Toenail Fungus and Oral Lamisil

[zip2play]

My dearest friend has had a toenail fungus for more than 30 years. Totally black big toenail all the way to the root of the nail.
He finally decided on treatment( Oral Lamisil-terbinafine 250 mg) and the VA gave him 48 pills, checked his liver after the first 30 days and sent him 48 more.
Results: He's taken 86 of the 96 pills and the nail looks pink and beautiful on the new half. Black on the front half.

Here's the problem. After a ZILLION calls and letter to the VA we FINALLY got a doctor to respond. He said 90 days is the recommended treatment and wouldn't prescribe any more. I know the manufacturer claims a "resevoir effect" for terbinafine and the drug is supposed to last for months after treatment is stopped.

Problem:
Can lamisil be stopped before the infected nail is completely grown out, or will it tend to reinfect the newest part as it grows out? Is the doctor right or can my friend kiss the 96 days of treatment(and $800 worth of Lamisil) goodbye? That would be a travesty.
Any suggestions welcomed. Anybody else used the treatment for toenail fungus?

We considered a private doctor for more pills, but these pills are $8 a day in the USA. Probably too late to order from Canada ($2-$3 a pill).




[This message has been edited by zip2play (edited 08-29-2003).]

[Marti]

I have removed my previous answer.

[This message has been edited by Marti (edited 09-03-2003).]

[shadepra]

Lamisil can cause liver damage (sometimes severe), that is why your friend's doctor does not want him to continue taking it long-term. Hopefully, the treatment he has received so far will do the trick.

Should your friend notice that the infection appears to be coming back, have him try Vicks VapoRub, applied directly to the nail. I know it sounds strange, but MANY people have had success using it. I have been using it myself on a toenail that has been infected for years, and after about 3 weeks of use, my nail is looking very healthy again. This treatment needs to be continued every day until ALL of the affected nail has been completely cut off (which can take several months to a year or so, as toenails grow very slowly). Leaving even a tiny amount of affected nail can cause the fungus to take hold again.

This subject was discussed in detail a few weeks back on this board--go back a couple pages and you will find it.

[Marti]

I have also removed this answer.

[This message has been edited by Marti (edited 09-03-2003).]

[shadepra]

I was not using 'scare tactics'. Anyone considering using oral Lamisil on a long-term basis, and without their doctor's supervision, should be aware of the following information:

Quote: "On May 9, 2001. The Food and Drug Administration (FDA) issued a Public Health Advisory to announce significant safety-related updates to the labeling of Lamisil tablets and Sporanox products. Lamisil and Sporanox are used to treat nail (onychomycosis), skin and other systemic fungal infections.

Potential Liver Damage

This FDA warnings alerts healthcare professionals to rare cases of serious liver problems including liver failure, transplantation and death associated with the use of Lamisil tablets.

While adverse liver effects were previously included in the labeling for Lamisil products, the FDA decided to include this information in the advisory because some cases involved patients with no preexisting liver disease or any serious underlying medical condition.

As of March 2001, the FDA has reviewed 16 possible Lamisil associated cases of liver failure, including 11 deaths and two liver transplant patients."