Onychomycosis, a fungal infection of the nail, affects millions of people worldwide. It’s estimated that about 5% of the global population deals with this condition, and it accounts for a large percentage of all nail problems. Onychomycosis isn’t just a cosmetic issue; it can really affect a person’s quality of life.
Treatments for onychomycosis have traditionally included topical antifungals, oral medications, and even surgical removal of the nail. However, these methods often have drawbacks, leading to less-than-ideal results.
Enter tavaborole, a new topical treatment for toenail onychomycosis. The tavaborole brand name is KERYDIN. It’s part of a class of antifungals called oxaboroles, and it offers a topical alternative that may have fewer systemic side effects than taking pills. That’s a big plus for people who want to avoid the potential risks associated with oral medications.
This article will provide a detailed look at tavaborole (KERYDIN), including how it works, how effective it is, its safety profile, and where it fits into the overall treatment landscape for onychomycosis. We’ll explore the science behind this medication and help you understand if it might be a good option for you or someone you know.
How does tavaborole work?
The active ingredient in tavaborole nail lacquer, tavaborole, works by stopping the fungus from making proteins. Here’s how it works:
Inhibition of fungal protein synthesis
Tavaborole targets and inhibits an enzyme called leucyl-transfer RNA synthetase (LeuRS). This enzyme is super important for fungi to be able to produce proteins. Without it, they can’t grow or thrive.
Specificity and target
Tavaborole works by attaching to LeuRS, which messes up the fungus’s ability to make proteins. This ultimately kills the fungus. Because it targets LeuRS, tavaborole is less likely to affect other processes in the body.
How does it get into my body?
When you apply tavaborole to your toenail, it gets absorbed into the nail plate and the skin underneath the nail (the nail bed). In one study, researchers measured the amount of tavaborole in people’s blood after they applied it to their toenails.
They found that the average peak concentration (Cmax) of tavaborole after a single dose was 3.5 ± 2.3 ng/mL. The average AUClast (a measure of drug exposure over time) was 44.4 ± 25.5 nghr/mL.
How does my body get rid of it?
Tavaborole is mainly eliminated through the kidneys, where it’s broken down into metabolites and then excreted in urine.
Does it affect my heart?
Tavaborole isn’t expected to mess with your heart rhythm. Studies have shown that it doesn’t prolong the QTc interval, which is a measure of electrical activity in the heart.
How well does tavaborole work?
The effectiveness of tavaborole topical solution, 5% (Kerydin) has been tested in clinical trials.
Pivotal clinical trials
Two multicenter, double-blind, randomized, vehicle-controlled Phase 3 trials looked at how well Kerydin worked and how safe it was. A “vehicle” is a cream or ointment without any medicine in it, so comparing Kerydin to a vehicle helps researchers see if the drug is really working.
There were 1,194 people in the trials (795 used Kerydin, and 399 used the vehicle). They were between 18 and 88 years old, mostly male (82%), and mostly white (84%).
The trials measured “complete cure,” “almost complete cure,” and “mycologic cure” rates.
Efficacy results
Here’s what the trials found:
- Complete Cure Rates: In the first trial, 6.5% of people using Kerydin were completely cured, compared to only 0.5% using the vehicle. In the second trial, 9.1% of people using Kerydin were completely cured, compared to 1.5% using the vehicle.
- Complete or Almost Complete Cure Rates: In the first trial, 15.3% of people using Kerydin were completely or almost completely cured, compared to 1.5% using the vehicle. In the second trial, 17.9% of people using Kerydin were completely or almost completely cured, compared to 3.9% using the vehicle.
- Mycologic Cure Rates: In the first trial, 31.1% of people using Kerydin had a mycologic cure (meaning the fungus was gone), compared to 7.2% using the vehicle. In the second trial, 35.9% of people using Kerydin had a mycologic cure, compared to 12.2% using the vehicle.
What does this data mean?
The results showed that tavaborole significantly improved cure rates compared to the vehicle. In other words, it worked better than nothing.
The complete cure rates might seem low, but tavaborole is still a useful option, especially for people who can’t take or don’t want to take oral medications, which can have more side effects.
It’s important to remember that everyone is different, and what works for one person might not work for another. Talk to your doctor to see if tavaborole is right for you.
Safety and tolerability of tavaborole
Like all medications, tavaborole can cause side effects.
Common side effects
The most common side effects of tavaborole are application site reactions, such as:
- skin peeling
- ingrown toenail
- redness
- skin inflammation
In clinical trials of KERYDIN, the following percentages of people experienced these side effects, compared to the group using the vehicle (the inactive ingredients):
- Skin peeling: 2.7% with KERYDIN vs. 0.3% with the vehicle
- Ingrown toenails: 2.5% with KERYDIN vs. 0.3% with the vehicle
- Redness: 1.6% with KERYDIN vs. 0% with the vehicle
- Skin inflammation: 1.3% with KERYDIN vs. 0% with the vehicle
These side effects occurred in at least 1% of people using KERYDIN at a greater rate than they occurred in people using the vehicle.
