Because onychomycosis, aka, toenail fungus, tends to be difficult to treat and repeat infections are very common, doctors often prescribe oral antifungal medications for toenail fungus to try and clear the infected nail(s). Though over-the-counter creams and ointments are widely available, they simply are not effective in the vast majority of cases. Oral medications are much more effective, but they come with a risk for side effects.
Doctors are more likely to recommend oral medications for toenail fungus to people with certain conditions. Patients who have diabetes or a history of cellulitis are commonly prescribed antifungal medications. They are also frequently given to patients who are experiencing pain because of their infection. The two most common prescription medications are Lamisil, also known as terbinafine, and Sporanox, also known as itraconazole.
Oral medications for toenail fungus come with a high risk for side effects. Before prescribing Lamisil or any other antifungal medication, your doctor is likely to perform blood tests to check for liver function. It is important to let your doctor know if you suffer from liver disease, kidney disease or an autoimmune disease such as lupus. You should also tell your doctor if you have a history of depression prior to taking an oral antifungal medication.
The side effects associated with antifungal medications for toenail fungus vary greatly in terms of severity. Mild side effects include minor skin irritation, unpleasant taste, dizziness or upset stomach. Rarer and more severe side effects include serious skin reaction, weight loss, hearing problems, changes in mood or behavior and liver damage. You should stop taking the medication immediately and contact your doctor if you experience any signs of liver damage such as yellowing of the skin or eyes, dark urine, upper stomach pain or clay-colored stools. In some cases, patients have experienced severe liver damage leading to the need for a liver transplant or death. To reduce the likelihood of major complications, your doctor will closely monitor your liver function while you are taking the prescription.
Oral antifungal medications are usually taken for a course of 12 weeks. To ensure their effectiveness, they need to be taken for the prescribed length of time. Though the fungus should be killed during that time, it will take six months to one year for a new, healthy toenail to grow in and replace the infected one. Even with treatment, reinfection is possible, so it is important to take steps to limit your future exposure to fungus.
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