Griseofulvin‡

Oral

Suspension: 125 mg per 5 mL

Tablets (scored): 125 mg, 250 mg

Microsize (Grifulvin V suspension): 20 to 25 mg per kg per day; single daily dose or two divided doses (maximum: 1 g per day)

Ultramicrosize (Gris-Peg tablets): 10 to 15 mg per kg per day; single daily dose or two divided doses (maximum: 750 mg per day)

Microsize: $44 ($165) for 300 mL of 125-mg-per-5-mL solution

Ultramicrosize: $263 ($430) for 60 250-mg tablets

Yes, for children older than two years

No baseline testing in absence of liver disease

If required for longer than eight weeks, ALT, AST, bilirubin, and creatinine measurements and CBC every eight weeks^2,17

92%¹⁸

Six to 12 weeks (continue for two weeks after symptoms and signs have resolved)²

Terbinafine (Lamisil)§

Oral

Tablets: 250 mg

Granule packets: 125 mg, 187.5 mg

< 25 kg (55 lb): 125 mg once daily

25 to 35 kg (55 lb to 78 lb): 187.5 mg once daily

> 35 kg (78 lb): 250 mg once daily

Tablets: $4 ($660) for 30 250-mg tablets

Granules more expensive

Yes, for persons four years and older

Baseline ALT and AST measurement

CBC at six weeks for courses lasting longer than six weeks

94%¹⁸

Six weeks; longer for Microsporum infections

Assume Trichophyton unless culture reveals Microsporum

Fluconazole (Diflucan)||

Oral

Tablets: 50 mg, 100 mg, 150 mg, 200 mg

Suspension: 10 mg per mL, 40 mg per mL

Daily dosing: 6 mg per kg per day for three to six weeks

or

Weekly dosing: 6 mg per kg once weekly

Tablets: $100 for 30 150-mg tablets ($1,185 for 90 50-mg tablets)

Suspension: $33 ($290) for 35 mL of 40-mg-per-mL suspension

Not for this indication

Approved for children older than six months for other indications

Baseline ALT, AST, and creatinine measurement and CBC

84%¹⁸

Three to six weeks for daily dosing

Eight to 12 weeks for weekly dosing

Itraconazole (Sporanox)¶

Oral

Solution: 10 mg per mL

Capsules: 100 mg

Capsules: 5 mg per kg daily for four to six weeks

or

Solution: 3 mg per kg daily for four to six weeks

or

Pulse therapy with capsules: 5 mg per kg daily for one week each month for two to three months

or

Pulse therapy with oral solution: 3 mg per kg daily for one week each month for two to three months

Maximum: 500 mg per day

Solution: NA ($265) for 150 mL of 10-mg-per-mL solution

Capsules: $102 ($590) for 30 100-mg capsules

No

Baseline ALT and AST measurement

86%¹⁸

Four to six weeks

Ciclopirox (Penlac)

Topical

Bottle: 6.6 mL

Apply daily to affected nail and adjacent skin; remove with alcohol every seven days

$16 ($540) for one bottle

Yes, for persons older than 12 years

None

7%¹⁹

48 weeks

Terbinafine§

Oral

Tablets: 250 mg

Granule packets: 125 mg, 187.5 mg

10 to 20 kg (22 to 44 lb): 62.5 mg daily

20 to 40 kg (44 to 89 lb): 125 mg daily

40 kg (89 lb) or more and adults: 250 mg daily

Tablets: $4 ($660) for 30 250-mg tablets

Granules more expensive

Not for this indication

Approved for children older than four years for tinea capitis

Baseline ALT and AST measurement, CBC

ALT and AST measurement, CBC at six weeks

76%²⁰

Six weeks for fingernails; 12 weeks for toenails

Fluconazole||

Oral

Tablets: 50 mg, 100 mg, 150 mg, 200 mg

Suspension: 10 mg per mL, 40 mg per mL

Children: 3 to 6 mg per kg once weekly

Adults: 150 to 300 mg once weekly

Tablets: $100 for 30 150-mg tablets ($1,185 for 90 50-mg tablets)

Suspension: $33 ($290) for 35 mL of 40-mg-per-mL suspension

Not for this indication

Approved for adults and children older than six months for other indications

Baseline ALT, AST, alkaline phosphatase, and creatinine measurements, CBC

No repeat needed for once weekly therapy

48%²⁰

12 to 16 weeks for fingernails; 18 to 26 weeks for toenails