toenails.

It’s a fairly common problem that time, alone, won’t heal. If you want to eliminate the fungus, you’ll need to take a medication or apply medicine directly to your nails. Either way, seeing your toenails return to normal usually takes nine months to a year, sometimes longer.

You may have seen a commercial claiming: Cure your toe fungus in 14 days. That’s only if the fungus is growing on top of the nail and can be scraped off with a nail file. Toe fungus that grows under the nail is tougher to reach and stop.

You don’t have to treat toe fungus — it may be unattractive looking but it’s harmless unless your toenails hurt. If you do want to fight off the fungus, there are a variety of treatments available. Taking an anti-fungal medication seems to bring about the best results.

Toe fungus treatment

Antifungal prescription pills: Lamisil, the pharmaceutical drug name for terbinafine, is one of several oral medications that can be taken to kill toe fungus. After three months of taking terbinafine daily, your toenails grow out, and new healthy nails develop about six months later. Terbinafine is the most studied and commonly prescribed oral medicine for toe fungus. It’s about 80 to 85% effective, but recently some types of fungus are becoming resistant even to terbinafine.

Topical treatments: Among the prescription topical medications, Jublia is probably the most effective, but it is very expensive and not all insurances cover it. Common home remedies for toe fungus include Vicks VapoRub, apple cider vinegar and tea tree oil. Of those, Vicks VapoRub has been studied the most. One study showed a 20% improvement in eliminating fungus, which is significant.

Laser treatment: Using a laser, heat is directed to the nails to try to kill off the fungus. Several laser treatments are usually needed, and in the end, the method doesn’t always work.

What is the fastest way to cure toenail fungus?

No method is fast. But Lamisil, taken as a pill daily, is the fastest method for killing off toe fungus. It takes nine months to a year for toenails to return to normal. Before taking the medication, you’ll need to take a blood test measuring your liver enzymes to ensure your liver can handle the medication. Six weeks after you start on Lamisil, some healthcare providers will have you take a second blood test to ensure your liver is functioning well. Lamisil has been shown to affect liver functioning in a very small fraction of patients who take it.

What is the main cause of toe fungus?

Toe fungus comes from yeast or mold. It’s unclear why people get toe fungus. The most common places where toe fungus develops are the big toe and the fifth toe because they are in closest contact with your shoes.

How common is toe fungus?

It’s very common, especially among older people and anyone with diabetes because their immune systems are compromised so they have less of an ability to fight off the fungus. Also, as people age, their nails can become brittle and dry. Any cracks in nails can be a passageway for fungi to get under the nail and stay there.

How contagious is toenail fungus?

It can only be contagious if you’re exposed to the fungus and have a crack in your nail, or if your nail separates from the nailbed. Under those circumstances, the fungus could penetrate down to the nailbed and spread.

If you get a pedicure, it’s best not to have your cuticles cut or pushed back. That can allow fungus and bacteria to get behind the nail. Before getting the pedicure, ask to make sure the nail files and other instruments are sterilized between customers.

Also, never share shoes. Fungus lives inside everyone’s shoes where it’s dark and damp, the perfect environment for fungus to grow.

Treating Fungal Nail Infections with Lamisil Anti-fungal Tablets

Download this information as a PDF

Before taking a course of tablet treatment for fungal nail infection, diagnosis has to be confirmed by the doctor taking nail clippings from one or more of the affected nails and sending it to the hospital lab for fungal, stain and culture. It usually takes a month to get the full results back as fungus grows very slowly in the lab.

If the nail clippings confirm that there is a fungal nail infection which is sensitive to Lamisil tablets, the doctor will arrange to take routine bloods from you before starting a three month course of Lamisil tablets. It is important that you have your bloods checked before starting the course of treatment and have the bloods repeated one month into the course of treatment to ensure the tablets are not causing any side effects. Side effects from Lamisil tablets are rare but occasionally they can cause nausea, a generalised rash or liver problems. Should you develop any new symptoms that you feel may be as a result of the Lamisil tablets, please stop the tablets immediately and let the doctor who prescribed the tablets know.

The doctor will usually give you a prescription for the first month of the tablets and will not give you the prescription for the last two months until your bloods have been checked after completing the first month of tablet treatment.

On completion of the three month course of treatment your nails will still look unsightly and perhaps crumbly. It will take a further nine months for the nails to grow out clear.

Lamisil tablets are usually about 85% effective at clearing trichophyton rubrum which is the most common fungus to infect toenails. Some patients may get re-infected by the fungus a few years later. The chances of this can be reduced by wearing leather shoes in winter and open toe sandals in the summer to let the air at the feet.  You should also be careful not to walk around barefooted anywhere. Wear shoes, slippers or flip-flops in the family home, in public places such as swimming pools, changing rooms, gymnasiums and hotels.

