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Condition guide · /antifungal/
Antifungal treatments
Reviewed by Dr. Arjun Mehta, PharmD — Head Pharmacist. Updated May 2025.
3
Main drug classes
Topical
First for skin
Oral
For nail/systemic
Weeks–months
About this condition
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.
Treatment options
Fluconazole
Oral azole. First-line for vaginal thrush (single dose), oral thrush and systemic candida.
Terbinafine
Topical azoles
Clotrimazole, miconazole. Skin and vaginal infections. Apply 2–3 times daily for 2–4 weeks.
Nystatin
Topical/oral suspension for oral thrush, especially in infants and immunocompromised patients.
Common questions
Why is fungal nail infection so hard to treat?
Nails grow slowly and antifungal drugs penetrate them poorly. Three to six months of oral terbinafine is typical for cure.
Can I treat thrush without a prescription?
A single dose of oral fluconazole or topical clotrimazole are very effective for uncomplicated vaginal thrush. Recurrent or severe thrush deserves a medical review.
Are oral antifungals safe?
Generally yes, but terbinafine and itraconazole need liver monitoring on longer courses. Tell your prescriber about all your medicines as interactions are common.
Dr. Arjun Mehta, PharmD · Head Pharmacist
/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.
