For antifungal what kind of medication is needed. Broad-spectrum antifungal drugs in tablets - a list of effective ones with names and prices

Common forms of mycosis of the feet and nails, which have a severe course, require the use of systemic agents. You can buy antifungal tablets without a prescription and at an affordable price, but this should not exclude a visit to a dermatologist.

Antimycotic drugs have a toxic effect and have a number of contraindications. Self-medication with antifungal tablets can cause resistance of the microbial flora, leading to a chronic form of the disease. When choosing tablets from a fungus on the legs, all indicators must be taken into account. Particular attention should be paid to side effects and the spectrum of action.

Fluconazole-based drugs

The most common group. In pharmacies, fluconazole-based drugs have different trade names:

Diflucan;
Forcan;
Diflazon;
Mycosist;
Vero-flucunazole;
Mycomax.

It is a derivative of triazole. After ingestion of capsules and tablets, its concentration in fluids and tissues reaches 90%. The drug is excreted by the kidneys in its original form.

Indications in dermatology:

Mycosis of the legs, body and groin area.
Ringworm on the skin.
Fungal lesions of deep tissues, including histoplasmosis.
in patients with immune deficiency.

This antifungal agent in tablets is prescribed individually. The highest daily dose should not exceed 400 mg. The minimum amount of the substance per dose is 50 mg. Fluconazole is more commonly available in capsule form. The frequency of taking the drug once a day. This is an advantage over funds that have a short duration.

Fluconazole antifungal tablets should not be taken during pregnancy and lactation. They are prohibited for children under one year old and people with hypersensitivity to triazole.

Side effects:

diarrhea;
flatulence;
stomach ache;
nausea;
dizziness;
rash on the skin.

Fluconazole capsules should be used with caution in liver and kidney pathologies. When used together with hypoglycemic agents, their half-life increases. With simultaneous treatment with Rifampicin, fluconazole is retained in the tissues longer.

On a note!
The price of capsules varies dramatically depending on the manufacturer, and range from 20 rubles (Flukunazole) to 800 (Diflucan).

Orungal

It consists of a broad-spectrum substance - itraconazole. It destroys most types of fungal infections. The drug may have different names - Canditral,. The funds mainly have an encapsulated form and are used for systemic treatment:

onychomycosis;
severe mycoses of the skin;
histoplasmoses;
sporotrichosis;
blastomycosis.

The therapeutic minimum remains in the tissues for 1 month after the end of the course. The dosage of the drug is individual and depends on the identified pathogen and the severity of the course of the disease. I usually prescribe 100 mg per day at one time. In rare cases, 200 mg in the morning and evening for 4 weeks.

- a toxic agent. It qualitatively fights fungal infection, but has strict restrictions on use:

pregnancy at all stages;
women in the period of possible conception;
breast-feeding;
renal and hepatic pathology.

Side effects are manifested in the form of disorders of the digestive tract and allergic reactions. Orungal can provoke the appearance of headaches and peripheral neuropathies. With prolonged use in high doses, hair loss and dysmenorrhea are not excluded.

On a note!
Medicines consisting of itroconazole are effective, but expensive. Orungal in a package of 14 pieces can cost up to 3,000 rubles.

As an alternative you can use As an alternative you can use . It belongs to another group, but is cheaper and has fewer contraindications. Tablets are active against nail fungus and mycoses. But their use in pregnant women has not been studied. It belongs to another group, but is cheaper and has fewer contraindications. Tablets are active against nail fungus and mycoses. But their use in pregnant women has not been studied.

Terbinafine

In a pharmacy, an antifungal agent is sold at a price of about 600 rubles under the same name. Analogues based on terbinafine - and Exifin. These are the best antifungal pills for toenails. During the therapy, the drug actively accumulates in the tissues and provides a long-term fungicidal effect.

Indications are deep onychomycosis and fungal skin lesions caused by candida, dermatophyte species and other microorganisms.

Dosage: Adults: 500 mg divided into two divided doses. Children weighing less than 40 kg, but more than 20, half the adult dose. If the child is lighter than 20 kg, the daily dose will be 62.5 mg per day.

Antifungal drugs in tablets for toenails and foot mycoses, consisting of, do not have many restrictions. They are prohibited for individual intolerance. There is no information about the prohibition in pregnant women in the instructions. But there are recommendations to reduce the use of tablets of this group during the period of gestation and breastfeeding.

Side effects:

moderate abdominal pain;
nausea;
jaundice;
skin rash;
decrease in platelets in the blood;
headache.

Nystatin

It belongs to the group of polyene antibiotics. Funds of this type are the most affordable and cheapest. They are used in tablets against skin fungus on the feet. Nystatin destroys the membrane of microbial cells. Indications for use are skin mycoses caused by the Candida fungus.

Contraindications: allergic reactions and intolerance to the antifungal drug. During pregnancy, it is prescribed after a thorough assessment of the possible risk to the fetus. The decision to stop lactation during therapy is made by the doctor.

Uncontrolled use of Nystatin in diseases requiring stronger drugs can cause the growth of resistant forms of fungi.

Dosage: adults 500 thousand units 4 times a day. Children are prescribed in the amount of 100 thousand up to 4 times a day. The duration of antifungal treatment is 2 weeks.

The advantages of the drug over other tablets in low toxicity and price. But a narrow spectrum of action does not allow it to be taken with mixed pathogens. The high frequency of taking Nystatin is also a disadvantage.

Pimafucin

Antifungal antibiotic with the active ingredient natamycin. It copes well with lesions of nails and skin complicated by a secondary infection.

These are inexpensive but effective antifungal pills. You can buy them for an average of 400 rubles. The package contains 20 tablets. The drug can be used during gestation and breastfeeding. Natamycin is often prescribed for fungal sepsis and immune disorders. It is used in short courses. Adults are recommended to take 100 mg. up to 4 times a day, children the same dose 2 times in 24 hours.

Side effect: pimafucin is well tolerated. During the initial period of therapy, diarrhea and nausea may occur. Symptoms go away on their own and do not require discontinuation of the medication.

The mechanism of action of antifungal tablets and capsules

All antifungal agents have the same effect on the causative agent of the infection. They destroy the composition of the cell membrane and increase the permeability of the membrane. Penetrating into the nucleus, the drugs stop the metabolic processes and cause the death of the fungal flora. Universal means containing an antibiotic, simultaneously destroy pathogenic microorganisms.

Antifungal tablets and oral capsules require prior prescription by a doctor. During therapy, it may be necessary to control blood biochemistry. The course of treatment cannot be interrupted.

It is not allowed to independently reduce the dose and stop treatment. This can lead to the development of resistant strains of the fungus and cause a relapse.