If you are worried that there may be fungal residue in your footwear, please sprinkle Daktarin powder into all your shoes once at night for seven days at the start of the three month course of Lamisil tablets.

In summary, this is the normal schedule for treating fungal nail infections:

On your first visit, the doctor will take nail clippings for fungal, stain and culture and will also take routine blood tests.

After one month, you can phone for the results. If the fungal clippings grow fungus which is sensitive to Lamisil tablets and if your routine blood tests are normal, the doctor will post you out a prescription for one month of Lamisil tablets, 250mg once daily. You should also sprinkle you shoes with Daktarin powder daily for one week.

After completing one month of the tablets, you return to the nurse in The Ashe Street Clinic for routine blood tests. The nurse will organise for the doctor to issue another two months supply of Lamisil tablets on the same day (i.e. three months in total).

It will take nine to twelve months after finishing the tablets before you notice the nails growing clear.

Should you require any further information please talk to any of the doctors or nurses in The Ashe Street Clinic.

Z: My Docs/derm papers / Treating Fungal Nail Infections with Lamisil Anti-fungal Tablets Jan 18

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David Buckley is a member of the following professional organisations:

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Lamisil tablets against nail fungus

Lamisil in the treatment of onychomycosis | Volkova E.N.

O Nichomycosis is one of the most common human diseases. Fungal nail disease is currently thought to occur in 50% of patients with nail plate lesions. In Russia, the number of patients with onychomycosis varies from 4.5 to 15 million people.

The causative agents of onychomycosis are dermatophytes, yeasts, molds, however, their ratio in the incidence spectrum is estimated by researchers in different ways. The vast majority (91.3%) of patients identified dermatophytes – primarily Tr. rubrum (72%), rarely Tr. menthagrophytes (19.3%) [1, 15, 21] (Fig. 1.). In particular, Tr. rubrum , as a rule, is the cause of damage to the nail plates of the feet; yeast usually infects the nails on the hands, and non-dermatophytic molds, which cause 3–5% of onychomycosis, on the feet [23]. Mostly yeasts and molds are found in combination with Tr. rubrum .

Fig. 1. Proportion of pathogens in the etiology of onychomycosis

Predisposing factors for the development of mycotic infection include diseases of the vessels of the lower extremities (obliterating endarteritis, thrombophlebitis, varicose veins, Raynaud’s syndrome), systematic microtrauma of the nail plate, and dystrophic conditions. Usually, these factors make it difficult to treat onychomycosis, especially if the patient has a combined pathology of the nail (for example, mycosis on the background of psoriasis).

In the pathogenesis of onychomycosis, an essential role belongs to the pathology of carbohydrate metabolism, endocrine and neurological changes, disorders of the immune system. The disease often develops against the background of long-term use of drugs that suppress the body’s defenses (glucocorticoids, cytostatics, broad-spectrum antibiotics). According to the literature [8, 23], onychomycosis is registered in 40% of cases in people over 65 years of age with age-related immunosuppression.

The vast majority of cases of onychomycosis is characterized by a chronic persistent course. It is believed that with the defeat of Tr. rubrum , this is due to the impossibility of developing a specific immune response against the fungus due to the activity of special T-suppressor cells. The suppression of the cellular and the absence of an inflammatory response to the pathogen may also be due to its predominant localization in the stratum corneum of the epidermis and nail plates.

The literature provides numerous data on the comparative effectiveness of various methods of onychomycosis therapy: local application of antimycotics in the form of ointments, patches, varnishes, surgical removal of the nail plate, followed by treatment of the nail bed with antifungal drugs, as well as systemic antimycotics [1, 2, 12, 28 ]. An analysis of publications on the problem indicates that in world medical practice there is still no ideal remedy and method for the treatment of onychomycosis, which would be suitable for all patients without exception, would not give any side effects and in a short time provide 100% clinical and etiological cure of the patient. Therefore, even today the search and comprehensive study of new effective antimycotics that meet these requirements is justified.

Terbinafine (Lamisil, created in 1982 by the Swiss company Novartis) is a representative of the class of allylamines – chemical compounds included in the arsenal of the most effective means of treating dermatomycosis.

To date, after multilateral clinical trials, Lamisil has firmly entered the practice of treating patients with mycoses [11, 22, 29, 31]

This drug with a wide spectrum of antifungal activity [16, 34]. In therapeutic concentrations, it has a direct fungicidal effect on dermatophytes, yeasts and molds, both when administered orally and topically. The site of application of the drug is the cytoplasmic membrane of the fungal cell. The advantage of terbinafine is its action at the early stages of sterol metabolism, at the level of the squalene epoxidase cycle. By inhibiting the enzyme squalene epoxidase, terbinafine inhibits the formation of ergosterol, the main component of the cell wall of fungi, preventing their further reproduction [15, 19, 22].

