Nail fungus, also known as onychomycosis, is a common infection that affects the toenails or fingernails. It’s caused by various types of fungi, most commonly dermatophytes. Nail fungus can cause the nail to become discolored, thickened, and brittle. In some cases, the nail may separate from the nail bed. Beyond the physical symptoms, nail fungus can impact your self-esteem and overall quality of life.
One of the most common treatments for nail fungus is an oral antifungal medication called terbinafine, sold under the brand name Lamisil. While topical antifungal medications are also available, oral medications like Lamisil are often more effective for treating severe or persistent infections.
If you’re considering using Lamisil to treat your nail fungus, it’s important to understand the potential benefits and risks. This article provides a comprehensive overview of Lamisil, including its uses, dosage, potential side effects, and important warnings. It’s designed to give you a solid understanding of what to expect if your doctor prescribes Lamisil for your nail fungus and help you make informed decisions about your treatment options. Remember to always consult with your doctor or other qualified healthcare provider before starting any new medication.
What is Lamisil and how does it work?
Lamisil is an antifungal medication prescribed for infections of the fingernails and toenails.
Lamisil is a brand name. The active ingredient in Lamisil is terbinafine hydrochloride.
Lamisil is usually available in a 250 mg oral tablet.
How Lamisil works
Lamisil works by interfering with the way fungi grow and thrive. It’s like cutting off their food supply.
Terbinafine, the active ingredient, targets an enzyme called squalene epoxidase. This enzyme is essential for fungi to create their cell membranes. Without it, they can’t build healthy cell walls.
Specifically, terbinafine stops the fungus from producing ergosterol. Ergosterol is a crucial building block for fungal cell membranes.
Without ergosterol, the fungal cell membranes become weak and leaky. Eventually, the fungus dies.
Because Lamisil targets a process specific to fungi, it doesn’t harm human cells. This makes it an effective treatment for nail fungus infections, as it can kill the fungus without causing significant side effects in the person taking the medication.
How to use Lamisil
Always follow the instructions of your doctor when taking any medication. Be sure to ask your doctor any questions you have about Lamisil.
Approved Uses
Onychomycosis (Nail Fungus)
Lamisil’s main job is to treat fungal infections in your toenails and fingernails, also known as onychomycosis. Typically, the treatment lasts for 6 weeks if you’re treating fingernails and 12 weeks if you’re treating toenails. Even after the fungus is gone, it can take months for you to see the full results.
Other Fungal Infections (Off-Label Uses)
Sometimes, doctors prescribe Lamisil “off-label” to treat other fungal infections, such as:
- Tinea pedis (athlete’s foot)
- Tinea corporis (ringworm)
- Tinea cruris (jock itch)
- Tinea capitis (scalp ringworm)
- Sporotrichosis
Dosage and Administration
Standard Dosage for Onychomycosis
The usual dose is one 250 mg tablet per day.
Dosage Adjustments
If you have kidney or liver problems, your doctor might need to change the dose. Be sure to talk to your doctor about the right dosage for you.
Important Instructions
Here are a few things to keep in mind when taking Lamisil:
- Take Lamisil exactly as your doctor tells you to.
- Don’t crush, chew, or break the tablets. Swallow them whole.
- You can take it with or without food.
Potential Side Effects of Lamisil
Like all medications, Lamisil carries the risk of side effects, some of which can be serious. It’s important to be aware of these potential issues before starting treatment.
Common Side Effects
During clinical trials, people taking Lamisil reported experiencing these side effects most often:
- Headache
- Diarrhea
- Dyspepsia (indigestion)
- Abdominal pain
- Nausea
- Rash
- Pruritus (itching)
- Taste disturbances
If you experience any of these side effects and they become bothersome or don’t go away, talk to your doctor or pharmacist.
Serious Side Effects
Although less common, some serious side effects have been linked to Lamisil use. These require immediate medical attention.
Hepatotoxicity (Liver Damage)
Lamisil has the potential to cause liver damage, including, in rare cases, liver failure. Watch out for symptoms like:
- Nausea
- Vomiting
- Abdominal pain
- Jaundice (yellowing of the skin and eyes)
- Dark urine
- Unexplained fatigue
Contact your doctor right away if you notice any of these signs.
Severe Skin Reactions
In rare instances, serious skin reactions like Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) have been reported with Lamisil. Symptoms include rash, blistering, and peeling skin. These reactions can be life-threatening and require immediate medical intervention.
Other Serious Side Effects
Other serious, though less common, side effects associated with Lamisil include:
- Allergic reactions (Drug Reaction with Eosinophilia and Systemic Symptoms, or DRESS syndrome)
- Depressed mood
- Blood disorders (low levels of lymphocytes or neutrophils)
- Lupus
- Thrombotic microangiopathy (TMA), a condition affecting small blood vessels
Post-Marketing Experience
Since Lamisil has been available for wider use, some people have reported experiencing taste and smell disturbances, including loss of taste and/or smell. This is something to be aware of, although it is not a common side effect.
Warnings and Precautions
Like any medication, Lamisil comes with a list of warnings and precautions. Be sure you understand them before you take the medication.
Contraindications
You should not take Lamisil if you have:
- Liver disease, either chronic or active
- Kidney problems (renal impairment). Use Lamisil cautiously if your creatinine clearance is less than 50 mL/min.
