Medicines with antimycotic action. Antifungal drugs - effective and inexpensive Types of antifungal drugs

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 focused 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 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 Therefore, you need to carefully consider the recommendations of the doctor and the prescribed regimen. Broad-spectrum antifungal drugs in tablets can cause:

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

How to use

Antifungal drugs with a wide spectrum of activity for systemic treatment can be used parenterally (dropper 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 polyene macrolide group - they do not affect only dermatomycetes with pseudo-allescheria. They mainly destroy representatives of the genus Candida, but can also be active against filamentous and dimorphic fungi, trichomonas, 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 substance: 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: hepatic or renal insufficiency, hypersensitivity, pancreatitis, ulcer, acute diseases intestines (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 antimicrobial agents (prevention).
• 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, disorders of the kidneys and liver, porphyria (disturbance of pigment metabolism), problems with cerebral circulation, lactation and pregnancy, systemic lupus erythematosus, changes in blood composition.

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 azole category 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, arms and legs, 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, foot mycosis.
• 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 / molds, versicolor, chronic superficial candidiasis, systemic infections (histoplasmosis, blastomycosis).
• Side effects: violation menstrual cycle, toxic hepatitis, loss of appetite, hemolytic anemia.
• Contraindications: liver disease, childhood up to 3 years, 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 in case of intolerance to other azoles (or lack of effect from them). Features of the drug:

• Active ingredient: vorkinazole.
• Indications: invasive aspergillosis, severe forms 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 last and their a large number of:

• 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, change in 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, problems with digestion, stool, skin manifestations 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: elderly age, disorders of the liver / kidneys.

Echinocandins

new category antifungal agents wide spectrum of action 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 conjunctival, which are caused by a fungus.
• Contraindications: neoplasms 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 drug, you need to laboratory research and get checked out by a dermatologist.

For deep mycosis

The colonization of bone tissue by pathogenic microorganisms, nervous system, internal organs, respiratory tract requires the use of immunomodulatory 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). Accurate 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 is considered more effective with intravenous administration. medicinal solutions- 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 clinical picture diseases.
• 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. Adult dosage is 250 U / kg, but at the first application, 100 U / kg are made. 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 avoiding the treatment of a child if possible local preparations because 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 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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Antifungal drugs for feet and nails in pharmacies are represented by a wide variety of types and forms. Depending on the type of mycosis lesion, individual treatment is selected, which may include systemic and topical application antimycotic - a means that destroys the fungus. The prolonged existence of infection on the feet leads to a cosmetic defect, a change in the shape and color of the nails, chronic intoxication of the body, which is fraught with weakened immunity and exacerbation of chronic pathology.

Types of antifungal drugs

The classification of antifungal agents is based on their division depending on the main active substance. The table shows modern antifungal drugs of various pharmacological groups that can be used to treat foot fungus.

Choice of antifungal drug therapy depends on the following factors:

• age;
• type of pathogen and its sensitivity to the drug;
• localization of a fungal infection;
• the depth and prevalence of the pathological process;
• duration of the disease;
• the presence of concomitant diseases that may serve as a contraindication.

Given all the factors, if you experience symptoms of a fungus of the skin (dermatophytosis) or nails (onychomycosis), you should contact a specialist who will prescribe an individual treatment.

On a note!

Inappropriate use of antifungal drugs can lead to lingering current disease, the appearance of side effects, especially when using systemic antimycotics.

Systemic therapy

Systemic antifungal drugs are prescribed in the following cases:

• deep mycoses;
• widespread damage to the smooth skin and nails of the toes;
• destruction or involvement in the pathological process of more than half of the nail plate;
• fungal mycelium damage to the nail growth zone;
• high probability of accession of pathogenic bacterial flora;
• total damage to the nails (at least 3).

The most commonly used oral medications are listed in the table below.

Antifungal therapy systemic drugs not performed during pregnancy. This is due to the fact that active substance enters the blood and with the placental blood flow can enter the body of the fetus. There is intrauterine liver damage in a child. When using antimycotics orally on early dates can lead to the development of congenital malformations.

Local therapy

Inexpensive but effective antifungals can be used as local therapy. The forms of release of these funds are diverse and the selection of funds is carried out depending on the clinical picture.

If oozing occurs, an antifungal cream, lotion, or powder is preferred. In dry areas, antimycotic preparations in the form of ointments are used. With onychomycosis, varnishes and pastes have an effective effect.

The table shows the most effective topical antifungals.

