How long must the tablets be taken?
The duration of intake and the dosage regimen vary from active ingredient to active ingredient and can therefore not be given as a general rule. In most cases, however, an intake period of several weeks is necessary – sometimes with interruptions – until the affected nail has been replaced by natural growth with a new nail. The active ingredient itraconazole in the dosage of 100 mg can be taken both according to an interval and a continuous schedule.
In interval therapy, 200 mg of itraconazole is taken twice daily for one week. This is followed by a 3-week break. Usually 3 intervals, i.e. 3 months, are sufficient for a successful treatment.
The continuous regimen also lasts 3 months with a continuous intake of 200 mg itraconazole a day. Also a therapy with Terbinafine usually lasts between 6 weeks and 3 months. In rare cases, an intake period of up to 6 months may be necessary. Therapy with Fluconazole tablets should be continued until the affected nail has been replaced by natural growth with a healthy nail. Therefore, the duration of treatment may vary from person to person with different dosages and different growth rates, but several weeks to months can be expected.
Can a strong nail fungus also be treated with tablets?
Especially a strong nail fungus must be treated with tablets. Such a therapy is also called systemic. For light nail mycosis, local measures such as the use of a special nail polish and cream are often sufficient.
A stronger fungal infection must, however, be treated additionally systemically, since otherwise an infection of the lower leg (erysipelas) can occur as a complication. However, the therapy with tablets must always be accompanied by hygiene measures, such as disinfection of the footwear, to ensure the success of the therapy. Factors that promote nail mycosis, such as diabetes mellitus, should also be treated.
Side effects
The taking of tablets against nail fungus is not without danger. Orally taken antimycotics have a number of adverse drug reactions. Common side effects of the tablets against nail mycosis are disturbances in the gastrointestinal tract.
Many patients complain about the occasional occurrence of abdominal pain or nausea during use. In addition, tablets used to treat nail fungus can cause headaches and dizziness. The occurrence of mild to moderate skin rashes is also not uncommon.
In rare cases, the liver can also be affected. If there is a noticeable increase in liver values (liver enzymes), the therapy should be stopped immediately and an alternative medication taken. Both patients with liver disease and children should not be treated at all with some antimycotics (e.g. azoles).
Other active ingredients in this group of drugs (Amphotericin B) can damage the kidneys and should therefore not be prescribed for renal failure. In addition, there is a risk of destruction of various blood cells when taking tablets against nail fungus. When using these drugs, the blood should therefore be examined at regular intervals.
Furthermore, tablets against nail mycosis can influence the effectiveness of other drugs. For this reason, a doctor should be consulted before taking the antimycotic if several drugs are being used. In general it can be said that the treatment of nail fungus by means of household remedies, varnish or creams is much gentler than the use of tablets.
In the following section the most important side effects of the different tablets against nail fungus are clearly presented. The active ingredient Fluconazole is usually well tolerated. However, side effects may occur.Fluconazole can cause headache, nausea, diarrhea, abdominal pain and stomach upset.
Occasionally (in one in 1000 treated patients) there may be a decrease in red blood cell count, liver damage, hives, loss of appetite and sleep disturbances. In rare cases, severe skin rashes may occur as an expression of an allergic reaction. Treatment with the active ingredient itraconazole may also be associated with side effects.
Itraconazole can often cause gastrointestinal problems such as abdominal pain and nausea. Occasionally vomiting, diarrhea and flatulence may occur. Liver values (liver enzymes) and bilirubin are also occasionally elevated.
Skin rashes are common and occasionally hives, hair loss and itching may occur. A severe complication is a severe allergic reaction or severe liver damage. However, these occur very rarely.
Among the most common side effects of a treatment with Terbinafine are headaches and a reduction in appetite. Furthermore, similar to a therapy with Fluconazole or Itraconazole, complaints of the gastrointestinal tract, including digestive disorders, nausea, mild abdominal pain, diarrhea and flatulence are common. A transient skin rash and hives are also common. In rare cases, liver dysfunction, muscle and joint pain and allergic reactions may occur.