Content

Most people have experienced itching near the nails, reddening of the lateral ridges, and an unpleasant smell from the feet, but this is not the only type of fungal infection - only the most common. If the lesion covers a large area or has affected internal organs, local treatment is indispensable: tablets are needed.

What are antifungal drugs in broad spectrum tablets

Antimycotics - the so-called drugs that have a fungistatic (suppress activity) or fungicidal effect (kill) on fungal microorganisms. They can be natural or synthetic, narrowly targeted, or broad spectrum, meaning they are effective against several groups of fungal microorganisms. Systemically (tablets) they are prescribed for:

severe course of the disease;
extensive area of damage;
infection of internal organs;
the need to protect yourself from a fungal disease (with a high risk of infection).

The main advantage of such systemic drugs is their effectiveness - they act on several different pathogens at once and do it quickly, suitable for a severe infection. The downside is high toxicity, a large number of contraindications and side effects, so you need to carefully consider the doctor's recommendations and the prescribed regimen. Broad-spectrum antifungal drugs in tablets can cause:

liver damage (hepatotoxic);
estrogen fluctuations;
severe allergic reactions;
anaphylactic shock.

How to use

Antifungal drugs with a wide spectrum of activity for systemic treatment can be used parenterally (dropper with solution) or orally. The specific scheme of application depends on the active substance, the form of the disease, the patient's condition. A few key points:

Suction allylamines does not depend on food intake, so they can be taken at any time, and azoles - always with meals. It is advisable to use antibiotics not on an empty stomach in order to reduce the likelihood of mucosal irritation.
Antimycotics it is advisable to drink only clean water. An exception is the situation of treatment with azoles in patients with low stomach acidity: they should take the pill with an acidic liquid (tea, pasteurized milk).
Griseofulvin should be taken with a tablespoon of vegetable oil, especially if the patient is on a low-fat diet.
Antifungals use according to the schedule, observing the time of admission and intervals (necessarily equal intervals). If you forget, take the pill as soon as you remember, but do not increase the single dose.
Capsules cannot be destroyed (cut, pour out the contents). The tablet can be divided if necessary to reduce the dosage.

Classification of broad-spectrum antifungal drugs in tablets

Official medicine has several ways of dividing antimycotics into categories. By origin, they are synthetic (artificial) and natural. The classification by chemical structure (active substance) is more extensive:

Azoles: derivatives of triazole, imidazole.
Allylamines.
Echinocandins.
polyene antibiotics.
Preparations of other chemical groups: ciclopirox, griseofulvin, flucytosine.

Antifungal antibiotics

The widest spectrum of action and high efficiency in the fight against the fungus are antibiotics of the group of polyene macrolides - they do not affect only dermatomycetes with pseudo-allescheria. They mainly destroy representatives of the Candida genus, but they can also be active against filamentous and dimorphic fungi, trichomonads, amoebas, leishmania. Known polyenes in tablets:

Amphotericin B;
Levorin;
Nystatin;
Mycoheptin;
Natamycin.

All of them work by binding to the fungal cell membrane with ergosterol, which leads to a violation of its integrity and subsequent lysis (death) of the cell. Each of the polyene antibiotics has its own spectrum of activity and a list of organisms sensitive to it, so they are not interchangeable. When taking tablets, active substances from the gastrointestinal tract are almost not absorbed. A highly effective antifungal drug of this type is Pimafucin, which does not have a systemic effect, working only in the digestive tract:

Active ingredient: natamycin.
Indications: non-invasive intestinal candidiasis (treatment / prevention), including those caused by drug therapy.
Side effects: in the first days of use, diarrhea, nausea.
Contraindications: intolerance to the active substance.

A powerful representative of polyenes is Levorin, which is active against yeast-like fungi, is prescribed for a long course (for 10-12 days). If necessary, the treatment is carried out twice. Features of Levorin:

Active ingredient: levorin.
Indications: gastrointestinal candidiasis, carriage of fungi of the genus Candida.
Side effects: diarrhea, nausea, vomiting, loss of appetite, headache.
Contraindications: liver or kidney failure, hypersensitivity, pancreatitis, ulcers, acute bowel disease (not fungal etiology), pregnancy. With caution, it is allowed to use Levorin in children under 2 years of age and while breastfeeding.

Nystatin is a cheap polyene antibiotic based on the active substance of the same name, which can be prescribed not only for the active treatment of a fungal infection, but also for the prevention of infection. Key points:

Active ingredient: nystatin.
Indications: candidiasis of the skin, mucous membranes, internal organs. Long-term treatment with antimicrobial agents (prophylaxis).
Side effects: nausea, vomiting, pruritus, fever.
Contraindications: peptic ulcer, pancreatitis, liver problems, pregnancy, sensitivity to the composition.

Among the antifungal antibiotics of the non-polyene group, doctors single out the drug Griseofulvin: it works on a substance of the same name that has a fungistatic effect. It is produced by mold fungi, causes disruption of cell wall synthesis, inhibits cell division and protein production. It tends to accumulate in the cells of nails, hair and skin. Features of Griseofulvin tablets:

Active ingredient: griseofulvin.
Indications: dermatophytosis of the scalp, epidermophytosis (trichophytosis) of the hands and feet.
Side effects: dyspepsia, headaches, dizziness, urticaria, leukopenia, increased levels of eosinophils.
Contraindications: uterine bleeding, malignant tumors, impaired functioning of the kidneys and liver, porphyria (violation of pigment metabolism), problems with cerebral circulation, lactation and pregnancy, systemic lupus erythematosus, changes in the composition of the blood.

Synthetic antimycotics

The appointment of polyene antibiotics (or non-polyene) is rare - mainly antifungal drugs in capsules or tablets belong to the group of synthetic antimycotics. It is represented by the following categories of drugs:

azoles;
allylamines;
echinocandins;
drugs of other drug groups (cyclopirox, flucytosine, amorolfine).

Azoles

Broad-spectrum drugs from the category of azoles have a fungicidal effect (destroy cells) on the fungus, if used in high doses, and fungistatic (do not allow to multiply) in low doses. These medicines are also divided into groups (the names of medicines are given for the most used active substances):

Triazole derivatives: miconazole (Daktarin, Klion D), ketoconazole (Oronazol, Nizoral, Fungavis), isoconazole, oxinazole, clotrimazole (Candide, Antifungol), bifonazole, sertaconazole, fenticonazole.
Imidazole derivatives: vorkinazole (Vikand, Vfend), itraconazole (Orungal, Irunit), fluconazole (Diflucan, Flucostat).