In advanced cases of onychomycosis, complete removal of the nail plate may be required. For this purpose, keratolytic agents containing urea are used. They are included in the following complexes:

• Mycospor (730-1022 rubles);
• Nogtimycin (95-131 rubles);
• Nail (105-148 rubles).

Before using these products, the nail plate affected by the fungus is softened with a soda foot bath for 15 minutes. Then the surrounding area is treated with zinc ointment or sealed with adhesive tape. A dissolving agent and a dressing are then carefully applied. After 1-3 days, the dressing is removed, and the dissolved nail tissues are removed with a scraper, which is included in the kit. The procedure is repeated until the nail bed is exposed.

I used a cheap antifungal kit to remove a nail affected by a fungus - Nogtimycin. The price is about 100 rubles. I was able to completely remove it within a week and a half. Then every day I treated with ointment. The effect is good. The new nail has already grown by half and there is no fungus on it.

Svetlana, Zarechny

Overview of popular antimycotic drugs

The list of the best antifungal agents is presented by drugs of different pharmacological groups. The rating of new generation antimycotics is based on their relevance and effectiveness. Feedback from patients who have used different dosage forms, mostly positive.

Lamisil

One of the most famous antimycotic drugs. Lamisil is produced in Europe by order of the reputable pharmaceutical corporation GlaxoSmithKline. This medicine has the following release forms:

• Lamisil cream and spray - 386-861 rubles;
• Lamisil Dermgel - 398-557 rubles;
• Lamisil Uno - 664-902 rubles.

The drug is indicated for all types of fungus of the legs and nails. Easy to use Lamisil Uno, which is applied to the affected areas once. After its distribution over the skin, a film is formed, which persists for 3 days. The active substance, terbinafine, which has a wide spectrum of antifungal activity, is gradually released from it.

Side effects of the drug are extremely rare. It could be allergic rash, redness and burning at the site of application. The course of treatment for foot fungus averages 4 weeks. Lamisil is contraindicated in children under 15 years of age, patients with kidney and liver damage, with individual intolerance, occlusive (clogging) pathologies of the vessels of the legs.

I want to talk about such a wonderful antifungal medicine as Lamisil Uno. I got a foot fungus from my husband. I immediately went to a specialist who prescribed this remedy for me. Just applied once - and all the redness and itching disappeared. Now I use spray for prevention.

Maria Semenova, Vladivostok

Terbinafine

Domestic antifungal drug, a complete analogue of Lamisil in terms of the active substance. In addition to the manufacturer, there is a significant difference in price. Terbinafine is available in the following forms: spray, gel, ointment, cream and tablets. In addition to high antimycotic activity, one of the advantages of Terbinafine is its price. A tube costs from 56-149 rubles, depending on the amount of medicine in it.

I know a lot about this antifungal drug, since I myself was treated with it. I took pills and smeared them on my feet. There is an effect, but not immediately. In the treatment of fungus, the main thing is an integrated approach and not to give up halfway through. The price compared to Lamisil is much lower, and the result is no worse.

Oleg Nikolaevich, Saratov

Griseofulvin

Fungicidal drug for the systemic treatment of severe skin and nail lesions. Produced by a domestic manufacturer in the form of tablets of 10, 25, 30 pieces. The price for a package of Griseofulvin is 171-240 rubles.

In the first month of treatment of onychomycosis, tablets are taken daily, from the second month - every other day, then twice a week. The course of treatment continues until the growth of a new nail. Drink the medicine with a meal with a teaspoon of vegetable oil.

For a very long time I treated the fungus between the fingers. I tried all the ointments, spent a lot of money, but the fungus did not recede - it only grew more and more. As a result, she turned to a dermatologist in a dispensary. They took the analysis and identified the pathogen. Then the doctor prescribed Griseofulvin tablets and continue to smear the fungus every day. Everything is gone.

Lydia, Astrakhan

clotrimazole

Antifungal agents for toenails based on clotrimazole are known to almost everyone. The main spectrum of action of the drug is yeast of the genus Candida. For the treatment of fungus on the legs, Clotrimazole is used in the form of a cream (104-206 rubles), an ointment (85-134 rubles), a solution for external use (204 rubles). This remedy is contraindicated in case of individual intolerance and in the first months of pregnancy.

After the operation, I had to take antibiotics for a long time. After that, the fungus got out wherever possible. I was surprised by the fact that the doctor prescribed Clotrimazole ointment for the treatment of fungus on my legs. Before that, I thought that it was only used vaginally. But the effect was fast. Every day I smeared them with areas with a fungus for a month. I also took tablets with griseofulvin.