- Had a previous allergic reaction or hypersensitivity to terbinafine or any of the inactive ingredients in Lamisil
Special Warnings and Precautions
Here are some special warnings and precautions to keep in mind if you’re taking Lamisil:
- Hepatotoxicity: Lamisil can sometimes cause liver problems. Your doctor should check your liver function with tests during your treatment. If liver abnormalities develop, you’ll need to stop taking Lamisil.
- Taste and smell disturbances: Some people have reported changes in their sense of taste and smell, including losing those senses completely. If this happens, stop taking Lamisil.
- Depressive symptoms: Lamisil might cause depression in some people. Be aware of mood changes and tell your doctor if you feel depressed.
- Hematologic effects: Lamisil can affect your blood. If you have a pre-existing blood disorder, your doctor should check your complete blood counts.
- Serious skin/hypersensitivity reactions: If you have a severe skin reaction or allergic reaction, stop taking Lamisil.
- Photosensitivity: Terbinafine can make your skin more sensitive to the sun. Protect yourself from the sun while you’re taking this medication by wearing sunscreen and protective clothing.
Drug interactions
Before you take any new medication, it’s always a good idea to look at the list of possible drug interactions. Lamisil is no different.
CYP450 enzyme interactions
When you take Lamisil, your body breaks it down using enzymes called CYP450s. Some drugs can either speed up or slow down these enzymes. If the enzymes slow down, the level of terbinafine in your blood could get too high. If the enzymes speed up, the level of terbinafine in your blood could get too low.
For example, CYP2D6 inhibitors may increase terbinafine levels, and rifampin (a CYP450 inducer) may decrease terbinafine levels.
Specific drug interactions
Lamisil can interact with drugs such as:
- antidepressants
- beta-blockers
- MAO-B inhibitors
- blood thinners
This list isn’t exhaustive, so you should always talk to your doctor or pharmacist about all the medications you’re taking before starting Lamisil.
The importance of telling your doctor everything
It’s really important to tell your healthcare provider about all the medications you’re taking, including prescription drugs, over-the-counter meds, vitamins, and herbal supplements. This will help them make sure Lamisil is safe for you and won’t cause any unexpected problems.
Lamisil: Special populations
If you’re considering using Lamisil, it’s important to know how it might affect certain populations.
Pregnancy
The FDA categorizes medications by how safe they are to take during pregnancy. Lamisil is in Pregnancy Category B, meaning that animal studies didn’t show a risk to the fetus, but there haven’t been enough well-controlled studies in pregnant women to know for sure.
Because of the uncertainty, it’s best not to use Lamisil during pregnancy unless the benefit clearly outweighs the risk.
If you’re pregnant or trying to get pregnant, talk to your doctor about the risks and benefits of using Lamisil.
Breastfeeding
If you’re breastfeeding, it’s important to know that terbinafine, the active ingredient in Lamisil, can pass into breast milk. It’s not known for sure whether terbinafine can harm a nursing infant.
Talk with your doctor about the risks and benefits of using Lamisil while breastfeeding. You and your doctor can decide whether the benefits of breastfeeding outweigh the possible risks to your baby.
Children
Lamisil oral granules are sometimes used to treat a fungal infection of the scalp called tinea capitis in children 4 years and older. However, the safety and effectiveness of Lamisil for treating nail fungus in children has not been established.
Older adults
If you’re an older adult, your doctor may prescribe Lamisil with caution. Older adults may be more likely to have side effects from the medication. For example, older adults may be more likely to have liver problems while taking Lamisil.
Frequently Asked Questions
Why is nail fungus so difficult to get rid of?
Nail fungus is notoriously stubborn because the infection resides deep within the nail bed, making it hard for topical treatments to penetrate effectively. Additionally, nails grow slowly, so it takes a long time for new, healthy nail to replace the infected portion. Systemic treatments (oral medications) are often needed for complete eradication.
What is the best antifungal tablet for nail fungus?
The “best” antifungal tablet varies depending on individual factors like health history, potential drug interactions, and the specific type of fungus. Common options include terbinafine (Lamisil), itraconazole (Sporanox), and fluconazole (Diflucan). A doctor can determine the most suitable medication for you.
How do I get rid of nail fungus ASAP?
There’s no truly “ASAP” cure for nail fungus. Even with the most effective treatments, it takes time for the nail to grow out. Oral antifungal medications generally offer the fastest results, but they still require weeks or months of treatment. Consistency and adherence to your doctor’s instructions are key.
Does Lamisil get rid of nail fungus?
Lamisil (terbinafine) is a commonly prescribed oral medication for nail fungus and is often effective. However, it doesn’t work for everyone, and success rates vary. It’s crucial to complete the full course of treatment as prescribed by your doctor to maximize the chances of clearing the infection.
What happens if you have toenail fungus for too long?
If left untreated, toenail fungus can worsen, causing pain, thickening of the nail, and potential spreading to other nails or even the skin. In severe cases, it can lead to difficulty walking or wearing shoes. Furthermore, it can become a chronic condition and more difficult to treat the longer it persists.
Wrapping Up
Lamisil (terbinafine) is a prescription antifungal medication that can treat nail fungus. The length of time you’ll need to take it depends on the severity of the infection, but it’s important to take it exactly as prescribed.
Before starting Lamisil, talk with your doctor, especially if you have any existing health conditions or take other medications. Your doctor can help you understand the risks and benefits of Lamisil and determine if it’s the right treatment for you.
It’s also vital to watch for side effects while taking Lamisil and to tell your doctor right away about anything unusual. While it can be an effective treatment, like any medication, Lamisil carries some risks, and you should be aware of them before you start taking it.