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TOENAIL-FOOT FUNGAS

Posted by judy h. on 5/11/05 at 17:37 (174748)

I DO NOT Want to take lamisil. (liver reasons). I was told today that I would have the fungas for the rest of my life and it would not go away. I am confused. My one big toe doesn't look that bad, but was stated that all my toes had the fungus. TWO DOCTORS OPIONIONS LATER, I AM STILL CONFUSED. WHY WANT THIS GO AWAY WITH THE PROPER MEDICINE IF 30 BILLION PEOPLE HAVE IT WHY IS THERE NOT A CURE. PLEASE HELP. I AM SOAKING NOW IN VINGEGAR DAILY, AND PENLAC ON MY TOES AT NIGHT. PLEASE HELP OR GIVE ME SOME INSIGHT. IS IT TRUE THIS WILL NEVER GO AWAY.

Re: TOENAIL-FOOT FUNGAS

Dr. Z on 5/11/05 at 20:59 (174769)

Lamisil is very effective . Taking tylenol for five days will increase your liver enzyme more then taking lamisil. I would re-consider lamisil if your toe nail is completely taken over with fungus.

Re: TOENAIL-FOOT FUNGAS

Julie on 5/12/05 at 03:28 (174797)

I am not a doctor, but I know that it is very difficult to get rid of a fungal infection. Lamisil is effective, but taken internally it can also have severe side effects and some doctors question the wisdom of taking a systemic drug long term to get rid of a fungus. A podiatrist who didn't recommend oral lamisil once told me that topical lamisil can be effective but that you have to use it religiously as directed and for as long as it takes, keep your feet absolutely clean, change socks every day, etc.

You could try essential tea tree oil, which some people have found to be effective. And someone here once recommended Listerine antiseptic.
.

Re: TOENAIL-FOOT FUNGAS

Ed Davis, DPM on 5/13/05 at 12:34 (174906)

Julie:

I think that the word 'can' leaves things open to a drug that has significant side effects less than 1% of the time. Oral Lamisil has significnat side effects less than 1% of the time and those effects are stopped by simply quitting the Lamisil. The biggest side effect of Lamisil is the incredible cost per capsule.

Side effects, should they occur, usually do so with longer term use. It is possible to take Lamisil long enough just to clear out the nail bed and the 'root' of the nail, then switching to effective topicals.

Remember that oral Lamisil does not treat the nail, it treats the tissue (germinal metrix) that creates new nail. Topical preparations treat the nail but not the germinal matrix.
Ed

Re: TOENAIL-FOOT FUNGAS

Ed Davis, DPM on 5/13/05 at 13:16 (174914)

ps Ihave seen a number of docs discourage use of Lamisil due to its price, sometimes by discussing the issue of price but sometimes by emphasing its very small physical downside. A doc who prescribes a lot of an expensive drug may run into conflict with third party payors...
Ed

Re: TOENAIL-FOOT FUNGAS

Suzanne D. on 5/13/05 at 22:24 (174963)

Yes, Lamisil is extremely expensive. I have had fungal infection in both big toenails for years. I was prescribed Lamisil by a podiatrist but didn't realize how expensive it is until I went to the drugstore to fill it. I couldn't afford it. My family doctor later told me (and this was a few years ago) that a person could count on $800 a toenail, and then it would come back after the medicine was discontinued. He also said no insurance would cover it as it is considered 'cosmetic'.

My toenails go through cycles; they get worse, eventually come off, then it starts again. At times there is quite a bit of sensitivity, even pain, in the area. I have used topical applications, soaked in Listerine, etc. Certain things have helped at times, but never enough to make a real difference. I wish something could be developed that would be safe and effective and not cost so much. (Pretty big wish!)

At least when I wear closed-toe shoes, I wear Birkenstock Annapolis shoes which have a deep toe box. This helps by not pressing down on the nails which can causes pain.

Suzanne :)

Re: TOENAIL-FOOT FUNGAS

Julie on 5/14/05 at 03:56 (174976)

Ed, I can't argue with your less than 1%, but I know several people who have had to stop taking Lamisil because of unwanted side effects. One was my husband, who was told to take Lamisil for eight weeks, and after taking it for four weeks developed a very unpleasant whole-body rash that took six weeks to clear. Simply? Not for him. It was very uncomfortable, and very disappointing.

My 'can' still holds, and is valid, I think.