Anastasia, Moscow

Exoderil

The Austrian-made antifungal product for the feet of the Merck company has established itself as effective remedy fight against onychomycosis. The active substance of the drug is naftifine, a broad-spectrum antimycotic.

Exoderil has two forms of release in the form of a solution (430-606 rubles) and a cream (332-806 rubles). Before applying the medicine of any of these forms, it is necessary to remove the nail damaged by the fungus as much as possible with a nail file or nippers.

enjoyed antifungal drops Exoderil. I liked it, it is convenient to use - you gently rub the liquid over the nail cotton swab and that's all, you can additionally process the skin around. Such treatment quickly helped me, although the case was not running.

Maria Frolova, Bor

The pathogenicity of fungi is largely determined by their ability to directly affect the cells of the affected organ or organism, causing changes in the structure of the cell wall or metabolism in it. At the same time, fungi are able to produce individual toxins (aflatoxins, phallotoxins), various proteo- and lipolytic enzymes (hydrolases), which destroy tissue and cellular elements.

Rice. 2. Main mechanisms and localization of action of antifungal agents.

Depending on the clinical manifestations, localization of pathological processes and the degree of damage to the skin, nails, mucous membranes, pathogenic fungi are divided into:

Affecting the superficial part of the stratum corneum without inflammation (keratomycosis);

Affecting the thickness of the stratum corneum and causing an inflammatory reaction, affecting the epidermis, hair, nails (dermatomycosis);

Living in the stratum corneum and causing an inflammatory reaction of the underlying layers (subcutaneous mycoses);

Affecting the skin, subcutaneous tissue, muscles, bones, internal organs (systemic or deep mycoses).

Antifungal agents are usually prescribed depending on the location of the lesion, the type of pathogen, the antifungal spectrum of the drug, the characteristics of its pharmacokinetics and toxicity.

1. Means used in the treatment of diseases caused by opportunistic fungi of the genus Candida:

amphotericin B, levorin, nystatin, naftifine, natamycin, clotrimazole, miconazole, ketokenazole, decamethoxin.

2. Means used for dermatomycosis (keratomycosis, epidermomycosis, trichomycosis):

griseofulfin, terbinafine, miconazole, ketokenazole, decamethoxin, undecic acid, sanguirythrin.

3. Means used for systemic mycoses:

amphotericin B, flucytosine, ketoconazole, miconazole, itraconazole, fluconazole, griseofulvin.

Classification of antifungal drugs

Antifungal drugs are classified according to their chemical structure, spectrum of activity, pharmacokinetics, and clinical use in various mycoses.

I. Polienes:

Nystatin

Levorin

Natamycin

Amphotericin B

Amphotericin B liposomal.

For systemic use

Ketoconazole

Fluconazole

Itraconazole

For topical application

clotrimazole

Miconazole

Bifonazole

Econazole

Isoconazole

Oxyconazole.

III. Allylamines:

For systemic use

Terbinafine

For topical application

Naftifin.

IV. Preparations of different groups:

For systemic use

Griseofulvin

Potassium iodide

For topical application

Fmorolfin

Cyclopirox.

Polyena

Polyenes that are natural antimycotics include nystatin, levorin, and natamycin, which are applied topically and orally, as well as amphotericin B, which is used primarily for the treatment of severe systemic mycoses. Liposomal amphotericin B is one of the modern dosage forms of this polyene with improved tolerability. It is obtained by encapsulating amphotericin B in liposomes (a fat bubble formed when phospholipids are dispersed in water), which ensures the release of the active substance only upon contact with fungal cells and its inactivity with respect to normal tissues.

Mechanism of action.

Polyenes, depending on the concentration, can have both fungistatic and fungicidal effects due to the binding of the drug to the ergosterol of the fungal membrane, which leads to a violation of its integrity, loss of cytoplasmic content and cell death.

Unwanted reactions.

Nystatin, levorin, natamycin

With systemic use:

GIT: abdominal pain, nausea, vomiting, diarrhea.

Allergic reactions: rash, itching, Stevens-Jones syndrome (rare).

When applied topically:

irritation of the skin and mucous membranes, accompanied by a burning sensation.

Amphotericin B.

Reactions to intravenous infusion: fever, chills, nausea, vomiting, headache, hypotension. Prevention measures: premedication with non-steroidal anti-inflammatory drugs (paracetamol, ibuprofen) and antihistamines (diphenhydramine).

Local reactions: pain at the site of infusion, phlebitis, thrombophlebitis. Prevention measures: administration of heparin.

