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Anti-fungal Medications

For oral Candidiasis/Thrush: Mycelex/Clotrimazole Troche tid Mycostatin oral suspension 5 cc qid in mouth, then swallow Diflucan/Fluconazole 200 mg/day PO, then 100 mg/day x13days Sporanox/Itraconazole soln 20 ml (=200 mg)1x/day swish then swallow.

For finger or toe nail fungal infections (Onychomycosis): Lamisil/Terbinafine 250 mg 1x/day x 3 months Sporanox/Itraconazole 100 mg 2 cap bid x 1 week, rest x 3weeks  period, then repeat 2x.  Griseofulvin as Fulvicin p/G 125-165-250-330 tab.  330-375 mg/day Topical Loprox/Ciclopirox 1% lotion or cream bid Topical Fungoid/miconazole tincture/soln  bid Topical Spectazole/Econazole 1% cream

For skin fungal infections: Loprox/Ciclopirox 1% lotion or cream bid Nizoral/Ketoconazole 2% cream tid or shampoo  Clotrimazole/ Lotrimin/ Mycelex 1% cream or lotion 15-30 gm size Lotrisone (Lotrimin + Betamethasone) cream Terbinafine /  Lamisil AT 1% cream Fungoid/Miconazole tincture or soln bid Miconazole/ Micatin/Desenex/ Monistat-Derm 2% cream Mycostatin/Nystatin cream or ointment Spectazole/Econazole 1% cream Fungizone/Amphotericin B Halotex/Haloprogin  Tolnaftate / Tinactin 1% cream

For systemic fungal infections: *Amphotericin B - usually 0.6 - 1 mg/kg/day.  Test dose 1 mg in 20 mL D5W over 2-4 hrs, then 0.25 mg/kg/day IV over 4-6 hrs, then gradually increase by 5-10 mg/day upto 0.6-1 mg/kg/day up to total dose of 30 mg/kg (about 1,000-2,000 mg) *Diflucan/Fluconazole 400 mg, followed by 200 mg/day PO  or IV for cryptococcal meningitis. *Itraconazole 200 mg bid is equal or more effective than Fluconazole 400 mg/day in the treatment of Coccidioidomycosis infection.   (AIM Nov.7, 2000;133:676 John N. Galgiani, etc.)

2006