Managing side effects
If you experience any of these side effects, talk with your doctor. Mild topical corticosteroids may help manage any skin reactions at the application site.
Your doctor will want to monitor you for persistent irritation. If irritation doesn’t improve, you may need to stop treatment.
Precautions
Keep these things in mind when using tavaborole:
- KERYDIN is flammable. Keep it away from heat and flame.
- Keep the bottle tightly closed when you’re not using it.
- Throw away the product within 3 months of inserting the dropper into the bottle.
Tavaborole compared to other treatments for onychomycosis
There are many ways to treat onychomycosis. Here’s a look at how tavaborole stacks up.
Systemic antifungal agents
Oral medications like terbinafine and itraconazole are common treatments for nail infections.
These systemic agents tend to have higher cure rates, but they also come with a higher risk of side effects that can affect your whole system, not just your toes.
Topical antifungal agents
Besides tavaborole, which is similar to other topical options, there are other topical options, too.
Ciclopirox
Ciclopirox olamine 8% lacquer is another topical treatment you paint on your nails.
One study showed that it resulted in clinical improvement in about 63% of patients, with a mycologic cure (meaning the fungus was gone) in about 54% of patients.
Efinaconazole
Efinaconazole is another topical solution that’s a triazole antifungal.
Cure rates for efinaconazole ranged from about 15% to 25%, with the fungus gone in about 53% to 87% of cases.
How does tavaborole compare?
Tavaborole is a topical treatment, which means it doesn’t expose your whole body to the medication, which is an advantage.
But topical treatments usually don’t cure the infection as often as oral medications do.
Tavaborole might be a good choice if you have a mild to moderate infection or if you can’t take oral medications.
What’s next?
Researchers are always looking for better ways to treat onychomycosis.
One idea is to combine topical and oral treatments to improve cure rates.
Another is to develop new ways to deliver the medication more directly to the infection.
Practical Considerations for Using Tavaborole (Kerydin)
Here are some key points to keep in mind when using tavaborole (brand name Kerydin) for toenail fungus.
Dosage and Administration
The instructions for using Kerydin are straightforward:
- Apply Kerydin to the entire surface of the affected toenail, including under the tip, once a day for 48 weeks.
- Proper application is key for the best results. Make sure you understand how to apply it correctly.
- Wash your hands thoroughly after applying Kerydin.
Patient Counseling
When starting treatment with Kerydin, it’s important to:
- Emphasize that consistent, daily application for the full 48-week treatment period is essential. Don’t skip doses!
- Be aware of potential side effects and know how to manage them. Talk to your doctor or pharmacist if you have any concerns.
- Have realistic expectations. Understand that cure rates vary, and it may take time to see improvement. Toenails grow slowly, so be patient and manage expectations, especially when considering treatments such as Kera Nail Gel.
Contraindications
There are some situations where you should NOT use tavaborole:
- If you have a known allergy or sensitivity to tavaborole or any of the other ingredients in the medication.
- Avoid contact with your eyes, mouth, and vagina. Kerydin is for toenails only! If it gets in these areas, rinse thoroughly with water.
Frequently Asked Questions
What is another name for tavaborole?
Tavaborole is the generic name for the medication, but it’s primarily known by its brand name, Kerydin. So, while tavaborole is the active ingredient, Kerydin is the commercially available product you’d find at the pharmacy.
What does Mayo Clinic recommend for toenail fungus?
The Mayo Clinic typically recommends a multi-faceted approach to treating toenail fungus, including prescription antifungal medications (oral or topical), proper foot hygiene, keeping nails trimmed and filed, and addressing any underlying medical conditions that might contribute to the infection. Always consult with a healthcare professional for personalized advice.
Is tavaborole the same as Kerydin?
Yes, tavaborole is the same as Kerydin. Kerydin is simply the brand name under which tavaborole is sold. Think of it like acetaminophen and Tylenol – same active ingredient, different name and marketing.
How effective is tavaborole for toenail fungus?
While tavaborole (Kerydin) can be effective for treating toenail fungus, its success rate varies. Studies have shown it can clear the infection in some individuals, but it often takes several months of consistent application to see results, and complete cure rates aren’t always guaranteed. Factors like the severity of the infection and individual response to the medication play a role in its effectiveness. Talk to your doctor about whether Kerydin is right for you and what to expect.
Wrapping Up
Tavaborole, sold under the brand name Kerydin, is a topical treatment option for onychomycosis, or nail fungus. It’s a useful tool to have, offering a way to treat nail fungus without taking oral medications.
While tavaborole is generally safe, it may not work as well as oral medications for clearing up the infection. It’s important to talk to your doctor about the pros and cons of all available treatments to decide what’s right for you.
When deciding on a treatment, your doctor will consider how bad the infection is, your preferences, and any risks and benefits that might apply to you.
Scientists are constantly working on new ways to treat onychomycosis, including better ways to deliver drugs and combinations of different treatments. This research may lead to even better results for people with nail fungus in the future. If Kerydin doesn’t work for you, don’t give up hope. There may be new and better treatments available soon.