The drug has a dual mechanism of action: fungicidal and fungistatic, and the fungicidal effect is the main one. It is caused by the accumulation of squalenes in the fungal cell, which, like a kind of lipid sponge, extract lipid components from the membranes. The lipid granules accumulating inside the cell, gradually increasing in volume, break the defective cytoplasmic membranes, leading the fungal cell to death [11, 17]. The fungistatic effect is due to the defectiveness of the membranes of the fungal cell due to the suppression of the synthesis of ergosterol, which leads to the loss of the ability of the fungal cell to develop – it only survives.

The predominant fungicidal action of lamizil, which distinguishes it from previously created systemic antimycotics, determines the higher efficacy of the drug, as well as a smaller number of relapses in its use, due to which treatment is cheaper than other systemic antimycotics [9, 14].

The drug is well absorbed from the gastrointestinal tract: 2 hours after a single dose of 250 mg, its plasma concentration is 0.8-1.5 mg / ml. Due to lipophilicity, it accumulates in the dermis, epidermis, adipose tissue, from where it is slowly absorbed into the blood [19].]. Terbinafine also penetrates the secretion of the sebaceous glands, which leads to the creation of the highest possible concentrations in the hair follicles, hair and skin rich in sebaceous glands. The drug is found in the stratum corneum of the epidermis within a few hours after oral administration, which is achieved by its excretion by the sebaceous glands and, to a lesser extent, by passive diffusion [11, 17]. Terbinafine is characterized by long-term persistence in the blood due to the continuous regimen of the drug, which is an important component of its pronounced effectiveness. In the distal parts of the nails, its concentration persists for 48 weeks after the end of the course of therapy, which causes a positive fungicidal effect and makes it possible to cure onychomycosis without removing the nail plates [19, 29]. Biotransformation leads to the formation of metabolites that do not have antimycotic activity, which are excreted from the body mainly with urine [9].

Distribution features of terbinafine include its lymphatic transport due to its lipophilicity and association with chylomicrons. Through the lymphatic vessels, terbinafine directly reaches infiltrative-suppurative and abscessed lesions complicated by lymphangitis. This nature of terbinafine transport, combined with its antibacterial properties comparable to those of gentamicin, leads to a fairly rapid resolution of complicated forms of dermatophytosis [23].

The drug does not suppress liver enzymes, binding little to cytochrome p-450, as a result of which it practically does not affect the metabolism of drugs, i. e. the risk of drug interactions is minimal. This is an important advantage of the drug, since it ensures safety in the treatment of patients receiving concomitant therapy for intercurrent diseases (diabetes mellitus, diseases of the cardiovascular, nervous systems, etc.) [21, 31]. The bioavailability of terbinafine as a result of co-administration with other drugs and food does not change. At a concentration 5 times higher than therapeutic, terbinafine does not inhibit chemotaxis, phagocytosis and metabolic activity of leukocytes, i.e. does not have an immunosuppressive effect [34]. Moreover, Barbareschi, 1993 [13] showed that in vitro incubation of polymorphonuclear neutrophils with terbinafine leads to an increase in their activity [13].

Lamisil has an excellent safety profile [20, 36, 39, 40]. Its safety is comparable to placebo [29]. According to the data presented by a number of authors [16,27], according to the results of the analysis of case histories of 25884 patients who took pills, the side effects that occurred when taking lamisil are extremely rare and refer mainly to mild gastrointestinal events (Table 1). ).

All the noted properties of the drug contributed to its rapid introduction into clinical practice in more than 80 countries around the world [17, 21, 25, 27]. The data of foreign researchers given in the table testify to the high efficiency of lamisil in the treatment of onychomycosis. The positive experience of treatment with lamisil is also noted by many domestic scientists, demonstrating very impressive performance.

Thus, according to A.A. Kubanova [4], a positive clinical effect and microbiological cure were observed in 94.4% of patients. The results of Yu.V. Sergeev [9], which demonstrates clinical and mycological cure in 82% of patients. Data by N.S. Potekayeva [8] testify to the high efficiency of lamisil: mycological cure was obtained in 96% of patients (see Table 2). V.M. Leshchenko and G.M. Leshchenko [6] evaluate the results of treatment of patients with onychomycosis of the feet and hands, combined with lesions of smooth skin, as positive. At the end of the traditional course of treatment (250 mg once for 12 weeks), clinical recovery was noted in 96% of patients. The drug was well tolerated. In 478 patients after treatment with lamisil, fungi were not found microscopically in the material from the nail plates, and 6 months after the start of treatment, all of them had a clinical and microbiological cure.

