Oral Antifungals for Toenail Fungus

[Melin28]

Hello, I have a stubborn toenail fungus that will not go away without oral medication. The options are fluconazole (Diflucan), griseofulvin (Fulvicin), itraconazole (Sporanox), or terbinafine (Lamisil oral). Are any of these safe for breastfeeding?

I am still breastfeeding, although it is very, very minimal (once in the evening before bed). My daughter is over 20 months. Thanks!

[admin]

Melin28:

You need to talk with a Dermatologist. One treatment schedule I know that works is terbinafine once daily for 7 days. Do this every 3 months for a year. This way you don't have to do blood work all the time.

Other regimens include terbinafine (250 mg) once daily for 12 weeks. But this may require blood work.

Itraconazole 200 mg daily for 12 weeks.

I'd discuss these options with your dermatologist.

IN YOUR CASE with a 20 month old infant, I'd suggest there is probably very little risk, as the volume of milk at this time is probably quite low.

Tom Hale Ph.D.

[Brittanyp120]

I have the same condition that my podiatrist wants to treat with Terbinafine 250mg once daily for 90 days. I see this is an option mentioned above. When bloodwork is indicated, is this for myself or for my infant? I have a 9 month old who is breastfeeding, I do not want to wean her at 12 months, and I don’t think she will be ready for table food as her only nutrition source at that time as she is currently not the best eater.

I’d like to begin this treatment but I want to be sure my daughter will not be affected by the medication. Is the dose, frequency and duration prescribed above safe while breastfeeding?

[admin]

Brittany:

If you are using Terbinafine for 90 days, you should have routine blood work done. As for the infant, I would do the blood work just to be cautious.

Tom Hale Ph.D.