Is Terbinafine Effective for Toenail Fungus? Doctor's Insights

Q: Is Terbinafine Effective for Toenail Fungus? Doctor's Insights

Hello： The Department of Health has strict regulations regarding various medications. <br>As long as the medication is approved by the Department of Health, the public can use it with confidence. <br>If you have any questions about medication, you can consult your attending physi

Questions about Atypical Antipsychotics

Hello doctor, I previously visited a physician due to toenail fungus.
They prescribed me terbinafine, which I took continuously for 12 weeks, and now my toes are almost healed...
However, the toenails on both of my big toes have not improved (they had previously grown back normally but then the fungus returned).
I went back to see the doctor, and he told me that if the medication doesn't work, it won't be effective.
He also mentioned that this treatment can be very harmful to the liver (or kidneys; I can't remember clearly)...
Is this true? What should I do? Sorry for the lengthy message...
Thank you.

AA, 10~19 year old female. Ask Date: 2006/10/19

Dr. Hong Zhengsheng reply Dermatology

Hello: The Department of Health has strict regulations regarding various medications.
As long as the medication is approved by the Department of Health, the public can use it with confidence.
If you have any questions about medication, you can consult your attending physician in person or ask the pharmacist when picking up your prescription; this can help resolve your concerns immediately.
Additionally, there is a "Drug Information Network" on the Department of Health's website that provides relevant medication information for the public, which you can utilize.

Regarding your issue with onychomycosis (fungal nail infection), I apologize that based on your description, I cannot ascertain your exact condition.
Answers found online can only speculate based on the description and experience, and cannot provide the precise diagnosis and treatment that an in-person consultation can offer.
I recommend that when you notice the symptoms described, you should promptly visit a public hospital in your city or county under the Department of Health and consult with a dermatologist.
All of our physicians are very willing to assist you.
Thank you for using "Taiwan e-Hospital" to ask your question.
"Taiwan e-Hospital" cares about your health.

Reply Date: 2006/10/19

More Info

Terbinafine is indeed an effective treatment for toenail fungus, also known as onychomycosis. It belongs to a class of antifungal medications called allylamines, which work by inhibiting the synthesis of ergosterol, an essential component of fungal cell membranes. This action ultimately leads to the death of the fungus. Terbinafine is particularly effective against dermatophytes, the most common type of fungi responsible for nail infections, such as Trichophyton rubrum.

In your case, it sounds like you have been undergoing treatment for an extended period, which is typical for toenail fungus due to the slow growth of toenails. The standard treatment duration for terbinafine is usually 6 to 12 weeks, depending on the severity of the infection and the specific nail involved. It is important to note that while terbinafine can be very effective, it may not work for everyone, and some patients may experience recurrence of the infection after treatment.

Regarding your concern about liver or kidney damage, it is true that terbinafine can have side effects, including potential liver toxicity. Therefore, it is essential to monitor liver function through blood tests during treatment, especially if you have pre-existing liver conditions or are taking other medications that may affect liver function. Your doctor should have discussed these risks with you before starting treatment. If you experience symptoms such as jaundice (yellowing of the skin or eyes), dark urine, or persistent nausea, you should contact your healthcare provider immediately.

If you find that your toenail fungus has not fully resolved after completing the prescribed course of terbinafine, it is crucial to follow up with your healthcare provider. They may recommend additional treatment options, which could include a longer course of terbinafine or switching to another antifungal medication, such as itraconazole or fluconazole, which have different mechanisms of action and may be effective against resistant strains of fungi.

In some cases, a combination of oral and topical antifungal treatments may be necessary, especially if the infection is extensive or if there are multiple nails involved. Topical treatments, such as ciclopirox or efinaconazole, can be applied directly to the affected nails and may help in conjunction with oral therapy.

It is also worth noting that maintaining good foot hygiene and nail care is essential in preventing recurrence. Keeping your feet dry, wearing breathable footwear, and avoiding walking barefoot in communal areas can help reduce the risk of reinfection. Additionally, if you have a history of fungal infections, consider discussing preventive measures with your doctor.

In summary, while terbinafine is effective for treating toenail fungus, it is essential to monitor for potential side effects and follow up with your healthcare provider if the infection does not resolve. They can provide guidance on the best course of action tailored to your specific situation.

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