Treatments
Prescription treatments for fungal nail infection in the UK
For extensive or multi-nail infection, systemic treatment reaches the nail bed through the bloodstream. It is effective, but it is a months-long commitment with monitoring.
Summary
Terbinafine is the usual first choice in the UK — typically 250mg daily for six weeks for fingernails or twelve weeks for toenails. Itraconazole pulse therapy is an alternative, particularly for Candida. Both require a confirmed diagnosis, usually from nail clippings, before a GP will prescribe.
What to expect
Practical points before starting.
- Nail clippings sent for microscopy and culture first
- Liver function tests before and sometimes during treatment
- Interactions with other medicines are common — bring your full list
- The nail keeps looking abnormal until it grows out
Side effects
Most people tolerate terbinafine well. Reported effects include taste disturbance, nausea, headache and rash; rare liver problems mean any jaundice, dark urine or persistent nausea should be reported immediately.
Who it suits
Extensive disease, several nails, matrix involvement, or failure of topical treatment. It is often combined with mechanical or chemical nail reduction to shorten the course.
When to seek medical advice
Always — these are prescription-only medicines. Never buy oral antifungals from an unregulated online source.
References
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Medical disclaimer. This article is general information written for a UK audience. It is not medical advice and does not replace assessment by a GP, pharmacist or podiatrist. Always read the patient information leaflet supplied with any product before use.