The new oral antifungal agents for onychomycosis of the toenails

  1. Aditya K. Gupta*,
  2. Neil H. Shear

Article first published online: 29 SEP 2006

DOI: 10.1111/j.1468-3083.1999.tb00837.x

Issue

Journal of the European Academy of Dermatology and Venereology

Journal of the European Academy of Dermatology and Venereology

Volume 13, Issue 1, pages 1–13, July 1999

Additional Information

How to Cite

Gupta, A. K. and Shear, N. H. (1999), The new oral antifungal agents for onychomycosis of the toenails. Journal of the European Academy of Dermatology and Venereology, 13: 1–13. doi: 10.1111/j.1468-3083.1999.tb00837.x

Author Information

  1. Division of Dermatology, Department of Medicine, Sunnybrook Health Science Center and the University of Toronto, Toronto, Canada

* * Corresponding author. 490 Wonderland Road South, Suite 6, London, Ontario N6K 1L6, Canada. Tel.: +1–519–657–4222; fax: +1–519–657–4233. E-mail address: agupta@execulink.com (A.K. Gupta)

Publication History

  1. Issue published online: 29 SEP 2006
  2. Article first published online: 29 SEP 2006

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Keywords:

  • Onychomycosis;
  • Itraconazole;
  • Terbinafine;
  • Fluconazole;
  • Griseofulvin;
  • Ketoconazole;
  • Toenails

Abstract

Objective

To review the use of the new oral antifungal agents, itraconazole, terbinafine and fluconazole for the treatment of onychomycosis of the toenails.

Background

Until about 10 years ago the two oral agents available to treat onychomycosis were griseofulvin and ketoconazole. Since then the new oral antifungal agents have superseded the traditional oral agents for the management of toenail onychomycosis.

Methods

Literature review.

Results and conclusion

Itraconazole, terbinafine and fluconazole have been used approximately 100 million times to treat superficial mycoses. These agents are more effective than the traditional antimycotics for the treatment of pedal onychomycosis; furthermore, the new agents have a broader spectrum of action than griseofulvin. In general, itraconazole, terbinafine and fluconazole have a favorable adverse-effects profile with drug interactions that are usually predictable and manageable. The new oral antifungal agents have a high benefit-to-risk ratio when used to treat toenail onychomycosis.

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