What are some oral antifungal medications for treating toenail fungus?

Anthony L. Komaroff, MD
Internal Medicine
There are several oral antifungal medications. Terbinafine (the active ingredient in Lamisil but also available as a generic) is the best of the bunch. A three-month course clears the fungal infection about 60% to 70% of the time. Itraconazole (Sporanox) is an alternative, but studies have shown it to be a little less effective, and there are more problems with drug interactions with itraconazole than with terbinafine.

One thing to keep in mind is that terbinafine needs to get into the nail to work. Toenails grow slowly, so even if it seems like a three-month course hasn't finished the job, it may have. Give it some time -- six to 12 months. As the new toenail grows out, healthy nail tissue may replace tissue that has been infected with fungi. If it doesn't, then you can see about starting another course of terbinafine or alternative medications. Insurance companies do keep a close eye on expenditures for toenail fungus treatment. Terbinafine is fairly expensive, and treating toenail fungus is usually not a medical necessity.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.