Most of the azole preparations are used in the treatment of mycoses of the scalp, hands and feet, to combat lichen and especially thrush (vaginal candidiasis), since such tablets are highly effective against the Candida fungus. Among the most popular drugs from the azole group, doctors singled out the most non-toxic and approved Flucostat during pregnancy:

Active ingredient: fluconazole.
Indications: candidiasis of the mucous membrane of the eye, vagina, internal organs (including prophylaxis during antibiotic treatment), pityriasis versicolor, mycosis of the feet.
Side effects: dizziness, headache, diarrhea, nausea.
Contraindications: hypersensitivity to azoles, age up to 3 years, taking hepatotoxic drugs, breastfeeding.

Mycozoral among the other azoles is considered the most powerful (concerns the central component), therefore it is used mainly where treatment with other antimycotics did not work. Key points:

Active ingredient: ketoconazole.
Indications: deep mycoses, lesions of the scalp with dermatophytes/mold fungi, versicolor versicolor, chronic superficial candidiasis, systemic infections (histoplasmosis, blastomycosis).
Side effects: menstrual disorders, toxic hepatitis, loss of appetite, hemolytic anemia.
Contraindications: liver disease, children under 3 years of age, intolerance to any component of the composition. Tablets require care when combined with other medicines.

Biflurin tablets (as well as other drugs on vorkinazole) are little known, they can be the drugs of choice for intolerance to other azoles (or lack of effect from them). Features of the drug:

Active ingredient: vorkinazole.
Indications: invasive aspergillosis, severe forms of invasive candidiasis.
Side effects: peripheral edema, chills, fever, chest pain, nausea, vomiting, indigestion, anemia.
Contraindications: hypersensitivity, taking rifampicin, barbiturates, efavirenzine, ergot alkaloids.

Allylamines

The elimination of dermatomycosis (on the skin of the body, head) and onychomycosis is the main effect of drugs from the allylamine group, which include only 2 substances: naftifine and terbinafine. Tablets are released only on the latter and there are a large number of them:

Fungoterbin;
Exifin;
Binafin;
Thermikon;
Mycoferon;
Lamisil.

In the group of allylamines, terbinafine is considered more common and effective: it has a wide spectrum of action, is able to eliminate infections caused by protozoa (leishmaniasis, trypanosomiasis), deep mycoses, pityriasis versicolor. Naftifine (Exoderil) works only locally. Allylamines act by inhibiting the synthesis of ergosterol and destroying the shell of fungal spores, which leads to the death of the infectious agent. Low dosages are effective against molds and dimorphs. The most famous allylamine is Lamisil:

Indications: dermatophytic onychomycosis, fungal infections of the scalp, feet, legs, candidiasis. With multi-colored lichen, the effectiveness is low.
Side effects: headache, dizziness, altered taste perception, loss of appetite, abdominal pain, urticaria.
Contraindications: hypersensitivity to the composition, chronic / acute liver disease, impaired renal function.

Most allylamines have approximately the same spectrum of action due to the same central component in the composition (they differ only in dosages and additional substances, therefore, to replace the expensive (due to its wide popularity) Lamisil, you can purchase a more budgetary Termikon:

Active ingredient: terbinafine.
Indications: mycoses of the scalp (trichophytosis, microsporia), skin and nails, severe extensive ringworm of the body, superficial candidiasis (not internal organs).
Side effects: nausea, digestive problems, stool problems, skin manifestations of allergies, muscle or joint pain.
Contraindications: pregnancy, lactation, alcoholism, inhibition of hematopoiesis, disorders of the liver / kidneys.

Close in cost to Termikon and Exiter, which, by analogy with all tablets on terbinafine, requires careful attention to the instructions, since it can affect the cardiovascular system. Features of the drug:

Active ingredient: terbinafine.
Indications: mycosis of the skin and nails, candidiasis of the mucous membranes.
Side effects: jaundice, drug-induced hepatitis, muscle, headache or joint pain, nausea, vomiting, skin rash, taste disturbances.
Contraindications: old age, disorders of the liver / kidneys.

Echinocandins

A new category of broad-spectrum antifungal agents are echinocandins, presented in a small assortment. They have not been fully studied by specialists, therefore they are prohibited for patients under 18 years of age, during pregnancy and lactation. Echinocandins work through the blockade of the synthesis of a fungal cell component, which disrupts the process of its construction. In this category, antifungal drugs are present only in powder (tablets are not available). The most studied is Cancidas:

Active ingredient: caspofungin.
Indications: candidiasis (strains insensitive to azoles), aspergillosis, suspected fungus in patients with febrile neutropenia (a sharp decrease in the level of neutrophils in the blood).
Side effects: headache, chills, fever, nausea, abdominal pain, diarrhea, anemia, increased bilirubin levels, tachycardia, shortness of breath, skin rash with itching.
Contraindications: age up to 3 months. Persons with hepatic insufficiency should be careful when taking.

Less well-known is the drug Mikamin, presumably even less toxic for children (there is no strict ban on use in the instructions, it is allowed to use the drug for a fungal rash on the buttocks of a child). Most doctors prescribe Mikamin to patients over 16 years of age. Features of the tool:

Active ingredient: micafungin.
Indications: Prevention or treatment of candidiasis, including candidal stomatitis.
Side effects: leukopenia, anemia, increased number of eosinophils and bilirubin, hypokalemia, headaches, nausea, diarrhea, abdominal pain.
Contraindications: intolerance to any component of the composition.

Eraxis, in comparison with other echinocandins, is the most budgetary representative of this group, since 100 ml of lyophilisate cost 5700-6000 rubles. - Mikamin in the same volume will cost the consumer 15,000 rubles. Cancidas next to him (14,000 rubles for 70 g). Eraxis Features:

Active ingredient: anidulafungin.
Indications: candidiasis (including damage to the esophagus).
Side effects: skin allergic reactions, bronchospasm, shortness of breath, decreased pressure (occurs rarely), diarrhea.
Contraindications: sensitivity to any echinocandins.

Other groups

Most dermatologists, when selecting antifungal drugs in tablets or capsules for systemic treatment of an infection, choose from the categories presented above. Azoles, allylamines, echinocandins and polyenes cope with most mycoses, but in rare cases it is necessary to turn to drugs from other groups. They have a less wide spectrum of action, but are often not so dangerous for the body. The only drug for systemic intravenous use is Ankotil:

Active ingredient: flucytosine (fluorinated pyrimidine).
Indications for use: has a fungicidal and fungistatic effect against pathogens of candidiasis, cryptococcosis, chromoblastomycosis (the main indications for use), disrupts the synthesis of fungal DNA. For aspergillosis, it is used with amphotericin B.
Contraindications: The drug is non-toxic, prohibited in chronic renal failure, blood diseases. The teratogenic effect was found only in rats, so the question of using Flucytosine during pregnancy is decided by the doctor.
Side effects: nausea, vomiting, diarrhea, dry mouth, stomach bleeding, headaches, dizziness, acute renal failure, severe weakness, fatigue, allergic reactions, fever.

