Antifungal drugs are of two kinds, systemic and topical. Systemic antifungaldrugs are medicines taken by mouth or by injection to treat infections causedby a fungus. Topical antifungal drugs are medicines applied to the skin to treat skin infections caused by a fungus.
A fungus is a one-celled form of life. Unlike a plant, which makes its own food, or an animal, which eats plants or other animals, a fungus survives by invading and living off other living things. Because fungi thrive in moist, dark places, fungal infections are especially likely to be found in the mouth, armpits, groin, and genital areas. But they can also occur on the scalp, neck,trunk, and other parts of the body. Common fungal infections include athlete's foot, jock itch, candidiasis (also called thrush or yeast infection), andringworm, which is not caused by a worm, but by a fungus. Topical antifungaldrugs not only relieve the symptoms of fungal infection, such as itching, burning, and cracked skin, but they also eliminate the fungus. However, those that occur inside the body or that do not clear up after treatment with creamsor ointments may need to be treated with systemic antifungal drugs. These drugs are used, for example, to treat a type of fungal infection called candidiasis also known as thrush or yeast infection), which can occur in the throat,in the vagina, or in other parts of the body. They may also be used to treatfungal infections such as histoplasmosis, blastomycosis, and aspergillosis, which can affect the lungs and other organs.
Systemic antifungal drugs, such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), and miconazole (Monistat I.V.) are available only by prescription. They are available in tablet, capsule, liquid, and injectable forms. Topical antifungal drugs are available without a physician's prescription and come in many forms, including creams, ointments, liquids, powders, aerosol sprays, and vaginal suppositories. Creams and liquids are usuallythe most effective for treating fungal infections on the skin, because theycan get into the cracks and crevices where fungi grow. But because powders absorb moisture, they are good to use in moist areas of the body, such as between the toes. Commonly used topical antifungal drugs include ciclopirox, clotrimazole, econazole, miconazole, nystatin, oxiconazole, terconazole, and tolnaftate. Among the brands of products that contain topical antifungal drugs areAbsorbine Jr., Desenex, Gyne-Lotrimin, Loprox, Lotrimin, Micatin, Monistat,Mycelex, Mycolog-II, Oxistat, Spectazole Cream, Terazol, and Tinactin.
The recommended dosage depends on the type of antifungal drug and the medicalproblem for which the drug is being taken. Doses may also be different for different patients. Check with the physician who prescribed the drug or the pharmacist who filled the prescription for the correct dosage. Always take systemic antifungal drugs exactly as directed. Itraconazole and ketoconazole should be taken with food. Fungal infections can take a long time to clear up, soit may be necessary to take the medicine for several months, or even for a year or longer. It is very important to keep taking the medicine for as long as the physician says to take it, even if symptoms begin to improve. If the drug is stopped too soon, the symptoms may return. Systemic antifungal drugs work best when the amount of medicine in the body is kept constant. This meansthat the medicine has to be taken regularly. Try to take the medicine at thesame time every day, and do not miss any doses. While taking this medicine, visit the physician as often as the physician recommends. The physician needsto keep checking for side effects throughout the antifungal therapy.
Topical antifungal drugs are meant to be used only on the skin or in the vagina. Be careful not to get the medicine in the eyes. Wash the hands with soapand water after applying antifungal drugs to the skin. Stop using the topicalantifungal drug and call a physician if the infection has not cleared up inthe amount of time given for each type of infection.
Women who are pregnant or who plan to become pregnant should check with theirphysicians before taking systemic antifungal drugs. Any woman who becomes pregnant while taking systemic antifungal drugs should let her physician know immediately. Similarly, some antifungal drugs pass into breast milk. Women whoare breastfeeding should check with their physicians before using systemic antifungal drugs.
Liver problems, stomach problems and other problems may occur in people who drink alcohol while taking systemic antifungal drugs. Do not drink alcohol oruse any prescription or nonprescription (over-the-counter) medicines that contain alcohol while using this medicine. (Medicines that may contain alcohol include some cough syrups, tonics, and elixirs.) Continue to avoid alcohol forat least a day after you stop taking an antifungal drug. Taking systemic antifungal drugs with certain other drugs may affect the way the drugs work or may increase the chance of side effects. The most common minor side effects ofsystemic antifungal drugs are constipation, diarrhea, nausea, vomiting, headache, drowsiness, dizziness, and flushing of the face or skin. These problemsusually go away as the body adjusts to the drug and do not require medical treatment. Less common side effects, such as menstrual problems in women, breast enlargement in men, and decreased sexual ability in men also may occur anddo not need medical attention unless they do not improve in a reasonable amount of time.
Systemic antifungal drugs may cause serious and possibly life-threatening liver damage. Patients who take these drugs should have liver function tests before they start taking the medicine and as often as their physician recommendswhile they are taking it. More serious side effects are not common, but mayoccur. If any unusual symptoms are noted, check with the physician who prescribed the medicine immediately.
Serious and possibly life-threatening side effects can result if the oral forms of itraconazole or ketoconazole or the injectable form of miconazole are taken with certain drugs. Anyone who takes systemic antifungal drugs shouldlet the physician know all other prescription and nonprescription (over-the-counter) medicines he or she is taking. Be sure to check with a physicianor pharmacist before combining systemic antifungal drugs with any other medicine.