Lamisil or penlac

[psalmist]

I asked this question once before but will ask again since the pharmacist raised new concerns. I am looking at taking an antifungal medication called lamisil. I had a GP (who had no concerns about my coumadin) provide a perscription for generic lamisil. The concern with this drug is its affect on the liver! This could have an affect on my meds. When I called it into the pharmacist he highly and strongly recommended not using it because it would affect my meds. He recomended penlac. I never heard of it but it is a perscription and may be an option to look at. Anybody have any ideas? ( I have a couple of fingernails and toenails that are infected and it is embarrassing. It will not go away without treatment but I don't want to risk my life for it...)

 

[catwoman]

Seth:

Based on info below, I would go with lamisil. Can you use the lotion, rather than tablets?

http://www.bcbswny.com/content/bcbs_prov_guid_antifungal.pdf

It appears that lamisil is more effective than penlac.

Your INR would increase some. I would definitely test before starting whichever drug, and then about 3-4 days afterward.

I wouldn't worry about taking a drug that can cause an increase/decrease in my INR. Just be ready to get an INR before starting a new RX, then 3-4 days into regimen. If your INR had been steady previously, I would probably return to the usual dosage after finishing the new drug. (At least, this is what I would do.)

BTW, I had a Dr. Rx something for nail fungus back in 1977. Never got it filled. Since then, no Dr. has ever suggested I needed anything....... Not even the orthopedic surgeon who operated on my feet in 1980.

 

[Adrienne]

I asked this question once before but will ask again since the pharmacist raised new concerns. I am looking at taking an antifungal medication called lamisil. I had a GP (who had no concerns about my coumadin) provide a perscription for generic lamisil. The concern with this drug is its affect on the liver! This could have an affect on my meds. When I called it into the pharmacist he highly and strongly recommended not using it because it would affect my meds. He recomended penlac. I never heard of it but it is a perscription and may be an option to look at. Anybody have any ideas? ( I have a couple of fingernails and toenails that are infected and it is embarrassing. It will not go away without treatment but I don't want to risk my life for it...)

I tried Penlac for a couple of years, and it did not cure the toenail fungus. Then I started using (I kid thee not) Vick's Vapo Rub on the nails because Mary of VR.COM said it cleared up her husband's toenail fungus. Well, it did not clear mine up. However, it makes the nail much softer and easier to file down, etc. I REFUSE to take lamisil (even though I am not on Coumadin) because there is a risk, however little, of it causing liver failure. I can live with toenail fungus - I cannot live with liver failure!!!

 

[dtread]

If possible avoid taking the tablets - the side effects sound bad. Lamisil ointment works great, but will not work for toenail fungus under the toenails. Here is a little known method to get rid of toenail fungus. Get your podiatrist to remove the toenail. Then, after it has healed for a few days, put Lamisil ointment on it for a week or so (follow the directions on the tube). It worked for me, but I only had one toenail that was infected. If you have a lot of toenails that are infected it might not work, plus there is a certain amount of pain involved in walking with toenail removed (after its removed - they'll give you a local for the actual toenail removal). However, the pain moderates after a few days. If all ten of your toenails are infected than the toenail removal method might be either too daunting or whatever to attempt. But you could possibly do it one foot at a time, perhaps a couple of weeks apart. This method is a lot better than the tablets, in my opinion (whether you're on Coumadin or not). Good luck

http://www.youtube.com/watch?v=Zzq5X-p2C0Y

 

[catwoman]

One home treatment for fungus -- regardless of the type -- is a diluted bleach-water solution.
Yep, bleach-water.
I had thought of that when Seth posted his query, but didn't suggest it. Bleach is a very effective topical treatment for the R-word (ringworm) & great on/around showers and bathtubs if you get mildew buildup.

I googled bleach and toenail fungus, and found many hits. Common suggestion was to use diluted solutions (1:32 is the usual dilution), and soaking the foot.

If anyone does this, be very cautious with any fabrics (towels, or clothing) around the solutions or your feet. I would probably put it in a rubber dish pan about 6-8" deep in a bathtub. After soaking the foot/feet, thoroughly rinse the foot/feet off and then use paper towels to dry off.

