Tablets against nail fungus


Along with athlete's foot, nail fungus is one of the most common fungal infections in Central Europe.

The cause are usually fungi from the family of the sprout or filamentous fungus. In rare cases, however, yeasts or molds can also lead to the development of such nail changes.
The pathogens of the nail fungus multiply mainly in moist and warm areas of the body. For this reason, the spaces between the toes and the nail region represent the ideal habitat for these pathogens. In addition, the pathogens responsible for nail fungus also like to colonize the groin, armpits and sweaty skin folds. In the case of fungus on the feet, it can be seen that the fungus often develops on the basis of a common athlete's foot infection. However, nail fungus can also be triggered by a direct infection of the nails.

People who are often in public swimming pools, saunas, fitness studios, showers or changing rooms and walk around there without suitable footwear are particularly at risk. Regular and proper disinfection of hands and feet can, however, effectively prevent infection.

In addition, it can be shown that certain systemic diseases favor the development of fungal diseases in general and the formation of nail fungus in particular. In particular, patients who suffer from diabetes mellitus or circulatory disorders are more likely to develop nail fungus.
In addition, the risk of fungal infections increases with age. This can be explained by the fact that a decreasing immune sovereignty of the body makes it more susceptible to fungal spores.

Nail fungus is transmitted through smear and contact infection. This means that the responsible pathogens can be transmitted either directly from person-to-person or indirectly via the common use of objects.

Typical symptoms of a fungal infection of the nails are yellow, whitish or brown discoloration of the nail plate. In addition, affected patients complain of enormous fragility of the affected nail. A nail infected by nail fungus will in most cases increase in thickness.

Read more on this topic at: Medicines for nail fungus

Tablets for nail fungus

Nail fungus can be treated in several ways. When it comes to the question of which form of therapy is best for the respective patient, both stage, as well as that Extent of fungal infection be taken into account.
In early stages can simple home remedies get great results. However, once a Most of the nail bed (more than 70%) can use home remedies and special paints no longer achieve a sufficient effect. The reason for this is the fact that the infected nail bed ensures that the newly forming nails immediately infected by the fungus.

Treatment of nail fungus can only be carried out over the once the nail bed is affected oral administration of tablets respectively. The ingredients of these tablets can be different Antifungal drugs (fungicidal substances) be. These active ingredients are stored in the Area of ​​the nail root into the newly formed nail substance. This way the fungal spores will leak into the fresh ones nail be prevented. So completely healthy, fungus-free nail substance can grow back over time.

When using tablets to treat nail fungus, however, it is essential to ensure that they are taken regularly, without interruption. In addition, the nail fungus tablets must be taken until the infected nail has been completely replaced by healthy nail substance. For this reason, the application period can be several weeks. In the case of infected fingernails, this can take anywhere from three to six months. Toenails usually grow much more slowly, the duration of treatment is correspondingly longer.

Different tablets against nail fungus

Various active ingredients are available for internal treatment of nail fungus and are administered as tablets. The main ingredients are fluconazole, itraconazole and terbinafine. These active ingredients differ partly in their mechanism of action and in their respective side effects. What they have in common, however, is their effectiveness against fungi, which are known as dermatophytes. Such dermatophytes are the most common cause of nail fungus. Only in very rare cases are yeasts or molds responsible for nail fungus. However, itraconazole and fluconazole are also effective against yeasts.

The active ingredients exist as tablets from different manufacturers and in different dosages. The active ingredient contained is the same, regardless of the manufacturer. Fluconazole is available, for example, as "Fluconazole Ratiopharm" in doses of 50, 100 and 150 mg. The usual dose for a fungal nail attack is 150 mg once a week until a healthy nail has grown back. The active ingredient itraconazole is available, for example, as "Itraconazole AL 100mg" in tablet form. The last active ingredient terbinafine is also available in hard capsule form from various manufacturers in various dosages. An example of a terbinafine tablet is “Terbinafine AL 250 mg”.

How long must the tablets be taken?

The duration of intake and the dosage regimen vary from active ingredient to active ingredient and therefore cannot be given across the board. In most cases, however, an intake of several weeks - sometimes with interruptions - is necessary until the affected nail has been replaced with a new nail by the natural growth.

The active ingredient itraconazole in a dosage of 100 mg can be taken on an interval as well as on a continuous basis. With interval therapy, 200 mg itraconazole are taken twice a day for a week. This is followed by a 3 week break. As a rule, 3 intervals, i.e. 3 months, are sufficient for successful treatment. The continuous scheme also lasts 3 months with a continuous intake of 200 mg itraconazole per day.

Therapy with terbinafine also usually lasts between 6 weeks and 3 months. In rare cases, an intake of up to 6 months may be necessary.

Therapy with fluconazole tablets should be continued until the affected nail has been replaced by natural growth with a healthy nail.Therefore, the duration can vary from person to person with different dosages and different growth rates, but several weeks to months are to be expected.

Can a strong nail fungus also be treated with tablets?

In particular, a strong nail fungus must be treated with tablets. Such a therapy is also called systemic. In the case of mild nail fungus, local measures such as the use of a special nail polish and cream are often sufficient. A stronger fungal infestation must, however, also be treated systemically, otherwise an infection of the lower leg (erysipelas) can occur as a complication. Therapy with tablets must, however, always be accompanied by hygiene measures, such as disinfecting the shoes, in order to ensure the success of the therapy. Factors that favor nail fungus, such as diabetes mellitus, should also be treated.