As an antifungal agent (but not with a wide spectrum of activity), Potassium iodide, which is available in the form of eye drops and is used externally, can also be prescribed by a doctor. The solution is not used orally, if there is no iodine deficiency established by the results of the analysis. Before use, you need to know:

Active ingredient: potassium iodide.
Indications: lesions of the cornea, pathological conditions of the conjunctiva, which are caused by a fungus.
Contraindications: neoplasms of the thyroid gland, kidney disease, hypersensitivity to iodine (and its excess in the body), acne.
Adverse reactions: increased lacrimation, burning, disruption of the thyroid gland, redness of the mucous membrane of the eyes, blurred vision.

What antifungal drugs for internal use are prescribed

The choice of drug is determined by the specific pathogen, since even broad-spectrum tablets are not absolutely universal. So azoles are mainly used for lichen, onychomycosis, lesions of the scalp, and antibiotics are needed for extensive damage or systemic infection. Self-selection of an antifungal agent is prohibited, since this can aggravate the situation - the pathogen mutates and becomes resistant. To select a medicine, you need to conduct laboratory tests and undergo an examination by a dermatologist.

For deep mycosis

The colonization of bone tissues, nervous system, internal organs, and respiratory tract by pathogenic microorganisms requires the use of immunomodulating drugs. Such severe infections include coccidioidomycosis, cryptococcosis, blastomycosis, histoplasmosis. Among the broad-spectrum antifungal agents, doctors distinguish polyene antibiotics and some azoles (miconazole, ketoconazole, itraconazole, fluconazole):

Itraconazole- medicine in capsules, with systemic fungal infections, it is used for 2-12 months (check with your doctor). The exact dosage depends on the specific disease and condition of the patient. Mostly adults are recommended 200 mg / day one-time.
Ketoconazole DS- the dosage is calculated according to the patient's weight: 30 kg or more - 200-400 mg, less - 4-8 mg / kg. The daily dose is taken as a single dose. Used for 4 weeks or longer (determined by physician).

Treatment with intravenous administration of medicinal solutions is considered more effective - polyenes and azoles are also used here. Vorkinazol-Sandoz was highly appreciated by doctors, the dosage of which is set individually. It is worth paying attention to:

Flucorus (fluconazole)- 50-400 mg, the frequency of use is 1 r / day. In case of impaired renal function, the dosage is determined individually. The duration of therapy depends on the clinical picture of the disease.
Amphotericin B (or Ampholip)- the release form is not a tablet, but a powder for infusion (intravenously), which is done at a frequency of 20-30 drops / min. The adult dosage is 250 U/kg, but the first dose is 100 U/kg. The concentration of the solution is 100-125 IU per 1 ml of water for injection. Treatment lasts 4-8 weeks with the use of the drug every other day or 2 r / week.

With epidermomycosis

Skin infection requires active local treatment - the use of systemic antifungal agents is considered an additional step in the main therapy. Here, the non-polyene antibiotic Griseofulvin, synthetic antimycotics on terbinafine, Chlornitrophenol are used. Iodine preparations (potassium iodide) are allowed. Your doctor may recommend these broad-spectrum antifungal tablets:

Exifin (terbinafine)- is prescribed for 2-4 weeks or more, 250 mg per day after meals. In case of renal / hepatic insufficiency, reduce the dose by 2 times.
Itraconazole- with dermatomycosis, tablets are drunk at 200 mg / day for a week or 100 mg / day for 15 days. With lichen, only a weekly version with a high dose is practiced.
Griseofulvin- the daily dosage for adults is 500 mg (taken at a time or divided into several servings), in case of severe illness, it is determined by the doctor. The course of treatment lasts 4-6 months if mycosis is on the fingers, 2-4 weeks for the body, 4-6 weeks for the scalp and feet. It is possible to increase up to a year with a severe form of dermatomycosis.

With candidiasis

Yeast infection of the genital organs (vaginal thrush), intestines, oral mucosa is eliminated mainly with the help of 2 categories of broad-spectrum antifungal agents: polyene antibiotics and azoles. Candidiasis responds to the following medications:

Levorin- adults from candidiasis are recommended to drink 500 thousand units up to 4 r / day. The duration of treatment is 10-12 days.
Nystatin- dosage for adults with candidiasis of internal organs: 500 thousand units with a frequency of 4-8 r / day, therapy lasts 2 weeks. If the infection is generalized, the dose is increased to 6000 thousand units per day (divided into 4-8 doses).
clotrimazole- vaginal tablets are used for 3 days, 1 pc. morning and evening or just before bedtime, but for a whole week. If there is no effect, the doctor must adjust the therapeutic course. If necessary, treatment is extended.
Miconazole- used for intestinal candidiasis at a dosage of 120-240 mg with a frequency of 4 r / day, is prescribed for 10-14 days.
Fluconazole (analogue - Diflucan)- the most famous pills for recurrent thrush, are taken at 150 mg on the 1st, 4th and 7th day, and after 50 mg weekly for six months.

The severe course of a fungal infection, especially candidiasis of the internal organs, requires the use of solutions for droppers. The following antimycotics of a wide spectrum of activity have such a dosage form:

Fluconazole- 200-400 mg / day, treatment lasts 6-8 weeks. A dropper is placed every day once.
Miconazole- With caution, adults are prescribed 10 mg / kg intravenously (one-time no more than 600 mg). Dilute the solution with sodium chloride. The duration of the use of droppers is determined by the doctor.
Micafungin-Nativ- with candidiasis of the esophagus intravenously, adults are prescribed 150 mg / day. The number of procedures is set individually.

For the treatment of fungal infections in children

Pediatricians recommend treating a child with topical medications whenever possible, since most broad-spectrum antifungal tablets are toxic. Ingestion is advisable for candidal stomatitis (tablets and lozenges), large lesions for other mycoses and active progression of the infection. The doctor should prescribe the therapeutic regimen - do not select such medicines for the baby yourself. In children, systemically can be used:

Lamisil (terbinafine)- children over 3 years of age 125 mg / day (if the weight is 20-40 kg) or 250 mg / day (weight 40 kg or more). Dosages for tablets and intravenous solution are similar. The course of treatment is individual.
Fluconazole- single use, calculate the dose by weight: 6-12 mg / kg, with food candidiasis once 3 mg / kg. For tablets and intravenous solution, the calculation is the same. The duration of therapy is from 2 weeks.
Amphotericin B- the initial daily dose of the solution is 0.25 mg / kg (dilute with dextrose 5%), gradually increase it to 1 mg / kg (step - 0.125 mg / kg every other day). Application once a day, the duration of use is determined by the doctor.

