Terbinafine (Lamisil) is significantly more effective for treatment of onychomycosis than fluconazole (Diflucan), according to Professor Väinö Havu (Turku University Central hospital, Finland) and colleagues.
Reporting in the British Journal of Dermatology (2000;142:97), they describe how they gave 46 patients 250mg terbinafine daily for 12 weeks, 43 patients 150mg fluconazole once weekly for 12 weeks and 41 patients 150mg fluconazole once weekly for 24 weeks.
The researchers say that, at the end of the study, 67 per cent of the terbinafine group were completely cured clinically. This compared with 21 per cent of those who received the fluconazole 12-week course and 32 per cent of the patients who received the 24-week course of fluconazole. Mycological cure was also higher in the treatment group. In addition, 65 adverse events were reported by patients taking terbinafine, while those in the two fluconazole groups suffered 90 and 75, respectively. "The results clearly demonstrate that continuous treatment with terbinafine 250mg daily for 12 weeks is significantly more effective than fluconazole 150mg given once weekly for 12 or 24 weeks," they conclude.
Diflucan is not licensed for treatment of onychomycosis in the UK. A spokeswoman for Pfizer, the UK manufacturer of Diflucan, told The Journal on February 23 that the study had some interesting findings, which would be seen and evaluated by health care professionals in the context of all the data available in this area.