According to V.A. Molochkova [5], in the treatment of patients with onychomycosis, the use of lamisil turned out to be highly effective, a positive clinical effect and microbiological cure were noted in 9 patients.5.2% of patients. Interesting data on the use of lamisil in patients with diabetes were obtained by S.A. Burovaya [3]. The presented long-term results (6 months after the end of treatment with lamisil) indicate that clinical recovery is observed in 85.7% of patients, microbiological sanitation in 89.3%. HE. Pozdnyakova demonstrates the efficacy and safety of lamisil in 48 patients with chronic liver diseases without exacerbation [8] in the compensated and subcompensated stages: after the end of therapy, mycological cure was observed in 100% of patients. Information about the use of lamisil in immunodeficiency states seems to be encouraging, given that the number of these patients is increasing every year. To date, 82 cases of the use of lamisil tablets in immunodeficiencies have been described: AIDS [26, 37, 38], Down’s syndrome, after organ transplantation [18, 24, 27].

Yu.K. Skripkin and Zh.V. Stepanova [10], summarizing the experience of domestic and foreign researchers, once again emphasized the effectiveness and safety of lamisil, good tolerance, and a convenient application regimen. The effectiveness of treatment, according to their data, was 94%.

Under our supervision there were 32 patients with onychomycosis of the feet (18 men, 14 women) aged 25 to 55 years with a disease duration of 1 to 15 years. Concomitant diseases were detected in 28% of patients, including gastritis, colitis, thyroid dysfunction; 50% of patients considered themselves practically healthy. Predisposing factors causing the development of the mycotic process were identified in 100% of patients. Thus, 26 patients were regular visitors to swimming pools, 18 to saunas; 14 patients were engaged in professional sports, which is associated with constant traumatization of the nail plates. The diagnosis of onychomycosis was established in each case on the basis of the clinical picture of the disease and the detection of fungi during microscopic examination of the affected nail plates. In 20 patients, in addition to onychomycosis (damage from 1 to 16 nail plates), there was a lesion of the skin of the corresponding localization: feet and hands (4 patients), smooth skin of the trunk (6 patients), large folds (10 patients). According to the clinical picture, the nail plates were affected mainly by a mixed type, i.e. in the same patient on different fingers they were changed according to the hypertrophic, normotrophic type with onycholysis phenomena and the area of ​​nail damage from marginal (5–10%) to total, involving the skin of the feet and palms in the process with skin changes characteristic of rubrophytosis exaggeration of skin furrows, small-lamellar (mucoid) peeling, hyperkeratosis, maceration of the epidermis, cracks in the interdigital folds of the skin of the feet.

Patients received Lamisil orally at 250 mg per day for 12 weeks, and during therapy, a complete blood count, urine, and liver function tests were examined. In each case, shoes were treated at home with a 25% formalin solution or a 0.5% solution of chlorhexidine bigluconate twice with an interval of 1 month. In order to increase the intensity of growth of the nail plate, 5 patients were prescribed phytin, zinc-containing vitamin complexes orally.

Patients tolerated the treatment well. Of the side effects in 1 patient, a temporary loss of taste sensations was noted: this phenomenon resolved itself without requiring drug withdrawal.

Control microscopic examination was performed 3, 4, 6 months after the start of treatment, and 6 months after the end of therapy, the results of microscopic examination were negative in 100% of cases. In 4 patients, despite the absence of fungi on microscopic examination, the nail plates remained dystrophically altered, and in each case they had a history of injury to the corresponding nail.

As a result of treatment, skin rashes, especially in large folds, resolved after 2-3 weeks. Affected nails with a lesion area of ​​up to 60% on the feet were replaced with visually healthy ones after 5–6 months, i.e. 3-4 months after the end of taking lamisil. There were no recurrences of the disease (9–14 months of follow-up).

Thus, on the basis of literature data and the results of our own studies, it can be argued that the appearance of lamisil led to a significant improvement in the prognosis of patients suffering from onychomycosis, which was previously difficult to treat and was characterized by a persistent course. Lamisil therapy has changed the view that onychomycosis is difficult to cure: the drug is highly effective, provides a high cure rate in a shorter period than previous generations of antimycotics. The fungicidal effect, active penetration of lamisil into keratin and its long-term retention in the nail plate, combined with the relative rarity of serious adverse effects and relapses, made the drug the drug of choice in the treatment of fungal infections of the nails and smooth skin. It should be noted that at present it is included in the list of medicines for preferential services for the disabled and pensioners at the expense of the fund of insurance companies.

References can be found at http://www.rmj.ru

Terbinafine–

Lamisil (trade name)

(Novartis Pharma)

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