Kidneys: dysfunction - decrease in diuresis or polyuria. Control measures: monitoring of clinical analysis of urine.

GIT: abdominal pain, anorexia, nausea, vomiting, diarrhea.

Nervous system: headache, dizziness, paresis, sensory disturbances, tremor, convulsions.

Allergic reactions: rash, itching, bronchospasm.

Amphotericin B liposomal.

Compared to the standard drug, it rarely causes anemia, fever, chills, hypotension, and is less nephrotoxic.

Indications.

Nystatin, levorin.

Candida vulvovaginitis.

Preventive use is ineffective!

Natamycin.

Candidiasis of the skin, oral cavity and pharynx, intestines.

Candida vulvovaginitis.

Candida balanoposthitis.

Trichomonas vulvovaginitis.

Amphotericin B.

Severe forms of systemic mycoses:

invasive candidiasis;

Aspergillosis;

Cryptococcosis;

Sporotrichosis;

Mucormycosis;

Trichosporosis;

Fusarium;

Feogyphomycosis;

Endemic mycoses (blastomycosis, coccidoidosis, paracoccidioidomycosis, histoplasmosis, penicilliosis).

Candidiasis of the skin and mucous membranes (locally.

Leishmaniasis.

Primary amoebic meninoencephalitis caused by N. fowleri.

Amphotericin B liposomal.

Severe forms of systemic mycoses (see amphotericin B) in patients with posterior insufficiency, with the ineffectiveness of the standard drug, with its nephrotoxicity, or severe reactions to intravenous infusion that cannot be stopped by premedication.

Contraindications.

For all polyenes:

Allergic reactions to drugs of the polyene group.

Additionally for amphotericin B:

Liver dysfunction;

kidney dysfunction;

Diabetes.

All contraindications are relative, since amphotericin B is almost always used for health reasons.

Azoles

Azoles are the most representative group of synthetic antimycotics, including drugs for systemic ( ketoconazole, fulconazole, itraconazole) and local ( bifonazole, isoconazole, clotrimazole, miconazole, oxiconazole, econazole) applications. It should be noted that the first of the proposed "systemic" azoles - ketoconazole - after the introduction of itraconazole into clinical practice has practically lost its significance due to high toxicity and has recently been more often used topically.

Mechanism of action.

Azoles have a predominantly fungistatic effect, which is associated with the inhibition of cytochrome P-450-dependent 14-demethylase, which catalyzes the conversion of lanosterol to ergosterol, the main structural component of the fungal membrane. Local preparations, when creating high local concentrations in relation to a number of fungi, can act fungicidal.

Unwanted reactions.

Common to all systemic azoles:

GIT: abdominal pain, loss of appetite, nausea, vomiting, diarrhea, constipation.

CNS: headache, dizziness, drowsiness, visual disturbances, paresthesia, tremor, convulsions.

Allergic reactions: rash, itching, exfoliative dermatitis, Stevens-Johnson syndrome (more often when using fluconazole).

Hematological reactions: thrombocytopenia, agranulocytosis.

Liver: increased activity of transaminases, cholestatic jaundice.

Common for local azoles:

For intravaginal use: itching, burning, hyperemia and swelling of the mucous membrane, vaginal discharge, increased urination, pain during intercourse, burning sensation in the penis in the sexual partner.

Indications.

Intraconazole.

Dermatomycosis:

Epidermophytosis;

Trichovitia;

Mycosporia.

Pityriasis versicolor.

Candidiasis of the esophagus, skin and mucous membranes, nails, candidal paronychia, vulvovaginitis.

Cryptococcosis.

Aspergillosis (with resistance or poor tolerance to amphotericin B).

Pseudoallescheriosis.

Feogyphomycosis.

Chromomycosis.

Sporotrichosis.

endemic mycoses.

Prevention of mycoses in AIDS.

Fluconazole.

invasive candidiasis.

Candidiasis of the skin, mucous membranes, esophagus, candidal paronychia, onychomycosis, vulvovaginitis).

Cryptococcosis.

Dermatomycosis:

Epidermophytosis;

Trichovitia;

Mycosporia.

Pityriasis versicolor.

Sporotrichosis.

Pseudoallescheriosis.

Trichosporosis.

Some endemic mycoses.

Ketoconazole.

Candidiasis of the skin, esophagus, candidal paronychia, vulvovaginitis.

Pityriasis versicolor (systemically and locally).

Dermatomycosis (locally).

Seborrheic eczema (locally).

Paracoccidiosis.

Azoles for local use.

