Prescription Medication for Toenail Fungus

Fungal nail infections are notoriously difficult to treat. Unfortunately, while early treatment is the most effective, most people don’t recognize or look for the early symptoms. By the time they experience enough discomfort to prompt a trip to the doctor, the nail infection often has passed the mild stage and moved into the territory where it has become difficult to treat. There are a variety of toenail fungus medications available with a variety of success rates and side effects.

When a doctor selects a type of toenail fungus medication to treat an infection, he has two types of drugs to choose from: oral prescription medications and topical prescription treatments. The problem with both is that the toenail fungus cure rate is low and the side effects can be serious. Here’s a look at the medications currently being prescribed to treat fungal nail infections.

Oral Toenail Fungus Medications

There are three oral nail fungus medications on the market. Two of these drugs (Lamisil and Sporanox) are approved by the FDA to treat fungal nail infections. The other drug (Diflucan) is FDA approved to treat other conditions, but not approved to specifically treat a fungal nail infection. All of the oral medications prescribed for a nail fungus infection have significant side effects, the most serious of which is potential liver damage. Everyone who takes these prescriptions must be monitored for liver and blood cell function on a regular basis. These drugs as a whole have a less than 50% percent cure rate.

1. Lamisil (Terbinafin)


Of the three oral antifungal medications, FDA approved Lamisil seems to have the best cure rate for treating dermatophytes, the common fungus responsible for nail fungal infections, but it has also the most severe side effects. This medication works by inhibiting the enzyme responsible for allowing the fungus to growth. Prescribed in 250 mg doses, it is taken for at least six weeks for fingernail fungal infections and a minimum of twelve weeks for toe nail fungal infections.

The most common side effects experienced while taking Lamisil include gastrointestinal problems such as:

  • Diarrhea
  • Abdominal pain
  • Indigestion

Of even greater concern is the damage that it can cause to the liver. It is suspected to have caused such severe liver damage in some patients that they required a liver transplant or even died. Patients who take Lamisil are advised to watch for liver damage symptoms such as:

  • Jaundice
  • Nausea
  • Loss of appetite
  • Taste disturbance
  • Stomach pain
  • Itching
  • Dark urine
  • Clay-colored stools

Of those who are able to take Lamisil almost half report a cure.

In addition to side effects, Lamisil can interact with other common drugs such as tricyclic antidepressants, selective serotonin reuptake inhibitors, beta-blockers and monoamine oxidase inhibitors Type B. Anyone that is pregnant or suffers from kidney disease or immune system deficiencies should not take Lamisil.

2. Sporanox (Itraconazole)


Sporanox or Itraconazle is used to treat yeast and fungal infections including fungal infections of the mouth (thrush), esophagus (esophageal candidiasis), lungs (aspergillosis), and nails. This oral prescription drug is FDA approved and works by killing the fungus and inhibiting its growth. Doses vary with the individual and the seriousness of the infection.

The most common side effects for this nail fungus medication include:

  • Nausea or vomiting
  • Diarrhea
  • High blood pressure (hypertension)
  • Convulsions
  • Fever
  • Irregular heartbeat
  • Shortness of breath
  • Increased thirst
  • Dark urine
  • Loss of appetite
  • Mood changes
  • Muscle pain or cramps
  • Numbness or tingling in the hands, feet, or lips
  • Unusual tiredness or weakness

3. Diflucan (Fluconazole)


Diflucan is a medication that is used to treat a variety of fungal yeast infections but it has not been approved by the FDA to treat nail fungal infections. It is commonly used to treat Candida yeast infections such as vaginal yeast infections, urinary tract yeast infections, peritonitis, pneumonia and cyptococcal meningitis.

Side effects are less severe with Diflucan than either Lamisil or Sporanox, but it is also less effective used as a nail fungus medication. Some of the side effects include:

  • Nausea
  • Diarrhea
  • Stomach pain
  • Headache
  • Dizziness
  • Hair Loss
  • Temporary hepatic (liver) reactions

Topical Toenail Fungus Medications

There are several prescription topical antifungal medications that are prescribed for the treatment of a fungal nail infection. Unfortunately, they have a very low success toenail cure rate and are most likely to produce a cure when used in the very earliest stages of the infection. As the condition worsens, topical nail fungus medications are less effective and even they have side effects.

1. Penlac (Ciclopirox) Nail Lacquer

Penlac Nail LacquerPenlac is an antifungal medication used to stop the growth of fungus. As a cream it is used to treat athlete’s foot, ringworm, jock itch and minor fungal infections of the nail. Penlac Nail lacquer is brushed on to the surface area of the affected nail, the underside of the nail and the skin beneath the nail. It should be left on for eight hours before showering. The most common side effects include burning and itching at the site. Cure rates range from 9% to 36%.

2. Loceryl (Amorolfine) Nail Lacquer

Loceryl has not yet been approved by the FDA. In mild cases Loceryl has been shown to have a 40% cure rate, but in more severe cases the cure rate falls off dramatically. It is applied by brush once or twice a week to the infected nail area for up to six months. Like Penlac, the side effects of Loceryl are localized to the site and include burning, itching, scaling and dry skin.




Conclusion & Recommendation

In conclusion, the prescription nail fungus medications on the market have a low cure rate and are fraught with side effects. The oral prescription medications present the most concern to the user with the serious risk of long term damage to the liver. It is important to consider all of the risks before taking any nail fungus drug.

From among all the treatments covered by our study, two natural remedies met our requirements and achieved a high success rate. These products, Zetaclear and Funginix, are free of side effects, very effective for most people, and affordable. Both are approved by the FDA. Click here to learn how these toenail fungus treatments can help you.


We recommend the use of Loceryl on Superficial white Onychomycosis, however it doesnt appear to be that effective on deeper nail fungus.



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