| Terbinafine (Lamisil) | First-line therapy for dermatophytic infections (most cases of onychomycosis) | 250 mg per day for 6 weeks to treat fingernails and for 12 weeks to treat toenails* | Complete blood count and ALT and AST levels at baseline, then every 4 to 6 weeks during therapy |
| Itraconazole (Sporanox) | Alternative first-line therapy for dermatophytic infections | Continuous therapy: 200 mg per day for 6 weeks to treat fingernails and for 12 weeks to treat toenails* | ALT and AST levels at baseline, then every 4 to 6 weeks during therapy |
| Preferred therapy for nondermatophytic and candidal infections | Pulse therapy: 200 mg twice daily for 7 days per month, with the treatment repeated for 2 to 3 months (“pulses”) to treat fingernails* and for 3 to 4 months to treat toenails† | None recommended |
| Fluconazole (Diflucan) | First-line therapy for candidal infections but also active against dermatophytes | 150 mg once weekly until nail is normal or acceptably improved (treatment often requires 6 to 9 months)† | None recommended |
| Consider for use in patients with complicated medication regimens |