<!-- @page { size: 21cm 29.7cm; margin: 2cm } P { margin-bottom: 0.21cm } -->
Terbinafine is an allylamine antifungal agent that is active against dermatophytes, which are responsible for the majority of onychomycosis cases. Itraconazole is a newer triazole medication with a broad antifungal spectrum that includes dermatophytes, many nondermatophytic molds and Candida species. Like itraconazole, fluconazole is active against common dermatophytes, Candida species and some nondermatophytic molds.
Fluconazole is not currently labeled by the FDA for the treatment of onychomycosis, but early efficacy data are promising. Attention has focused on once-weekly dosing (450 mg), taking advantage of the drug's pharmacokinetics to reduce treatment costs, decrease rates of adverse effects and potentially improve compliance.
In one placebo-controlled study involving patients with fingernail onychomycosis, fluconazole in a dosage of 450 mg taken once weekly for three months was associated with a 90 percent clinical cure rate and nearly total mycologic eradication. Lower dosages were slightly less effective. No differences in complication rates were observed between the treatment and placebo groups.
Published outcomes data on the use of fluconazole in toenail fungal infections demonstrated clinical improvement rates of 72 to 89 percent, compared with 3 percent for placebo. Treatment duration in these studies varied from four to nine months, with a small but measurable advantage shown for longer courses.
Adverse effects, including nausea, headache, pruritus and liver enzyme abnormalities, are reported in approximately 5 percent of treated patients. These side effects remit after the discontinuation of fluconazole. The absorption of this drug is not pH sensitive and is not affected by acid suppression or food intake. However, fluconazole has important drug interactions.
Much of the published data on the treatment of onychomycosis are of limited clinical use. Many studies have been small and observational, and they have lacked randomization and control subjects. Recently, however, the results of a handful of larger randomized, controlled trials have been published. These studies provide more convincing guidance in choosing appropriate therapy.
In a study of patients with dermatophytic onychomycosis, continuous terbinafine therapy was shown to be more effective than continuous itraconazole therapy in patients with toenail onychomycosis. Intention-to-treat analysis showed nearly 85 percent negative cultures in the treatment group compared with 55 percent in the placebo group, and 65 percent clinical improvement in the terbinafine group compared with 37 percent in the itraconazole group.
Other studies comparing terbinafine and itraconazole had similar findings. A recent prospective, double-blind, randomized, controlled trial compared the use of continuous terbinafine therapy and pulsed itraconazole therapy in patients with toenail fungal infection. This well-designed study showed that terbinafine provided superior clinical and mycologic outcomes.
Fungus occurring under nails is usually beyond the reach of standard remedies which are simply not strong enough and permeable to actually get rid of the infection. Recent advances in the scientific understanding of the medicinal plant extracts in Nail Fungus-Rx suggest a much broader use of natural medicine to treat and cure nail fungus than science thought possible just ten years ago.
As most standard treatments for fungal infections are not effective against fungus which has worked its way under the nails, the antifungal effects of this product are of increasing interest. Nail Fungus-Rx is concentrated with a wide spectrum of powerful antifungal plant extracts exhibiting a curative effect against nail fungus, as demonstrated by a wealth of scientific and clinical studies.
Application of AntiNailFungus-Rx 2-3 times per day has shown to eliminate even the toughest nail fungus infections. This product is concentrated with naturally occurring phenolic compounds which exhibit a tremendous antifungal activity. They safely destroy fungal infections and act as natural pharmaceuticals. As a result, AntiNailFungus-Rx is remarkably effective against nail fungus.
Clinical evidence supports laboratory tests which show that theses extracts have penetrating antifungal actions which destroy fungi without causing tissue damage. However, this treatment is very potent and therefore only to be applied to finger/toe nails where skin and nails are hardened and less sensitive. To learn more, please go to http://www.naturespharma.org.
Terbinafine is an allylamine antifungal agent that is active against dermatophytes, which are responsible for the majority of onychomycosis cases. Itraconazole is a newer triazole medication with a broad antifungal spectrum that includes dermatophytes, many nondermatophytic molds and Candida species. Like itraconazole, fluconazole is active against common dermatophytes, Candida species and some nondermatophytic molds.
Fluconazole is not currently labeled by the FDA for the treatment of onychomycosis, but early efficacy data are promising. Attention has focused on once-weekly dosing (450 mg), taking advantage of the drug's pharmacokinetics to reduce treatment costs, decrease rates of adverse effects and potentially improve compliance.
In one placebo-controlled study involving patients with fingernail onychomycosis, fluconazole in a dosage of 450 mg taken once weekly for three months was associated with a 90 percent clinical cure rate and nearly total mycologic eradication. Lower dosages were slightly less effective. No differences in complication rates were observed between the treatment and placebo groups.
Published outcomes data on the use of fluconazole in toenail fungal infections demonstrated clinical improvement rates of 72 to 89 percent, compared with 3 percent for placebo. Treatment duration in these studies varied from four to nine months, with a small but measurable advantage shown for longer courses.
Adverse effects, including nausea, headache, pruritus and liver enzyme abnormalities, are reported in approximately 5 percent of treated patients. These side effects remit after the discontinuation of fluconazole. The absorption of this drug is not pH sensitive and is not affected by acid suppression or food intake. However, fluconazole has important drug interactions.
Much of the published data on the treatment of onychomycosis are of limited clinical use. Many studies have been small and observational, and they have lacked randomization and control subjects. Recently, however, the results of a handful of larger randomized, controlled trials have been published. These studies provide more convincing guidance in choosing appropriate therapy.
In a study of patients with dermatophytic onychomycosis, continuous terbinafine therapy was shown to be more effective than continuous itraconazole therapy in patients with toenail onychomycosis. Intention-to-treat analysis showed nearly 85 percent negative cultures in the treatment group compared with 55 percent in the placebo group, and 65 percent clinical improvement in the terbinafine group compared with 37 percent in the itraconazole group.
Other studies comparing terbinafine and itraconazole had similar findings. A recent prospective, double-blind, randomized, controlled trial compared the use of continuous terbinafine therapy and pulsed itraconazole therapy in patients with toenail fungal infection. This well-designed study showed that terbinafine provided superior clinical and mycologic outcomes.
Fungus occurring under nails is usually beyond the reach of standard remedies which are simply not strong enough and permeable to actually get rid of the infection. Recent advances in the scientific understanding of the medicinal plant extracts in Nail Fungus-Rx suggest a much broader use of natural medicine to treat and cure nail fungus than science thought possible just ten years ago.
As most standard treatments for fungal infections are not effective against fungus which has worked its way under the nails, the antifungal effects of this product are of increasing interest. Nail Fungus-Rx is concentrated with a wide spectrum of powerful antifungal plant extracts exhibiting a curative effect against nail fungus, as demonstrated by a wealth of scientific and clinical studies.
Application of AntiNailFungus-Rx 2-3 times per day has shown to eliminate even the toughest nail fungus infections. This product is concentrated with naturally occurring phenolic compounds which exhibit a tremendous antifungal activity. They safely destroy fungal infections and act as natural pharmaceuticals. As a result, AntiNailFungus-Rx is remarkably effective against nail fungus.
Clinical evidence supports laboratory tests which show that theses extracts have penetrating antifungal actions which destroy fungi without causing tissue damage. However, this treatment is very potent and therefore only to be applied to finger/toe nails where skin and nails are hardened and less sensitive. To learn more, please go to http://www.naturespharma.org.
SHARE
