Onychomycosis (tinea unguium) is a fungal infection of the nail, usually caused by a dermatophyte. Toenails are affected more often than fingernails.
Although fluconazole is not currently labeled by the FDA for the treatment of nail fungus, is active against dermatophytes, Candida species, and some nondermatophytic molds, which cause onychomycosis.
Fluconazole promptly penetrates the nail and nail bed, and persists in the nail for about 5 months after discontinuation of therapy2. Studies show high cure rates but a need for long-term treatment.
For example, in one study of 20 patients with toenail onychomycosis (all 20 patients) and fingernail onychomycosis (4 patients), 150 mg of fluconazole per week and urea ointment were used for an average of 9.3 months3. As a result, 92% of affected nails were cured.
In the study of 362 patients with onychomycosis of the toenail, once-weekly dosing with fluconazole resulted in a clinical success rate 80-90%. Completely healthy nail was achieved in 28% to 36% of patients4.
Fluconazole is less effective than terbinafine and itraconazole.
The dosage range of fluconazole: 150-450 mg once weekly for 3-4 months for fingernail fungus or 4-8 months for toenail fungus.
- 1. Rodgers P, Bassler M. Treating onychomycosis. Am Fam Physician. 2001 Feb 15;63(4):663-72, 677-8.
- 2. Debruyne D, Coquerel A. Pharmacokinetics of antifungal agents in onychomycoses. Clin Pharmacokinet. 2001;40(6):441-72.
- 3. Kuokkanen K, Alava S. Fluconazole in the treatment of onychomycosis caused by dermatophytes. J Dermatol Treat. 1993;3:115–117.
- 4. Scher RK, Breneman D, Rich P, et al. Once-weekly fluconazole in the treatment of distal subungual onychomycosis of the toenail. J Am Acad Dermatol. 1998 Jun;38(6 Pt 2):S77-86.
- 5. Arca E, Taştan HB, Akar A, Kurumlu Z, Gür AR. An open, randomized, comparative study of oral fluconazole, itraconazole and terbinafine therapy in onychomycosis. J Dermatolog Treat. 2002 Mar;13(1):3-9.
Author: OriginalDrugs Team
Last reviewed: February, 2015