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Antimycotics or otherwise antifungal drugs are an extensive class of various chemical compounds with specific activity against pathogenic fungi. They are both of natural origin and obtained by chemical synthesis. Antifungal drugs are divided into several groups that differ in chemical structure, clinical use in various mycoses (fungal infections), as well as in the features of the spectrum of activity.

To date, the need for the use of antifungal drugs in tablets, creams, gels, liquids has increased significantly. This is due to the frequent use of powerful broad-spectrum antibiotics, their misuse, sometimes inappropriate and unjustified. And also with an increase in the number of patients with various disorders of the immune system and with an increase in the prevalence of severe forms of systemic mycoses.

Below is a brief overview of antifungal tablets. These drugs have a number of contraindications and unwanted side effects, so their purpose, dosage and duration of administration should be determined only by the attending physician.

Patients taking oral antimycotic drugs should strictly follow the regimen and regimen, do not stop the prescribed course of therapy on their own, take the dose at regular intervals and do not skip the dose. If a dose is missed, the next dose should be taken as soon as possible without doubling the dose. Irregular intake, skipping and premature termination of therapy increases the risk of relapse.

Antifungal agents of the group - Polyenes:

Among all antifungal drugs, polyenes have the widest spectrum of activity. These include - nystatin, natamycin, levorin, amphotericin B. When applied topically, they are active mainly on Candida spp., Natamycin (Pimafucin) is also active against protozoa, for example, Trichomonas. Polyenes are resistant to pseudo-alescheria and dermatomycete fungi, that is, the scope of this group of antimycotic drugs is candidiasis of the mucous membranes, skin, and gastrointestinal tract.

- an antifungal antibiotic from the group of polyenes, highly active against fungi of the genus Candida. Practically not absorbed in the gastrointestinal tract. Recently, it is practically not used.

Indications for use: Candidiasis of the skin, intestines, oral cavity and pharynx. Prevention and treatment of gastrointestinal candidiasis arising from long-term treatment with tetracycline and penicillin antibiotics. Prevention of candidiasis in the postoperative period during surgery of the gastrointestinal tract.
Contraindications: Hypersensitivity.
Side effect: Allergic reactions, nausea, vomiting, abdominal pain, chills, diarrhea.
Price: 15-50 rubles.

Levorin- most active against Candida albicans, protozoa - Trichomonas, amoebas, leishmania. With prostatic hypertrophy, it reduces dysuric phenomena, sometimes reduces the size of adenoma.

Indications for use: Candidiasis of the skin, intestines, oral cavity and pharynx. Levorin tablets are used for candidiasis, gastrointestinal candidiasis, and prostatic hypertrophy as part of complex therapy.
Contraindications: liver or kidney failure, acute non-fungal bowel disease, gastric ulcer, pregnancy, pancreatitis. With caution - children under 2 years of age and during lactation.
Side effect: Decreased appetite, allergic reactions, nausea, vomiting, headache.

(Natamycin) - antifungal polyene antibiotic, has a fungicidal effect. Most mold, pathogenic yeast fungi are sensitive to pimafucin, including the genera Aspergillus, Candida, Fusarium, Cephalosporium, Penicillium. Pimafucin tablets, coated enteric coating, have an effect only in the intestinal lumen, without exerting a systemic effect.

Indications for use: intestinal candidiasis, vaginal candidiasis, acute atrophic candidiasis in patients with immune deficiency, after therapy with corticosteroids, antibiotics, cytostatics. It can be used during pregnancy and lactation.
Contraindications: hypersensitivity to the components of the drug.
Side effects: diarrhea, nausea, may occur in the first days of taking the medicine, and during the treatment they pass on their own.
Price: average price 400 rubles. for 20 tab.

Amphotericin B - analogues Ambizom, Amphoglucamine, Amfocil, Ampholip, Fungizone is a lyophilisate for infusions. Used for life-threatening, progressive fungal infections, disseminated forms of candidiasis, abdominal infections, peritonitis, fungal sepsis.

Antifungal drugs of the group - Azoles:

Azoles- a group of synthetic antimycotics, including, ketoconazole, itraconazole. Ketoconazole, after the introduction of itraconazole, has lost its significance due to its high toxicity and is currently used mainly only for the local treatment of mycoses. This group of antimycotics is effective in the treatment of certain types of lichen, fungal infections of the skin, nails, scalp, candidiasis of the mucous membranes.

Ketoconazole, analogues Oronazole Mycozoral, Nizoral, Fungavis- a synthetic derivative of imidazoledioxolane, active against yeast-like fungi, dermatophytes, higher fungi and dimorphic fungi.

Itraconazole- analogues , Itrazol, Canditral, Orungal, Rumikoz, Orunit. Synthetic antifungal drugs in tablets, have a wide spectrum of action against fungi: dermatophytes, yeast Candida spp, mold fungi. The effectiveness of treatment for mycoses should be assessed 2-4 weeks after the end, at 6-9 months.

Fluconazole- analogues Vero-fluconazole, Diflucan, Medoflucon, Diflazon, Mikomax, Mikosist, Mikoflukan, Flukostat. Antifungal drugs in tablets with a highly specific effect, inhibit activity on fungal enzymes, disrupt their growth and replication.

Indications for use: Generalized candidiasis with damage to the respiratory organs, abdominal organs, eyes and urinary organs. Systemic infections with Cryptococcus fungi - sepsis, meningitis, infections of the lungs and skin, in patients with various immune disorders and with a normal immune response. Candidiasis of the mucous membranes of the mouth, esophagus, pharynx, non-invasive bronchopulmonary candidiasis. Genital candidiasis, prevention of fungal infections in patients with malignant tumors. , mycoses of the skin: body, nails (onychomycosis), with pityriasis versicolor. Deep endemic mycoses sporotrichosis, coccidioidomycosis, and histoplasmosis in patients with normal immunity.
Contraindications: Hypersensitivity, simultaneous administration of terfenadine and astemizole, lactation. Take with caution in patients with liver failure, during pregnancy, people with organic heart disease.

Side effects: Digestive system: nausea, diarrhea, abdominal pain, taste changes, abnormal liver function. Nervous system: headache, dizziness, convulsions. Organs of hematopoiesis: neutropenia, leukopenia, thrombocytopenia. Allergic reactions: skin rash, exudative erythema, swelling of the face, angioedema, urticaria, skin itching. Cardiovascular system: ventricular fibrillation / flutter, an increase in the duration of the QT interval.
Price : Fluconazole-150mg.1 piece - 15 rubles, 50mg. 7pcs - 32 rubles, Diflucan- 150 mg. - 720 rubles. 50mg 7pcs -850 rub. Mycosist 150mg. 1 piece - 270 rubles, 50 mg. 7 pieces. - 550 rubles. Flucostat-150mg. 1 piece - 150 rubles, 50 mg. 7 pieces. - 250 rubles.