Candidiasis of the skin, oral cavity and pharynx, vulvovaginal candidiasis.

Dermatomycosis:

Trichophytosis and epidermophytosis of smooth skin;

Hands and feet with limited lesions.

With onisomycosis, they are ineffective.

Pityriasis versicolor.

Erythrasma.

Contraindications.

Allergic reaction to drugs of the azole group.

Pregnancy (systemically).

Breastfeeding (systemically).

Severe liver dysfunction (ketoconazole, itraconazole).

Age up to 16 years (itraconazole).

Antimycotic (antifungal) drugs are drugs whose mechanism of action is aimed at neutralizing and completely destroying pathogenic fungi.

Such pharmaceutical products can have both chemical and natural composition. Antifungal drugs have their own classification, so it’s quite difficult to choose the right remedy for yourself.

Alas, statistics show that today the need for such medicines has increased significantly. This is due to many different factors, the impact of which is often the result of rash actions of the person himself.

It is important to remember that antimycotics have a large number of contraindications, and can cause serious side effects. This is especially true for tablets and capsules for oral administration, therefore, without a doctor's prescription, it is better not to get involved in taking them. Only a specialist can accurately calculate the dosage, and choose a drug substitute if necessary.

Patients undergoing therapy with antifungal medications must strictly follow all the recommendations of the attending physician. You can not independently change the regimen of therapy and adjust the dosage. Such actions can, at best, nullify all attempts to overcome the disease, and at worst, lead to more serious health problems.

How to choose the right medicine?

When symptoms of a fungus appear, it is better not to run to the pharmacy for a medicine, but to make an appointment with a dermatologist.

The doctor can determine the type of fungal infection, the degree of skin damage, and identify symptoms associated with the disease. Based on the data obtained, a drug is selected that will be most effective in a particular situation.

But the patient will not be able to independently perform the necessary diagnostic manipulations. Based on this, you should not self-medicate.

Dosage forms of drugs for the treatment of onychomycosis

Before prescribing a specific antimycotic, it is necessary to determine the type of causative agent of mycosis. To do this, a scraping is carried out from the surface of the nail plate or skin, and the selected material is subjected to a thorough laboratory study.

Treatment of onychomycosis can be carried out:

• topical preparations (gels, ointments, creams, varnishes, solutions);
• means for oral administration - capsules, tablets.

The use of topical drugs does not always give the expected results. Their components do not penetrate well into the lower layers of the nail plate, so it is advisable to use them only for superficial fungus. In addition, before starting therapy, it is recommended to remove or cut off the affected nail, which does not always suit patients.

A good alternative to sprays and ointments are special medical varnishes. They have a versatile effect, and have a completely different mechanism of action than other local antimycotics.

Distinctive features of varnishes from fungus are:

• the presence in their composition of drying components (alcohol, oil extracts, etc.);
• the ability to penetrate into all layers of the nail and spread through them;
• preventing the penetration of air into the nail after hardening of the varnish, which contributes to the death of the fungal flora;
• the active substance of the varnish leads to destructive processes in the membrane of fungi, as well as in the enzymes produced by them;
• the formation of a protective film on the surface of the nail, which prevents its re-infection.

If onychomycosis occurs in a chronic or complicated form, then, in addition to local, systemic antimycotic drugs are also prescribed. These drugs are very toxic, so their selection is carried out for each patient separately. In this case, the role is played not only by the type of pathogen, but also by the reaction of the patient's body to a specific agent.

The scheme of therapy is based on the use of "shock" doses of drugs in short courses. After one therapeutic course, a long break follows, after which the second begins, etc.

Azoles

Azoles belong to the group of synthetic antimycotic drugs, and are used to treat fungal infections in the scalp, skin, and nails. They are also used for lichen, as well as candidal lesions of the epidermis or mucous membranes.

Below is a list of the most effective and well-known antifungal drugs in this group:

1. Ketoconazole. The drug is used to combat dimorphic and yeast-like fungi. They are used to treat folliculitis, dermatophyte, seborrheic dermatitis, chronic candidiasis, lichen. Ketoconazole is used for head fungus and skin if there is an extensive fungal infection and resistance to the infectious process. The drug can cause serious side effects, so it must be used carefully. This is especially true for children and persons old age. You can buy Ketoconazole at a price of 100 rubles.
2. Mycozoral. With the help of this ointment, diseases such as epidermophytosis, pityriasis versicolor, ringworm, seborrheic form of dermatitis are treated, different types candidiasis. Medications based on ketoconazole are also available in the form of shampoos and oral tablets. Their price starts from 200 rubles.
3. Sebosol is a shampoo and ointment used to treat fungal infections caused by yeast-like fungi, dimorphites, staphylococci and streptococci. The medicine is suitable for the treatment of fungus of the foot, nails, head. Its cost starts from 130 rubles.
4. - a broad-spectrum drug used for skin lesions with cryptococci and candida fungi. Capsules should be taken with caution by pregnant women, as well as patients with renal and hepatic diseases. The price of the drug is from 20 rubles.