Side effects

Taking pills for nail fungus is not entirely safe. Antifungal drugs taken orally have a number of adverse drug effects. Common side effects of the tablets against nail fungus are disorders in the gastrointestinal tract. Many patients complain of occasional abdominal pain or nausea during use. Tablets used to treat nail fungus can also cause headaches and dizziness. The occurrence of mild to moderate skin rashes is also not uncommon. In rare cases, the liver can also be affected. If there is a noticeable increase in liver values ​​(liver enzymes), therapy should be stopped immediately and an alternative medication should be taken. Both patients with liver disease and children should not be treated with some antimycotics (e.g. azoles) at all.
Other active substances in this group of drugs (amphotericin B) can damage the kidneys and should therefore not be prescribed for patients with renal insufficiency. In addition, when taking pills for nail fungus, there is a risk of destruction of various blood cells. The blood should therefore be tested at regular intervals while using these drugs. In addition, nail fungus tablets can affect the effectiveness of other medicines. For this reason, if you are using several medications, you should consult a doctor before you start taking the antimycotic. In general, it can be said that treating nail fungus with home remedies, varnish or creams is much more gentle than using tablets.

The following section is intended to provide a clear overview of the most important side effects of the various tablets against nail fungus.

Tablets with the active ingredient fluconazole

The active ingredient fluconazole is usually well tolerated. Nevertheless, side effects can occur. Fluconazole can cause headaches, nausea, diarrhea, abdominal pain, and stomach upset. Occasionally (affects 1 in 1,000 people), there may be a reduction in red blood cells, liver damage, hives, decreased appetite and difficulty sleeping. Rarely, severe rashes as an expression of an allergic reaction can occur.

Find out more about this: Hives

Tablets with the active ingredient itraconazole

Treatment with the active ingredient itraconazole can also have side effects. Itraconazole can often lead to gastrointestinal complaints such as stomach pain and nausea. Occasionally, vomiting, diarrhea, and flatulence occur. In addition, the liver values ​​(liver enzymes) and bilirubin are occasionally increased. Rashes and occasionally hives, hair loss and itching can occur. A severe allergic reaction or severe liver damage is considered a severe complication. However, these occur very rarely.

Tablets with the active ingredient terbinafine

The most common side effects of treatment with terbinafine include headache and decreased appetite. Furthermore, similar to therapy with fluconazole or itraconazole, symptoms of the gastrointestinal tract, including digestive disorders, nausea, mild abdominal pain, diarrhea and flatulence, are common. A fleeting rash and hives are also common. In rare cases, liver dysfunction, muscle and joint pain and allergic reactions can occur.

How harmful are nail fungus tablets?

In addition to being effective against a specific disease, active pharmaceutical ingredients unfortunately also have side effects and contraindications in common. Some drugs are better at this, others less well tolerated. To speak of harmfulness is inappropriate in this context. When used properly, nail fungus tablets are not harmful. Side effects and in rare cases also complications can, however, occur and not be foreseen even with correct use when all contraindications are observed. One possible complication or serious side effect common to all nail fungus tablets is damage to liver function. In the most severe cases, this can be accompanied by very severe damage. However, it must be emphasized that this is very rarely the case. Therefore, these tablets must not be taken if the liver is previously damaged. Another dangerous but very rare complication is a severe allergic reaction, which can be accompanied by skin damage or shortness of breath. In some cases, pills for nail fungus can cause changes in the blood count, but these are also rare and also reversible.

Are the tablets available without a prescription or only available on prescription?

Antifungal Active ingredients (active ingredients against fungi) are partly available without a prescription, partly only upon presentation of a prescription. However, the following rule applies to antimycotic tablets for oral use: They always require a prescription. Caution is advised with what are supposedly prescription-free offers from the Internet. Reputable mail-order pharmacies do not offer antifungal tablets without a prescription. The situation is often different with antifungal ointments, creams or nail polishes. These are also available without a prescription.

Antimycotics, like other active ingredients, are drugs that have good effects, but can also have side effects and may not be used for some pre-existing diseases. In addition, not every antifungal tablet is effective against every fungus. It is therefore necessary that a doctor can first assess which drug is likely to be effective and well tolerated for the individual patient.

Can a nail polish be used parallel to the tablets?

An antifungal nail polish can often be used in addition to systemic therapy with nail fungus tablets. Whether this is useful should ultimately be decided individually after consulting a doctor. However, it should be noted that there is a contraindication to the widely used antifungal cyclopirox nail polish during pregnancy.

Taking tablets against nail fungus and alcohol consumption

The question of whether while taking tablets against nail fungus Drank alcohol is allowed to be very controversial. In general, it should be assumed that the pathogens responsible for nail fungus are microorganisms, the growth of which can be influenced by various measures. For this reason, some experts recommend a fungal infection, such as nail fungus to adhere to a special diet. In this context, the Reduction of glucose content play a crucial role. In this way the multiplication of the nail fungus can be inhibited. People that Tablets against nail fungus should take for this reason urgently on the consumption of sugary alcohol (e.g. mixed drinks) dispense. In addition, the effect of nail fungus tablets can be inhibited by the consumption of alcohol such as beer, wine, sparkling wine, liqueur or schnapps.

Figure nail fungus

Figure: healthy nail (A) and nail fungus symptoms (B)

Nail - Unguis

  1. Free edge (of the nail) -
    Margo liber
  2. Cover fabric of the nail bed -
  3. Nail plate -
    Lamina unguis
  4. Nail fold - Matric sulcus
  5. "Moondchen" - Lunula
  6. Horny layer of the nail wall -
  7. Distal phalanx -
    Phalanx distalis
  8. Nail root - Margo occultus
    Nail fungus -
    Onychomycosis, Tinea unguium
    Nail fungus symptoms
  9. Brittleness,
    Crumbling of the nail
  10. Thickening of the nail
  11. Whitish, yellow or
    gray-brown spots in the nail
  12. White or yellowish
    Discoloration on the edge of the nail
  13. Dullness of the nail
  14. Chipping of the nail

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