Oral antifungals

Oral antifungals

Dr Christophe Hsu – dermatologist. Geneva, Switzerland

Your doctor has just prescribed an oral antifungal medication for you.

What are antifungals used for?

Antifungals are used to treat infections caused by fungus. These organisms can infect the skin, scalp, finger nails, toe nails, vagina and the intestinal tract. When the infection affects the intestinal tract, is extensive or is not improving, your doctor may prescribe for you an oral antifungal. This medicine has been prescribed for your present medical condition only and should not be given to other people or used for other problems.

How should I take antifungals?

• Oral antifungals come in the form of capsules, tablets, gel or liquids. Take this medicine as directed by your doctor.
• Most oral antifungals should be taken with meals as they are best absorbed with food. * If you have been prescribed an oral gel or liquid for treatment of fungal infection of the mouth or the gastrointestinal tract, it is best to keep the medicine in the mouth for 5 minutes before swallowing.
• For effective treatment, you should complete the full course of medication prescribed, even though there are signs of improvement. This is because fungal infections usually take a long time to clear up. If you stop using this medicine too soon, your symptoms may return.

What should I do if I forget a dose?

• Take the missed dose as soon as you remember. Take any remaining doses for that day at evenly spaced intervals.
• If more than 24 hours have lapsed after you missed the dose, do not take the missed dose. Resume your regular dosing schedule. Do not double your dose.

What other effects may antifungals cause?

Certain side effects of this medicine are not unusual and may even disappear during treatment. If any of the following effects persist or are severe, consult your doctor:

• Nausea, stomach upset, vomiting. Taking this medicine with food usually relieves these effects.
• Diarrhoea
• Dizziness or drowsiness.If affected, do not drive, operate machinery or do any work that requires you to be alert.
• Skin rash or itch
• Trouble in getting to sleep

Consult your doctor as soon as possible if these additional effects occur, as they may indicate more serious side effects:

• High fever
• Dark coloured urine
• Pale coloured stools
• Unusual tiredness or weakness
• Yellow eyes or skin

What precautions should I take?

• Before taking this medicine, check with your doctor if you are pregnant, intending to conceive or are breastfeeding.
• Avoid alcoholic drinks while you are taking this medicine. Alcohol may also increase the risk of liver problems with other antifungals.
• If you are taking ketoconazole tablets and have been prescribed gastric ulcer medication like cimetidine or ranitidine or other antacids, take them at least 2 hours after you take ketoconazole. If taken at the same time, these medicines will reduce the absorption and hence the effectiveness of ketoconazole.
• Griseofulvin may reduce the effectiveness of your oral contraceptive. Check with your doctor.
• Inform your doctor of any other medications that you are taking.
• Inform your doctor if you have ever had any unusual or allergic reactions to other antifungals or penicillins .(In some instances, people allergic to penicillins may also be allergic to some antifungals)

How should I store antifungals?

• Store this medicine away from heat and direct sunlight, in a cool, dry place, out of reach of children.
• Do not keep this medicine with other medications in the same container. Keep each medicine separately in labelled containers.

When in doubt, consult your doctor or pharmacist.

Contributors

Dr Christophe Hsu – dermatologist. Geneva, Switzerland

National Skin Centre. Singapore

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