Polyena

Polyenes are a group of broad-spectrum antifungal drugs. These drugs are the most common and frequently prescribed. In most cases, they are prescribed for fungal infections of the mucous membranes, skin and digestive tract.

The most effective drugs are:

1. . It is released in the form of tablets and ointments, and is used to treat fungal infections of the skin and mucous membranes. The use of the drug is advisable for candidal lesions of the vagina, oral cavity, intestines. The medicine has almost no contraindications and rarely causes side effects. Its cost is from 40 rubles.
2. Levorin. The drug is used for candidiasis of the digestive tract and skin. It is highly effective in the fight against Trichomonas, fungi of the genus Candida, as well as Leishmania. The drug is contraindicated in pregnancy, HB, liver and kidney failure, pancreatitis, peptic ulcer stomach and duodenum. It should not be used by children under 2 years of age. The cost of the medicine ranges from 100-130 rubles.
3. . It is effective for many types of fungi, and is prescribed for candidal lesions of the gastrointestinal tract and vagina. Pimafucin is also used to eliminate fungal infections caused by long-term use of antibiotics or corticosteroids. The price starts from 250 rubles.

Allylamines

It is advisable to use this group of drugs for dermatomycosis - fungal infections of hair, nails and skin. The most popular drug in this group is, which is released in the form of an ointment and cream. It is used to treat fungal infections of the nails and skin. Effective against dimorphic and mold fungi.

The medicine is prescribed for the treatment of the skin of the legs, head and torso. Its use is also appropriate for nail fungus. The cost is from 48 rubles.

Broad Spectrum Antifungals

This group of drugs has a fungicidal and fungistatic effect. They prevent the further development of a fungal infection, and also destroy the remaining fungi.

The mechanism of action of drugs depends on their active ingredients.

1. Ketoconazole, which prevents the synthesis of fungal cell membrane constituents. Most effective drugs- Oronazole, Mycozoral, Fungavis.
2. Griseofulvin, which stops the division of fungal cells.
3. Itraconazole - allows the formation of fungal cells. The most effective representatives of this group are Irunin, Orunit, Orungal.
4. Terbinafine interrupts the synthesis of fungal cells at the initial stage.
5. Fluconazole is a substance that prevents the formation of new fungal spores and neutralizes those that already exist. This group includes drugs: Mycomax, Diflucan and Fluxstat.

Antifungal drugs have a lot of contraindications, the most common of which include:

• chronic renal and hepatic diseases occurring in severe form;
• the period of pregnancy and GV;
• childhood;
• glucose-galactose malabsorption;
• individual lactose intolerance;
• the use of certain groups of medications;
• individual intolerance to one or more components of the drug.

Based on these contraindications, only a doctor can prescribe a systemic antimycotic.

Antifungal nail polishes

This group of antimycotic drugs can be used in isolation, or as part of complex treatment. The most effective varnishes are:

1. Mycosan. The drug can be used for extensive fungal infections of the nail plate.
2. Lotseril. The drug quickly stops the fungal infection, even in the later stages of its development.
3. Batrafen. Varnish can be used to treat advanced onychomycosis. It well eliminates the unpleasant symptoms of pathology, and has a pleasant aroma.
4. Neil Expert. It is advisable to use the tool for the defeat of nails with yeast-like fungi. It slows down the growth of microorganisms and prevents their further spread.
5. Demicten. This varnish is allowed to be used in parallel with other topical antimycotics. The drug is effective for extensive lesions of the nail plate.
6. Gazebo. The medicine is used to disinfect nails after a course of treatment for the fungus. It eliminates odor and inflammation.

Before applying varnish, the nail must be filed and treated with an antiseptic (ordinary alcohol is also suitable). After that, a medicine is applied that dries within a few minutes. How often you can apply antifungal varnish, only the attending physician can tell.

Antifungal solutions (drops) and sprays

These drugs can be used both independently and in parallel with other antimycotics. They contain active ingredients from the anzoles and allylamines.