Antifungal tablets - azoles should be taken with plenty of water and taken with meals. If the patient has low stomach acid, these medicines must be taken with acidic fluids. When taking systemic azoles, astemizole, terfenadine, pimozide, cisapride, quinidine, lovastatin and simvastatin should not be taken. Do not use azole tablets for pregnant and lactating women.

Antifungal tablets of the group - Allylamines:

Allylamines are synthetic antimycotics, the main indications for the use of which are dermatomycosis - fungal diseases of nails, skin, hair, lichen.

- analogues Terbinox, Terbizil, Exitern, Bramisil, Lamisil. This is allylamine, which has a wide spectrum of action against fungi that cause diseases of the nails, skin, hair, including dermatophytes. In low concentrations, it has an effect on mold and dimorphic fungi.

Indications for use: mycoses of the scalp, nails (onychomycosis), treatment of dermatomycosis of the legs, trunk, feet, in cases where the prevalence of infection is pronounced and oral antifungal agents are indicated. For Terbinafine, it is used only as a topical treatment, oral administration is not very effective in this disease.
Contraindications: Not recommended for patients with active, chronic liver and kidney disease. Pregnancy and lactation.
Side effects: Immune system: systemic and cutaneous lupus erythematosus. Nervous system: headache; taste disturbances, dizziness. Digestive system: feeling of fullness in the stomach, nausea, loss of appetite, abdominal pain, diarrhea. Dermatological reactions: skin reactions, psoriasis-like skin rashes. Musculoskeletal system: arthralgia, myalgia.
Price: Terbizil 14 pieces 1000 rubles, 28 pieces 1800 rubles. Lamisil 14 pcs 1800 rub. Terbinox 14 pcs 580 rub. 14 pcs. 480-560 rub.

Terbinafine is taken orally regardless of food intake, it must be washed down with a sufficient amount of water. When treated with any oral antifungal drugs, alcohol is contraindicated.

Antifungal agents of other groups:

Griseofulvin is one of the very first natural antimycotics, it has a narrow spectrum of activity, therefore it is used only in cases of dermatomycosis caused by dermatomycete fungi.

- an antifungal drug in tablets, which is used only for severe fungal infections. It is not used to treat fungal infections that are mild and easily eliminated with topical treatment. It is an antibiotic effective against fungi of the genus Epydermophyton, Trichophyton, Microsporum, Achorionum.

Griseofulvin is taken orally immediately after a meal or during a meal. If the patient is on a low fat diet, then the use of griseofulvin should be with one tbsp. a spoonful of vegetable oil.

Systemic antifungal therapy (taking drugs by mouth) is the most effective way to treat onychomycosis.

Benefits of tablets against nail fungus compared to other treatments:

the effectiveness of therapy is higher by 80%;
simple, convenient and labor-intensive treatment process.

Indications for systemic therapy

To treat nail fungus with pills, a number of factors must be taken into account directly. First of all, the doctor pays attention to the degree of development of the fungal infection, namely: lesion area and level of hyperkeratosis(thickening of the nail plate):

With unexpressed hyperkeratosis and visible damage to the nail up to 30%, external antifungal agents are used as standard.
With mild hyperkeratosis, if the degree of damage to the nail is 30-50%, systemic drug treatment is sufficient. Often, external preparations are also prescribed in the complex.
With moderate hyperkeratosis, if the degree of damage to the nail is 50-70%, the treatment regimen is similar to the previous one. There is a possibility of insufficient effectiveness without mechanical removal of keratinized tissues.
With severe hyperkeratosis and a lesion area of more than 50%, mandatory removal of the nail plate, cleaning of the nail bed while taking systemic drugs is indicated.

In addition to the clinical picture of the disease, the following are taken into account:

Age and physical features(localization of onychomycosis, the rate of nail regrowth);
Previous experience with fungus treatment, disease duration;
Associated health problems. For example: herpes labialis, type 2 diabetes mellitus, diabetic foot are factors in favor of systemic treatment.

Complete list of antifungal tablets

Overview of active ingredients used in preparations

Griseofulvin is effective only for dermatophytes.

Renders fungistatic effect on fungal cells (prevents their division and reproduction). Not suitable for the treatment of onychomycosis provoked by mold and yeast species.

Has a high degree of absorption. Metabolized by the liver, toxic.

The maximum concentration reaches 4-5 hours after ingestion.

Systemic treatment is carried out until the healthy nail grows completely, because after stopping the drug, the concentration decreases sharply within 2 days.

The average duration of therapy depends on the localization of onychomycosis: fingernails up to 6 months, on the legs 9-18 months.

Dosage forms: 125 mg, 250 mg, 500 mg tablets or oral suspension.

Dosage: on average, at the rate of 10 mg / 10 kg of body weight, i.e. 500-1000 mg of griseofulvin per day for adults and 125-500 mg for children. The last group of patients is not recommended to prescribe the drug. Consume after meals for better absorption.

Interacts with other drugs: weakens the effect of cyclosporine, anticoagulants, and hormonal contraceptives.

Adverse reactions: nausea, vomiting, diarrhea, hepatitis, dizziness, sleep disturbances.

Contraindications: pregnancy and lactation, childhood, liver and kidney diseases, systemic blood diseases.

The preparation of the allylamine group has a fungistatic (inhibition) and fungicidal (destruction) effect on dermatophytes and some mold fungi (Trychophyton spp., Microsporum canis, gypseum, Epidermophyton floccosum). Not effective enough against yeast species. The mechanism of action is aimed at destruction of the fungal cell membrane.

It is easily absorbed in the intestines, partially metabolized by the liver, and reaches its maximum concentration in a matter of hours. In the required amount, it accumulates in the nails after 3-8 weeks of administration and persists for a long time after discontinuation of the drug.

Available in the form of tablets of 125 mg and 250 mg.

The course of admission for treatment on the hands is 4-6 weeks, on the legs - 12 weeks. For adults, the daily dose of the drug is 250 mg, for children, 62.5 mg for every 20 kg of weight.

Concurrent use of rifampicin, cimetidine affect the metabolism of terbinafine and require adjustment of the dosage of the drug.

Side effects: nausea, abdominal discomfort, loss of appetite, changes in taste.

