Common brand names: Micatin. How it works: Miconazole halts and prevents fungal growth by inhibiting an enzyme. How and when to use: Apply the cream, lotion, spray or powder twice a day for four weeks. Important information: See a healthcare provider if irritation or blisters develop.

Active ingredient: Undecylenic acid. Common brand names: Blis-To-Sol liquid, Cruex. How it works: Undecylenic acid is an antifungal fatty acid that kills fungus and stops it from growing on the skin. How and when to use: Use undecylenic acid two times a day for four weeks.

Important information: Irritation and other possible adverse effects are rare. Your visible symptoms may disappear before the condition is actually cured.

Continue to use your antifungal medication for the recommended time period, even if your fungus appears to be cured. The following tips can help you get a safe and effective application of your athlete's foot medication:. As you go on with your day:.

Over-the-counter topical antifungal medications are a good option for mild cases of athlete's foot. But if your athlete's foot doesn't get better after about four weeks, it's time to see a healthcare provider. You may need prescription topical antifungal medications , which are stronger and more effective than anything available OTC.

Furthermore, your healthcare provider may prescribe you an antifungal that you take by mouth. Notably, oral antifungal medications need to be taken for several months and can cause liver damage. Your healthcare provider may need to follow your liver enzymes , and people with liver damage shouldn't take the drug.

Finally, bacterial infections could result from itching and scratching. If this occurs, you may require prescription antibiotics in addition to antifungal medication. National Library of Medicine: MedlinePlus.

Athlete's foot. National Library of Medicine. LABEL: ATHLETES FOOT- terbinafine hydrochloride cream. Crowley PD, Gallagher HC. Clotrimazole as a pharmaceutical: past, present and future.

J Appl Microbiol. Jimenez-garcia L, Celis-aguilar E, Díaz-pavón G, et al. Efficacy of topical clotrimazole vs. topical tolnaftate in the treatment of otomycosis.

A randomized controlled clinical trial. Braz J Otorhinolaryngol. Piérard GE, Hermanns-lê T, Delvenne P, Piérard-franchimont C. Miconazole, a pharmacological barrier to skin fungal infections. Expert Opin Pharmacother. Shi D, Zhao Y, Yan H, et al. Drug interactions occur less often with fluconazole than with other azoles.

However, fluconazole sometimes elevates serum levels of calcium channel blockers, cyclosporine , rifabutin , phenytoin , tacrolimus , and warfarin -type oral anticoagulants. Rifampin may lower fluconazole blood levels.

Itraconazole has become the standard treatment for lymphocutaneous sporotrichosis Sporotrichosis Sporotrichosis is a cutaneous infection caused by the saprophytic mold Sporothrix schenckii.

Pulmonary and hematogenous involvement is uncommon. Symptoms are cutaneous nodules that spread read more as well as for mild or moderately severe histoplasmosis Histoplasmosis Histoplasmosis is a pulmonary and hematogenous disease caused by Histoplasma capsulatum ; it is often chronic and usually follows an asymptomatic primary infection.

Symptoms are those read more , blastomycosis Blastomycosis Blastomycosis is a pulmonary disease caused by inhaling spores of the dimorphic fungus Blastomyces dermatitidis.

Occasionally, the fungi spread hematogenously, causing extrapulmonary read more , and paracoccidioidomycosis Paracoccidioidomycosis Paracoccidioidomycosis is progressive mycosis of the lungs, skin, mucous membranes, lymph nodes, and internal organs caused by Paracoccidioides brasiliensis.

Symptoms are skin ulcers It is also effective for chronic pulmonary aspergillosis, coccidioidomycosis Coccidioidomycosis Coccidioidomycosis is caused by the fungi Coccidioides immitis and C. posadasii ; it usually occurs as an acute, benign, asymptomatic or self-limited respiratory infection.

read more , and certain types of chromoblastomycosis Chromoblastomycosis Chromoblastomycosis is a specific type of cutaneous infection caused by one of several species of dematiaceous pigmented fungi. Symptoms are ulcerating nodules on exposed body parts. Despite poor CSF penetration, itraconazole can be used to treat some types of fungal meningitis, but it is not the drug of choice.

Because of its high lipid solubility and protein binding, itraconazole blood levels tend to be low, but tissue levels are typically high.

Drug levels are negligible in urine and CSF. Use of itraconazole has declined as use of voriconazole and posaconazole has increased. Other reported adverse effects include allergic rash, hepatitis, and hallucinations.

Food and Drug Administration boxed warning for heart failure has been issued. Drug and food interactions can be significant. When the capsule form is used, acidic drinks eg, cola, acidic fruit juices or foods especially high-fat foods improve absorption of itraconazole from the GI tract.

However, absorption may be reduced if itraconazole is taken with prescription or over-the-counter medications used to lower gastric acidity. Several medications, including rifampin , rifabutin , didanosine , phenytoin , and carbamazepine , may decrease serum itraconazole levels.

Itraconazole also inhibits metabolic degradation of other medications, elevating blood levels with potentially serious consequences. Serious, even fatal cardiac arrhythmias may occur if itraconazole is used with cisapride not available in the United States or some antihistamines eg, terfenadine, astemizole, perhaps loratadine.

Rhabdomyolysis has been associated with itraconazole -induced elevations in blood levels of cyclosporine or statins.

Itraconazole may increase the serum concentration of certain medications eg, tacrolimus , warfarin , digoxin and therapeutic drug monitoring is recommended when these medications are used with itraconazole. A new formulation of itraconazole SUBA- itraconazole , for SUper BioAvailable has improved bioavailability without the need for an acidic environment in the stomach.

SUBA- itraconazole is taken with food and can be used to treat histoplasmosis, blastomycosis, and aspergillosis. Its dosage is different from other forms of itraconazole.

This broad-spectrum triazole is available as a tablet and an IV formulation. It is considered the treatment of choice for Aspergillus infections aspergillosis Aspergillosis Aspergillosis is an opportunistic infection that usually affects the lower respiratory tract and is caused by inhaling spores of the filamentous fungus Aspergillus , commonly present in read more in immunocompetent and immunocompromised hosts.

Voriconazole can also be used to treat Scedosporium apiospermum and Fusarium infections. Additionally, this medication is effective in candidal esophagitis and invasive candidiasis Candidiasis Candidiasis is infection by Candida species most often C.

albicans , manifested by mucocutaneous lesions, fungemia, and sometimes focal infection of multiple sites. Symptoms depend read more , although it is not usually considered a first-line treatment; it has activity against a broader spectrum of Candida species than does fluconazole.

Adverse effects that must be monitored for include hepatotoxicity, visual disturbances common , hallucinations, and dermatologic reactions eg, photosensitivity. Voriconazole can prolong the QT interval. Drug interactions are numerous, notably with certain immunosuppressants used after organ transplantation.

The triazole posaconazole is available as an oral suspension, a tablet, and an IV formulation. Delayed-release tablets are the preferred formulation because of improved oral bioavailability. This drug is highly active against yeasts and molds and effectively treats various opportunistic mold infections, such as those due to dematiaceous dark-walled fungi eg, Cladophialophora species.

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