Medicines for nail fungus

General / Introduction

If the nail fungus is very pronounced, various systemically acting drugs are used. It has been shown, however, that the combination of a systemic and local therapy of the nail mycosis has an advantage over a simple systemic therapy. Different antimycotics (“anti-fungal” drugs) can be used for therapy, which differ mainly in their spectrum of action.

Nail fungus Drug product: griseofulvin

The nail fungus drug griseofulvin is a naturally occurring chemical compound secreted by the bacterium Penicillium griseofulvum. It is a benzofuran derivative and is also called mold fungus poison. This medication can be taken orally and is effective against filamentous pills (dermatophytes), which can cause nail fungus. However, it is ineffective against other fungi, such as mold. If griseofulvin is taken in too high doses, it can lead to sleep disorders, dizziness or headaches.

Nail fungus Drug: Itraconazole

Itraconazole as a medication against nail fungus is also a systemically effective antimycotic which can be taken orally. It is largely absorbed in the intestine and then enters the bloodstream. It can also be used as an intravenous therapy.

The drug is metabolized by cytochrome P3 A4 and can thus lead to liver damage or heart failure. The effect of this drug is based on the reduction of the ergosterol synthesis in the fungal cells. It inhibits the conversion of the precursor lanosterol into the required ergosterol.

Ergosterol is a vital component of the cell membrane of certain fungi and thus leads to the destruction of the fungal membrane. Also Itraconazol does not work against all mushroom forms, however against relatively many. The thread-fungi (dermatophytes), the yeast fungi, aspergillae and histoplasms belong to it. Still some further fungus-types are sensitive on Itraconazol, occurs however clearly more rarely.

Nail fungus Drug product: Terbinafine

The nail fungus medication Terbinafin is an allylamine derivative, which is used as a standard medication for nail fungal disease. This preparation can be used both locally and systemically. The oral and thus systemic effect is preferred for severe nail mycosis.

Like itraconazole, Terbinafine inhibits the synthesis of ergosterol in the fungal cell membrane. This inhibition occurs by blocking the conversion of squalene-2,3-epoxide into lanosterol, thus blocking the synthesis of ergosterol one step before the action of itraconazole. Lanosterol is a precursor of ergosterol, which prevents the fungal cell membrane from being built up. At the same time squalene accumulates in the fungal cell. Lamisil® is an antimycotic which contains terbinafine.