Home › Infection & immunity › Antiviral treatments
Reviewed by Dr. Arjun Mehta, PharmD — Head Pharmacist. Updated May 2025.
Main drug classes
First for skin
For nail/systemic
Fungal infections range from common nuisance conditions (athlete’s foot, thrush, ringworm) to serious systemic infections in immunocompromised patients. Most superficial infections respond well to topical treatment; deeper or nail infections usually need oral antifungals.
The three main classes are azoles (fluconazole, itraconazole, terbinafine isn’t an azole but used similarly), polyenes (nystatin, amphotericin) and allylamines (terbinafine). Nail infections in particular need a long course — three months for fingernails, six for toenails — because the drug works only as the nail grows out.
Oral azole. First-line for vaginal thrush (single dose), oral thrush and systemic candida.
Clotrimazole, miconazole. Skin and vaginal infections. Apply 2–3 times daily for 2–4 weeks.
Topical/oral suspension for oral thrush, especially in infants and immunocompromised patients.
Nails grow slowly and antifungal drugs penetrate them poorly. Three to six months of oral terbinafine is typical for cure.
A single dose of oral fluconazole or topical clotrimazole are very effective for uncomplicated vaginal thrush. Recurrent or severe thrush deserves a medical review.
Generally yes, but terbinafine and itraconazole need liver monitoring on longer courses. Tell your prescriber about all your medicines as interactions are common.
/our-pharmacists/arjun-mehta/ — Reviewed May 2025
This guide is reviewed every 12 months or sooner when clinical guidance changes. If you have a specific medical question, call our pharmacist team — we answer the phone, not a bot.
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