Fungal toenails and terbinafine

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Editor, – Professor Kamien recently wrote (Aust Prescr 1999;22:135) about the high cost of using terbinafine in people with suspected tinea of the toenails who are negative on microscopy or culture but who wish to purchase the drug privately. The cost of the treatment can be halved by using terbinafine 250 mg twice a day for one week in every four week cycle.1,2 This is continued for a total period of 12–16 weeks, i.e. three or four weeks of treatment over three or four months.

The regimen is apparently as effective as the current 250 mg a day for the same period, and effectively cuts the cost of the treatment down by a half.

K. Dallimore
Dermatologist
Mt. Lawley, WA