Often doctors resort to prescribing antifungal drops:

• Clotrimazole;
• Mycospora;
• Exoderil.

Among the sprays are very popular:

• Bifosin;
• Lamitel;
• Lamisil;
• Terbix.

It is necessary to apply drops and sprays on previously cleansed skin and nails. Multiplicity of application - 1-2 times a day. The duration of treatment is determined by the doctor individually for each patient.

How to choose the right treatment methods?

The method of treatment depends on the type of pathogen and the stage of the pathological process. So, with the defeat of the epidermis, therapy is carried out using local antimycotics.

Onychomycosis requires a comprehensive approach, although it is often treated with one of the following options: topical antifungal therapy, cleaning and filing of the affected nail, or systemic antifungal medication.

The first signs of a fungal infection of the skin and nails should be a good reason for an immediate appeal to a dermatologist. And although fungal infections do not pose a serious danger to human health, they significantly impair the quality of life. In addition, they are easily transmitted to other people, so they must be treated.

Moreover, therapy at the initial stages of the development of mycosis does not take much time, and does not require significant financial costs.

fungal infection is common cause visits to doctors of various specialties. In some cases, it becomes a threat to the patient's life and requires immediate treatment, in others, mycosis can only cause discomfort and a feeling of embarrassment in front of others. Many oncological and systemic diseases are treated with aggressive drugs that suppress the immune system and cause the reproduction of a pathogen that only antifungal drugs can eliminate. Therefore, it is important to recognize the infection in a timely manner and begin its treatment, and in some cases, prevent infection.

Antimycotics are represented by a wide variety of drugs. These are predominantly broad-spectrum drugs, many of which are effective not only against pathogenic fungi, but also against other microbes. They are prescribed by a doctor after the diagnosis is established and are taken until the infection is completely cured.

Types of antifungals

Antimycotics are available in the following dosage forms:

• topical products in the form of cream, gel, ointment, spray and drops;
• oral preparations in the form of capsules, tablets or syrup;
• solutions for intravenous infusions;
• intravaginal tablets.

Adverse reactions

Antifungal medicines can cause side effects. They usually only last for a short period of time. These include:

• itching or burning;
• redness;
• abdominal pain;
• diarrhea;
• rash on the skin.

Some drugs have more serious side effects. When taking them, the patient may develop anaphylactic shock or angioedema: the face, neck or tongue swell, breathing may be difficult, blisters appear on the skin.

In case of an overdose, as well as in patients with liver diseases, liver failure may develop, in which the patient complains of the following symptoms:

Polyena

This is a group of drugs of natural origin. The main substance is obtained from bacteria of the genus Streptomyces. Upon contact with the fungus, it interacts with ergosterol, which is part of the plasma membrane, as a result of which a channel is formed in the wall, respiratory processes are disrupted and the cell dies. Polyene antifungals include:

• Nystatin;
• Amphotericin B;
• Pimafucin.

Nystatin

Antimycotic agent effective against fungi of the genus Candida.

Nystatin is used for local infection, candidiasis of the oral cavity, mucous membranes, skin, and internal organs. In systemic diseases, it is not used.

The drug is available in the form of tablets, ointments, suppositories. It has low toxicity, rarely causes side effects, therefore it is approved for use in children. When taken, the medicine increases sensitivity to ultraviolet rays, therefore, during therapy, prolonged exposure to the sun should be avoided. Since sugar is present in the composition, the drug is contraindicated in patients with gastrointestinal enzyme deficiency.

Amphotericin B

A drug with a wide spectrum of activity, which is used to treat both severe fungal systemic diseases and local mycoses.

The drug can be taken by pregnant women, but with caution, lactation should be stopped for the duration of treatment. Do not use in patients with kidney and liver damage.

It is used externally as an ointment or intravenously. The introduction of the drug intravenously can be accompanied by a considerable number of side effects: from phlebitis (inflammation of the vein) in the area of ​​drug administration and to toxic effects on the liver and kidneys.

Azoles

The chemical structure of these agents includes two or three nitrogen molecules. Depending on the amount of this element, they are divided into imidazoles and triazoles. The imidazoles are:

• Ketoconazole;
• Miconazole;
• Clotrimazole.

A derivative of imidazole and benzothiophene is Zalain.

Triazoles are represented by two names:

• Fluconazole;
• Itraconazole.

The mechanism of action of this group of drugs is expressed in the inhibition of enzymes dependent on cytochrome P450, which are involved in the biosynthesis of cell membrane sterols. This leads to a violation of the integrity of the fungal cell.