Incidentally, though irrelevant, his prescription was free, thanks to our National Health Service. (Free because he is over 60: for anyone younger the prescription charge would have been around six pounds.) So it was a rash that cost him nothing.
.

Re: TOENAIL-FOOT FUNGAS

Dr. Z on 5/15/05 at 10:51 (175074)

Julie,
There are two side effects with Lamisil that I have seen. One is that whole body rash while not serious can be very very painful and take weeks to go away. The next is upset stomach. The reoccurrence rate is about 30% with lamisil, but it you want to get rid of toe nail fungus lamisil is the drug to use.

Re: TOENAIL-FOOT FUNGAS

Julie on 5/15/05 at 11:58 (175078)

Thanks Dr Z. Yes, I know Lamisil works, but being aware of what the side effects are, and having seen what my husband went through with one of them, I question whether it's a good idea to take a powerful systemic drug for an extended period of time to get rid of what is - usually - a minor, albeit hard-to-et-rid-of, problem.

The side effects are serious. Look at this, from the http://www.adrugrecall.com/lamisil/effects.html website:

'Lamisil side effects are very dangerous and deadly. The FDA found the Lamisil side effects to be so dangerous that a public health advisory warning was issued, in addition to Lamisil labeling changes. The FDA had received reports of liver failure in Lamisil patients, often leading to death.

There were 16 Lamisil side effects liver failure reports as of April 2001. When the Lamisil side effects warning was issued, healthcare professionals were sent letters alerting them of the reports of Lamisil liver failure, transplantation, and death. Physicians were recommended to take nail specimens for lab testing in potential Lamisil patients to reduce unnecessary risk of Lamisil side effects.'

I'd rather have a fungal toenail. :)
.

Re: TOENAIL-FOOT FUNGAS

Dr. Z on 5/15/05 at 13:55 (175086)

I agree they can be serious. I find that liver damage was due to improper workup and or monitering. Its the whole body rash that is really very very nasty and as you know painful and takes some time to treat.

For posters that don't know to want to deal with these risks/problems another very good but takes alot of self treatment at home is keralic gel Works in alot of cases where lamisil would have been used. So my treatment plan is keralic and then lamisil if know results.

Re: TOENAIL-FOOT FUNGAS

Ed Davis, DPM on 5/18/05 at 21:07 (175291)

Julie:

Your husband apparently was allergic to the drug. That can happen with almost any drug. Far more people are allergic to penicillin.

Sporonox is the other drug indicated for onychomycosis. It is probably equally effective but has the disadvantage of having several drug interactions, more so than Lamisil. It is chemically, quite different than Lamisil so being allergic to Lamisil would not make one's chance of being allergic to Sporonox any greater.

Diflucan is an antifungal drug that is used for yeast and fungal infections. It is not indicated for nail infections. It is harder on the liver than the first two but only one a week for about 12 weeks is needed and at that dose, rarely causes a problem. It is not officially indicated by the FDA for onychomycosis but is used off label. It is much less costly than the first two.
Ed

Re: TOENAIL-FOOT FUNGAS

Ed Davis, DPM on 5/18/05 at 21:19 (175295)

Julie:
Lamisil should not be used on patients who have liver disease or who are taking other drugs that are hard on the liver. The major cause of liver failure in the US is actually from acetominphen (Tylenol). All one needs to do is to obtain baseline liver function tests to see where one's liver enzymes are -- a very simple and inexpensive test and repeat that test every 4 to 6 weeks. I assure you that if the liver function tests are performed then no one need worry. Keep in mind that patient often take a number of substances that are hard on the liver simultaneously. Alcohol is one of the more common things. Tylenol is a major culprit becasue it is present in so many things including cold medicines, headache medicines, etc. Patients who wind up in the ER with liver failure due to tylenol often are not realizing how many things they take that include tylenol. Cholesterol lowering medications also should not be combined with Lamisil.
Ed

Re: TOENAIL-FOOT FUNGAS

Ed Davis, DPM on 5/18/05 at 21:36 (175298)

Suzanne:

Onychmycosis can be cosmetic but can also be painful if the nails thicken too much. The vast majority of insurance companies I deal with cover Lamisil if they are made aware that the Lamisil is not being prescribed for cosmetic reasons. It is not true that the onychomycosis will come back and it does not cost $800 at toenail -- your family doc just did not want to prescribe it.

