Prescription oral antifungals for athlete's foot

Examples

Oral allylamines

Generic Name	Brand Name
terbinafine hydrochloride	Lamisil

Oral azoles

Generic Name	Brand Name
fluconazole	Diflucan
itraconazole	Sporanox
ketoconazole	Nizoral

Other antifungals

Generic Name	Brand Name
griseofulvin	Fulvicin, Grifulvin, Gris-PEG

Allylamines and azoles are different classes of antifungal medicine. This is important because medicine from one class may work better than medicine from the other.

How It Works

Prescription oral antifungal medicines slow the growth of or kill fungi.

Oral medicines are usually taken for 1 to 8 weeks. The exact amount of time varies and depends on how much medicine you take each day.

If you stop taking the medicine early, even after your symptoms are gone, an athlete's foot infection will likely return. It is very important to take the entire course of medicine.

Why It Is Used

Oral antifungals for athlete's foot (tinea pedis) are usually only used for a severe infection or when topical antifungal medicines have not cured the infection. Some oral antifungals can also be used for fungal toenail infections, which may occur with athlete's foot.

How Well It Works

Research shows that oral antifungals successfully cure athlete's foot for many people.¹ Research has shown terbinafine and itraconazole to be more effective than a placebo for curing athlete's foot.² Research has also shown griseofulvin to be less effective in curing athlete's foot than terbinafine and possibly other oral antifungal medicines.²

Side Effects

Oral medicines can cause minor to serious side effects. Minor side effects may include:

• Stomach upset.
• Headaches.
• Skin rashes.
• Changes in taste sensation (rare).
• Visual disturbances (rare).

Oral antifungals carry a small but serious risk for dangerous side effects, which can include:

• Liver damage.³ During oral antifungal treatment, your doctor may require blood tests to check your kidney and liver function. Be aware of the symptoms of liver problems, such as nausea, vomiting, and stomach pain; dark urine; and changes in skin color.
• Heart failure. In the early stages of heart failure, many people do not notice symptoms. If you have heart problems or are concerned about this rare side effect, talk to your doctor about taking a medicine with a lower risk for this problem.

Oral antifungal medicines pass into breast milk. If you are pregnant, could become pregnant, or are breast-feeding, talk to your doctor before taking these medicines.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Tell your doctor about other medicines you are taking. Some medicines are not safe to take together with oral antifungals.

Do not drink alcohol while taking oral antifungals. Some forms of these medicines can cause or contribute to liver problems, which alcohol can make worse. During oral antifungal treatment, you may need to have blood tests to check your liver and kidney function.

If you use an antacid, wait at least 2 hours before taking ketoconazole. Antacids reduce ketoconazole absorption from the stomach into the bloodstream.

Oral antifungals cost more than nonprescription antifungal skin medicine.

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Author:	Maria G. Essig, MS, ELS	Last Updated: July 2, 2008
Medical Review:	Kathleen Romito, MD - Family Medicine Anne C. Poinier, MD - Internal Medicine
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