Ketoconazole from the azole group is active against dermatophytes and yeast fungi(Trichophyton, Epidermophyton floccosum, Microsporum, Candida). fungistatically acts on the pathogens of onychomycosis, destroys the cell membrane of the fungus.

Absorption by the intestines is partial, decreases with weak acidity, it is recommended to take it simultaneously with food. It enters the nail plate on average 1.5 weeks after the start of the intake. It has no properties to linger in the tissues after the end of consumption.

Dosage form: 200 mg tablets.

Dosage: the average rate for an adult is 200 mg per day for a course of 4-6 months and 8-12 months for the treatment of fungus on the hands and feet, respectively. For children weighing up to 30 kg, half the dose is sufficient.

Interacts with other drugs: rifampicin reduces the concentration of ketoconazole, and drugs to reduce gastric secretion interfere with absorption. Ketoconazole is not recommended to be taken simultaneously with antihistamines, anticoagulants.

May cause nausea, vomiting, abdominal discomfort.

Contraindicated in lactating and pregnant women, children under 3 years of age, with liver disease.

A modern representative of azoles. Differs in a wide spectrum of action: destroys cells of dermatophytes, yeasts and most molds.

It is well absorbed in the intestines. 7 days after the start of the intake, it accumulates under the nail, in the very focus of the infection. With each dose of the drug, the concentration increases several times. After cancellation, it remains in the tissues for a long period of time. Often used as part of pulse therapy: 400 mg / day for a week, followed by a break. For the treatment of toenails, on average, 3 courses of therapy are prescribed with an interval of 3 weeks. On hand - 2 courses with a similar interval.

Dosage form: capsules of 100 mg of the drug.

Interacts with other drugs, has a list of contraindications for the combination.

Side effects: nausea, constipation, abdominal pain, menstrual irregularities, dizziness.

Contraindicated in women during pregnancy (1 trimester) and lactation, with cardiac pathologies, impaired liver and kidney function.

Fluconazole works similarly to other drugs of the azole group. Has a wide spectrum of activity against dermatophytes and yeasts. In relation to mold species, the effectiveness is low.

Rapidly absorbed, practically not metabolized in the liver. Peak concentration occurs within the first hours after ingestion. It gets into the nails quickly, on average within a day.

Available in the form of capsules with a gelatin shell of 50, 100 and 150 mg

As part of pulse therapy, 150-300 mg is prescribed once a week for up to 6 months for onychomycosis of the hands and up to 12 months for the legs.

Taking rifampicin reduces the concentration of the antimycotic. And fluconazole itself increases the concentration of cyclosporine and phenytoin.

Adverse reactions due to a single dose per week usually do not occur.

Choosing the most effective drug

The optimal drug for systemic therapy is prescribed by the doctor based on the results of determining the type of fungus, localization and severity of the disease.

Main selection criteria:

Type of pathogen fungus. There are no universal tablets for the treatment of onychomycosis. All active components show different effectiveness against different types of fungi. With dermatophytes, griseofulvin and terbinafine are prescribed.
- With dermatophytes and / or yeast fungi of the genus Candida - azoles (ketoconazole and fluconazole).
- If there are several causative agents of the disease, then broad-spectrum drugs are prescribed. The most effective against all itraconazole and its analogue derivatives.
Localization of onychomycosis and severity of the disease. Grisefulvin and ketoconazole are not used for a long course due to high toxicity. It is mainly prescribed for the treatment of onychomycosis of the initial, middle stage, with localization on the hands.
Terbinafine and Itraconazole are relatively harmless and highly effective, suitable for the treatment of onychomycosis on the legs, as well as in advanced cases that require a longer course of therapy.
Contraindications. The choice of the drug largely depends on the general health of the patient, it is necessary to carefully study the contraindications and side effects before using antimycotics of any group.

Main contraindications

pregnancy and lactation;
childhood;
diseases of the liver, kidneys;
disorders of the nervous system;
cardiovascular diseases.

Possible complications

Antimycotics are toxic, have a particularly strong effect on the liver. In order to avoid complications, the medication should be taken under the supervision of a doctor. In parallel, hepatoprotectors are prescribed - drugs to protect and restore liver cells (Karsil, Essentiale Forte, Phosphogliv, Gepabene).

Alternatives to Systemic Therapy

There is no absolute alternative to systemic treatment due to its high efficiency. But in case of serious contraindications, the fungus can be cured without pills. Gives a similar effect:

, with normotrophic onychomycosis;
means for local therapy in combination with mechanical in hypertrophic onychomycosis.

The optimal treatment regimen is prescribed exclusively by a doctor. Due to the toxicity of antimycotic drugs, self-medication is dangerous to health.

Fungi are present in soil, food, water, and household items. Some of them live on the surfaces of the mucous membranes without causing discomfort. Only certain types of fungi are dangerous to humans. Getting on the skin, they provoke dermatomycosis, and when they penetrate the body - systemic mycoses. In this case, a broad-spectrum antifungal drug is prescribed. For outpatient treatment, doctors prescribe pills.

General information about antifungals

Antifungal agents for oral or injection administration are called systemic antimycotics. The need for them arises with advanced or generalized forms of skin lesions. In the initial stages of dermatomycosis, you can do without tablets.

Systemic drugs treat chronic forms of mycoses, when the patient is faced with periodic (regular) relapses. Tablets are useful in the treatment of nail fungus (onychomycosis), because therapy with only external preparations takes a long period and does not always end in recovery.

Mycoses of internal organs are treated exclusively with systemic antimycotics. Such conditions develop extremely rarely, often in people with immunodeficiency. Uncontrolled use of antibiotics can provoke systemic mycosis - such cases have become more frequent recently. Preparations of this group kill pathogenic microbes along with useful ones, but do not affect fungi. In the absence of normal bacteria, the latter "walk around" - they become active on the skin, internal and external mucous membranes, penetrate the bloodstream and spread to the organs. Mycosis of internal organs can be fatal.

The mechanism of action of antifungal tablets

All antifungal drugs can have a fungicidal effect (kill fungi) or fungistatic (suppress development and reproduction). Their mechanism of action is similar. Active components disrupt the synthesis of enzymes that the fungus needs to recreate and maintain the integrity of its membrane. In the absence of these compounds, the membrane becomes thinner and damaged. The contents of the cell come out - it dies.

The fungistatic effect is that in the absence of certain enzymes, cells stop multiplying. They die "from old age" without leaving behind "offspring".

At the moment, antifungal agents from the azole class (fluconazole, isoconosal, ketoconazole) are popular. These are compounds with a wide spectrum of antifungal activity, capable of destroying some fungi and suppressing others. They are absorbed into the systemic circulation, accumulate well in the bone and parenchymal tissue, and concentrate in the epithelial. Processed by the liver and kidneys. Excreted with feces and urine, as well as through the skin (along with sweat and sebaceous secretions). It is these drugs that are recommended for systemic fungal infections.