Here is how to use it cost effectively. First, the insurer must be aware that the Lamisil is not being used for cosmetic reasons. Use 3 weeks of Lamisil, take one week off, then continue for 3 weeks. You have now cleared the germinal matrix of fungus as well as the nail bed and used about $240 worth of Lamisil. The remaining fungus resides in the nail plate itself which can be greound very thin with by a podiatrist with a simple nail grinder. One then applies a topical antifungal such as Penlac which will work because the nail is thin enough to allow penetration and the Penlac need not penetrate to the nail bed nor germinal matrix which is clear. Continue applying the Penlac (completely non-toxic) once a day until the nail is perfectly clear (about 2 to 3 months) then apply the Penlac, which is a clear polish containing a concentrated antifungal, once a week to ensure that reinfection of the nail or re-occurrence does not occur. That is the end of onychomycosis.
Ed

Re: TOENAIL-FOOT FUNGAS

Suzanne D. on 5/21/05 at 07:21 (175406)

Dr. Ed, thank you very much for your explanation. You have helped me more than the two doctors I have seen for my toenail problems. I am printing out your reply for reference.

Suzanne :)

Re: TOENAIL-FOOT FUNGAS

Kimr on 6/04/07 at 14:45 (231082)

Is a medication by the name of itraconazole, generic-Sporanox found at Canadadrugs.com a valid treatment for the toenail fungas?

Re: TOENAIL-FOOT FUNGAS

robert m on 10/19/07 at 14:42 (238059)

MY BIG TOE NAIL(SECOND)LOOKS O.K. BUT TOE IS PAINFUL,SUGGESTIONS PLEASE

Re: TOENAIL-FOOT FUNGAS

Faith N on 3/20/08 at 09:02 (244786)

I am on Lamisil now, However, I am so sensitive to everything, I have become allergic to the medicine-- I have broken out in Hives and have had swelling of the lips and ears.

My Father and Grandfather both had the fungus until toenails and nails. My father took 1 round of the medicine and his toes have cleared up with no return. My grandfather had to take 2 rounds to get rid of his, but it has not returned yet.

the medicine is expensive, but my insurance paid for it. I only had to pay the cover charge of $10.00

I am very disapointed i had to stop using because i only had 23 pills left in my treatment. I am just hoping the pills i did take will still do the job

Toe fugus is not only ugly, but extremely painful. I would recommed taking the medicine! Is really does work, you just have to give it time to work and then clean out your system!!

You will never know if you dont take the chance to try it. I wouldn't have!! Just because i am allergic to you, doesn't mean you will be. Only 1.1% of people taking is said they had hives!!

Re: TOENAIL-FOOT FUNGAS

Happy Feet on 3/20/08 at 19:37 (244809)

I had tried Lamisil with no success. Someone mentioned the tea tree oil to me (as mentioned in Julie's post), and I thought it was kind of silly but gave it a try anyway. I was in shock to find that my stubborn toenail foot fungus actually disappeared. You may want to give it a try!

Re: TOENAIL-FOOT FUNGAS

Erik on 4/03/08 at 10:23 (245454)

Hi My question is for Dr. Ed

Dr. Ed I am 26 years old and have had toe nail fungus since I was 18. In 2002, I had four toe nails affected with toe nail funugus, and lamisil tablets were prescribed. It worked great, I took it for the full 3 months, and the nails grew back perfectly. In 2003, I had one toe nail that was once again affected, and Lamisil prescribed again, for the full 3 months, and the nail was perfect once again. In 2006, the same toe nail that was affected in 2003, was once again affected. Lamisil prescribed again, for the full three months, but this time it didn't work. It is now 2008, and I now have two toes affected with the fungus. It is very frustrating. My doc is hesitant to prescribe lamisil again. What dou think? It worked great the first 2 times. I want this fungus gone, I am too young to live with it. Does multiple uses of lamisil as in my case increase your risk to liver failur or no? My LFT's were checked all the time while on it and never raised. Also I know the warning label states to not drink alcohol with it, but is it still possible to drink while taking this med or does that increase your risk of liver failure as well? Also how can I prevent this from ever happenign again? Thanks for your help and advice.

Re: TOENAIL-FOOT FUNGAS

NajRellim on 8/09/09 at 14:38 (259531)

Are you certain that it is a fungal infection? I have what looks absolutely like a fungal infection (mycosis)on all of my toes but it continually tests negative for fungus. My doctors won't tell me just exactly what it is, only what it isn't. And because of that, they won't give me an Rx for it.

I had it many years ago and a dermatologist gave me an Rx for 'fulvicin