It's a suggestion worth investigating. It's cheap. You wouldn't have to worry about taking an Rx or other med that could increase your INR.

NOTE: I would not consider the above if you have any open sores, cuts or wounds or have had a toenail removed.

 

[jeffp]

Let me preface my response with the required disclaimer...I am not offering medical advice or advocating any medication, nor do I have any financial interest in any product mentioned. With that out of the way, I can report my observations after 25+ years practicing podiatry (you'd think I'd have gotten it right by then) and treatinf thousands of people with fungal nails.
1) The number of serious complications as a result fubgal infected toenails, maybe 1/2 dozen; and they were folks with really poor circulation and foot ulcers
2) The number of cases cleared by bleach solution = 0, number that developed skin reactions to bleach soaks, probably around 100
3) The number cleared by VicksVapo rub, 1 - yep, it does happen
4) Number of case of liver damage due to Lamisil, 0; number due to Sporanox, 3. The incidence of liver damage with either is VERY low.
5) Percentage is case cured with oral Lamisil (remember this would be 6-8 month after a 3 month course of the medication), about 25%, improved about 75%. With Penlac, those drop to about 5% and 25% respectively
In the end, you'll have to decide for yourself.

 

[Lynlw]

Let me preface my response with the required disclaimer...I am not offering medical advice or advocating any medication, nor do I have any financial interest in any product mentioned. With that out of the way, I can report my observations after 25+ years practicing podiatry (you'd think I'd have gotten it right by then) and treatinf thousands of people with fungal nails.
1) The number of serious complications as a result fubgal infected toenails, maybe 1/2 dozen; and they were folks with really poor circulation and foot ulcers
2) The number of cases cleared by bleach solution = 0, number that developed skin reactions to bleach soaks, probably around 100
3) The number cleared by VicksVapo rub, 1 - yep, it does happen
4) Number of case of liver damage due to Lamisil, 0; number due to Sporanox, 3. The incidence of liver damage with either is VERY low.
5) Percentage is case cured with oral Lamisil (remember this would be 6-8 month after a 3 month course of the medication), about 25%, improved about 75%. With Penlac, those drop to about 5% and 25% respectively
In the end, you'll have to decide for yourself.

Justin took oral Lamisil and had no problems He asked both his cards before his doc would write for it. It worked great, and takes a while, but he had a nice nail again, and then being Justin about a month later someone dropped a road case (full of band gear) on his toe and the whole nail turned comletely Black, so in a couple months hopefully THAT will be grown out and he has a nice nail

 

[catwoman]

Let me preface my response with the required disclaimer...I am not offering medical advice or advocating any medication, nor do I have any financial interest in any product mentioned. With that out of the way, I can report my observations after 25+ years practicing podiatry (you'd think I'd have gotten it right by then) and treatinf thousands of people with fungal nails.
1) The number of serious complications as a result fubgal infected toenails, maybe 1/2 dozen; and they were folks with really poor circulation and foot ulcers
2) The number of cases cleared by bleach solution = 0, number that developed skin reactions to bleach soaks, probably around 100
3) The number cleared by VicksVapo rub, 1 - yep, it does happen
4) Number of case of liver damage due to Lamisil, 0; number due to Sporanox, 3. The incidence of liver damage with either is VERY low.
5) Percentage is case cured with oral Lamisil (remember this would be 6-8 month after a 3 month course of the medication), about 25%, improved about 75%. With Penlac, those drop to about 5% and 25% respectively
In the end, you'll have to decide for yourself.

Jeff:

Why is toenail fungus such a problem? Is it just a superficial problem?

 

[jeffp]

Jeff:

Why is toenail fungus such a problem? Is it just a superficial problem?

For the vast majority, it's strictly a cosmetic issue. For a select few with poor circulation, various skin conditions, neuropathy, things like that; it can wind up causing infections and ulcerations. Those were the ones I'd generally go after more aggressively (and those with poor circulation did the worst as so little medication got down there ).

As you can see, I don't get to cruise the forum as much as I used to.