Another type of popular antimycotics is alliamins. The substance of this group, which is prescribed in the form of tablets, is terbinafine. The drug has a wide spectrum of antifungal activity and is more easily tolerated than azoles.

Polyene antibiotics (Levorin, Nystatin, Natamycin) are not absorbed into the systemic circulation and cannot be used to treat systemic mycoses. They are prescribed for the treatment and prevention of gastrointestinal candidiasis. The drugs are excreted unchanged through the intestines, simultaneously eliminating colonies of Candida bacteria.

On the basis of the same substances, ointments and creams are made. External use is appropriate only for laboratory-confirmed candidiasis of the skin and mucous membranes.

Information about contraindications and side effects

A general contraindication for the use of all antimycotic substances is individual sensitivity reactions. In fact, this is an allergy to a medicine that anyone can have. The interaction of chemical compounds and individual enzymes is not predictable, so some people tolerate drugs well, while others suffer from acute allergic manifestations (anaphylactic shock, angioedema, and others). It is impossible to say whether a person is allergic to a particular drug. This will become clear after the start of treatment.

All antimycotics cannot be used against the background of insufficiency of internal organs. Cardiac, renal and hepatic insufficiency are contraindications. It is undesirable to use these drugs for any pathologies of the liver and kidneys, since they are excreted by these organs. The risk of side effects is increased for diabetics.

Due to the risk of hepatotoxicity and nephrotoxicity, antifungal drugs should not be combined with any dose or type of alcohol.

Side effects are individual and occur with varying frequency. Most often, during treatment, nausea, vomiting, rashes on the body occur. Less often - edema and anaphylactic conditions.

Antimycotics can enter into drug interactions. These drugs do not combine well with anticoagulants, hormonal agents (including contraceptives). If the patient takes any medications on a regular basis, their names should be reported to the doctor before starting therapy.

Most antifungal drugs are contraindicated in pregnant women. They are prescribed if there is a danger to the life of the mother. Treatment takes place in a hospital.

Best Antifungals

Any fungal infection of the body is dangerous. Improper treatment of mycoses is fraught with the spread of infection throughout the body. Systemic fungal diseases are fatal. Skin lesions should be treated under medical supervision. Only a specialist should prescribe systemic drugs. Before choosing a medicine, he will assess the patient's condition, the results of laboratory tests and prescribe the remedy that is best suited. Self-administration of tablets is fraught with aggravation of the problem, the development of fungal resistance to the drug, overdose and serious side effects. Before purchasing and taking any antifungal tablets, you should consult your doctor.

One of the most affordable antifungal drugs in tablets. The price varies, depending on the manufacturer and the number of tablets in the package, from 70 to 200 rubles. In small quantities it is absorbed into the blood. It is used for the prevention and treatment of candidiasis against the background of antibiotic therapy, in the pre- and postoperative period. Works only in the gastrointestinal tract. Not suitable for the treatment of fungal infections of the feet and nails. Children, pregnant and lactating women should be prescribed by a doctor. Take 1-2 tablets 3-4 times a day. An analogue of Nystatin is Pimafucin (active substance - natamycin). The price of this drug varies between 550-650 rubles.

Antifungal tablets Clotrimazole (80-240 rubles) are in the affordable price range. This drug is not intended for oral administration. Tablets are used intravaginally to treat genital candidiasis in women. There are no oral medications containing clotrimazole.

Tablets with ketoconazole are prescribed for the treatment of extensive fungal skin lesions and rare mycoses (paracoccidioidomycosis, histoplasmosis, etc.). It can be taken orally only as prescribed by a doctor due to the high risk of liver damage. Assign 200-400 mg 1 time per day. Common side effects are nausea and headache. You can reduce negative manifestations by taking the remedy before bedtime or immediately after eating. Treatment should be supervised by a physician. It is advisable to take liver tests and urinalysis every 10 days. The risk of liver problems increases with long-term treatment with Ketoconazole (longer than 2 weeks). Analogues - Mycozoral, Nizoral. The price is from 220 to 600 rubles.

Fluconazole

They are produced in capsules under various trade names (Flyuzak, Futsis, Diflucan, Flucoric, etc.). Prices from 30 to 500 rubles per 1 capsule. Produced in different dosages (50, 100, 150, 200 mg), quantities (1,2,3,7,10 capsules) per package.

It is prescribed for the treatment of any type of fungal diseases, including generalized, lesions of the brain, lungs, mucous membranes, skin and nails. In people with immunodeficiency states, there is a need for prophylactic administration. Doses, frequency of administration, terms of treatment differ on an individual basis.

The drug is absorbed into the blood by 90%. Quickly penetrates into all biological fluids, accumulates in tissues. Creates stable concentrations of the active substance for more than a day. Fluconazole is usually well tolerated, but should be used with caution in people with liver pathologies. The risk of side effects increases with long-term use.

Terbinafine

A modern drug for the treatment of all types of fungal infections of the skin and mucous membranes, hairy areas of the body, systemic candidiasis. Produced by different companies. Trade names Terbinafine, Lamisil, Exifin, etc. The cost is from 300 to 2400 rubles - depends on the manufacturer and the number of tablets in the package.

Assign 125-250 mg once a day, regardless of food intake. The duration of treatment ranges from 10 days to 3 months. The drug should not be combined with alcohol - this increases the risk of developing hepatitis. During therapy, liver and kidney function should be regularly monitored. If necessary, appoint children from 3 years. In this case, the dose is calculated by weight.

Available antifungal drug with fungistatic action. It is prescribed for advanced forms of epidermophytosis, microsporia, favus and trichophytosis (foot rubromycosis). It costs 150-250 rubles.

After ingestion, it quickly accumulates in tissues rich in keratin - the surface layer of the dermis, skin appendages. The drug inhibits the reproduction of the fungus. As a result, infected keratin layers are shed over time, and already healthy ones form under them. The dose is calculated by weight. The classic scheme is 1 tablet per 10 kg. Tablets are taken together with vegetable oil - to increase the bioavailability of the drug. Due to the emergence of new substances with a fungicidal effect, doctors are gradually refusing to prescribe Griseofulvin.

Antimycotics are serious drugs. Overdose and abuse of tablets can lead to liver damage. For this reason, doctors prescribe these funds only in case of urgent need and in the shortest possible courses. For example, the treatment of candidiasis is a single dose of Fluconazole. In rare cases, therapy lasts 3-5 days. Skin diseases are treated for up to a month. The most dangerous for the liver is nail fungus therapy. With this disease, you will have to drink antifungal tablets from 3 months.