Oral Antifungal Medications

What are oral antifungal medications?

Oral antifungal medications, such as terbinafine, itraconazole, and fluconazole, serve as potent agents for treating fungal infections when topical alternatives are insufficient or impractical. These medications are particularly beneficial for treating extensive or severe cases, such as widespread tinea infections, invasive fungal infections, or onychomycosis (nail fungal infections). They can also be utilized for treating fungal infections that have penetrated deeper structures, like hair follicles, which topical treatments may not effectively reach.

What are possible side effects of oral antifungal medications?

The side effect profile for oral antifungal medications includes the potential for drug interactions, necessitating an updated medication list and possibly discontinuation or adjustment of concomitant medications. Additionally, these medications can exert hepatotoxic effects, meaning they can harm the liver. Therefore, regular liver function tests are often required to monitor for any adverse impact on liver health. Patients should be made aware of symptoms of liver dysfunction, such as jaundice, dark urine, or unexplained fatigue, and should report these immediately to their healthcare provider.

How are oral antifungal medications used?

The dosing regimen for oral antifungals varies depending on the type and severity of the infection, as well as any existing comorbidities. Some infections may respond well to "pulse dosing," where the medication is taken intermittently (e.g., once a week), while others may require daily dosing for a more aggressive approach. Daily dosing is generally more efficacious but requires closer monitoring, including periodic liver function tests. Pulse dosing, on the other hand, may provide a balance of efficacy and safety, potentially negating the need for as frequent liver monitoring.