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Oral anti-fungal medication for fungal toenails: Terbinafine / Lamisil

Lamisil for Toenail fungal infections

Lamisil / terbinafine for infected fungal toenails
Be sure to discuss your alcohol consumption with your doctor before using oral anti-fungal drugs.

A medication in tablet form is available that has proven to be quite effective in curing fungal toe and finger nail infections.  The active ingredient is Terbinafine hydrochloride and the original, trademarked name is Lamisil.  It has recently opened up to generic manufacturers, so more names will be appearing on chemist shelves for the same drug. At this time in Queensland, it is only available on prescription from a medical practitioner.   The same chemical is also used in a variety of topical applications for skin and nail infections.

In the oral (tablet) form, Terbinafine is very effective, although some manual care of the nail by a podiatrist during treatment will improve the chance of success. This is because the collection of debris that forms under an infected nail will stop the growing nail from attaching properly to the nail bed. If the nail bed is cleared of this layer at intervals of ~ six weeks, a better result is often attained.

When thinking about taking Lamisil, you should be aware that this is a drug that can be harsh on the liver.  Extra consideration is needed if you have known liver problems, drink or have drunk significant quantities of alcohol or take other pharmaceutical or recreational drugs that rely on the liver to metabolise them. We recommend asking these questions of your Doctor prior to commencement of treatment so that you can consider the options and potential consequences fully. It is wise to have a liver function test prior to starting a course of treatment.  As most instances of liver failure and death have occurred within a month of commencing the drug, a follow up liver function test early is also wise.  You may wish to read more about the Australian Government’s Therapeutic Goods Administration (TGA) warning about the use of Terbinafine to be fully informed. http://news.smh.com.au/national/lamisil-pill-linked-to-liver-deaths-tga-20080204-1q1m.html

As an alternative to oral drug treatment for fungal nails, our practice is pleased to offer laser anti-fungal therapy.  You can read a full account of the pros and cons of laser treatment here.


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