The range of action of drugs in this group is wide, and side effects are less common compared to polyene antibiotics. But with long-term use of azoles, life-threatening liver failure can occur.

It is more commonly caused by imidazoles than by triazoles. It is not recommended to take azoles together with medicines such as:

• Cyclosporine;
• antihistamines;
• oral hypoglycemic agents;
• anticoagulant drugs;
• drugs that are metabolized in the liver.

Ketoconazole

A good antifungal drug that is widely used in dermatology. Effective when taken in tablet form, but it can also be used topically. Available in the form:

• ointments;
• tablets;
• shampoo.

Active against infections caused by H. capsulatum and B. dermatitidis. The medicine is prescribed for the treatment of:

• thrush;
• dermatomycosis;
• nail fungus;
• ringworm;
• mycosis of the genitourinary organs.

The drug can be used prophylactically to prevent the occurrence of infection.

Fluconazole

It is used for mycoses of external localization and systemic fungal infection. Available as:

• capsules;
• syrup;
• solution for infusion.

One of the main indications for use is candidiasis of different localization (skin, genital area, oral cavity). The drug is well tolerated, side effects are rare, manifested by skin rash, diarrhea. Not recommended for use by children and pregnant women.

Itraconazole

An inexpensive antifungal drug that is prescribed for mycotic lesions of the skin, mucous membranes, and nail plates.

The drug is presented in the form of capsules for oral administration. It is not recommended to use Itraconazole in patients with medical conditions of cardio-vascular system, hepatic and kidney failure. During pregnancy and lactation, you can not take the medicine. Side effects may include:

• allergic reaction;
• the phenomena of dyspepsia;
• headache;
• dizziness.

Of the more severe complications, there is a possibility of developing heart and liver failure.

Zalain

A modern medicine of a new generation of a wide spectrum of action. It is used to combat the fungus of external localization and vaginal candidiasis.. Available in the form of ointments and suppositories. Zalain practically does not cause side effects and does not have a systemic effect on the body. Not recommended for pregnant and lactating women. The result after the start of application is noticeable almost immediately.

Allylamines

This group of antimycotic agents is represented by two drugs: Terbinafine and Naftifine. They are used for fungal diseases of external localization (onychomycosis, skin fungus).

Terbinafine

Terbinafine effectively fights against pathogenic fungi and has an antibacterial effect.

In the pharmacy, the medicine can be found in the form of tablets, spray, cream and solution for external use. The drug is approved for children over 2 years of age.

Adverse reactions are minimal, patients may complain of:

Naftifin

This antimycotic is used for external use for skin fungus, damage to the nail plates. Contraindicated in case of allergy to drug components. Pregnant women should be used with caution, children are not prescribed.

Side effects are predominantly local in nature: rash, itching, burning in the areas of application.

Morpholine derivatives

This group is represented by one medicine- Amorolfine. The drug is inexpensive, but correct application effective. Available as nail polish, cream and spray. The drug gives the most reliable result with onychomycosis.

• children (studies on the effect of the drug on the children's body have not been conducted);
• pregnant and lactating;
• people with hypersensitivity to the medicine.

Undesirable reactions can be manifested by rashes on the skin, itching.

Other antifungals

Based on the results of the tests, the doctor may prescribe antimycotics from other chemical groups.

Griseofulvin

An antifungal medicine derived from the bacterium Penicillium griseofulvum. Produced in the form of tablets. It is prescribed for mycoses of the skin, feet, scalp.

Contraindications for use are:

• systemic diseases;
• damage to the kidneys and liver;
• oncological diseases;
• age up to 2 years;
• pregnancy and lactation.

The drug reduces the effectiveness hormonal contraceptives and indirect anticoagulants.

flucytosine

This medicine is an antimetabolite that has fungicidal and fungistatic effects. Its mechanism of action is to inhibit the synthesis of DNA and RNA in the fungal cell.

The medicine is effective for:

• severe systemic diseases;
• fungal meningitis;
• candidiasis;
• cryptococcosis;
• aspergillosis.

Flucytosine is contraindicated:

• during pregnancy;
• during breastfeeding;
• in childhood;
• people with blood diseases and kidney failure.

The drug is used as an infusion for intravenous administration. It can have a large number of side effects, some of which are serious life-threatening:

• cardiac arrest, breathing;
• gastrointestinal bleeding;
• liver failure.

Therefore, a medicine is prescribed according to strict indications and its intake should be under the supervision of a doctor.

Before using any of medicines you need to read the instructions, and if unwanted reactions occur, immediately contact your doctor.