Fungal toenails and terbinafine

The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.

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
Mt. Lawley, WA


  1. Alpsoy E, Yilmaz E, Basaran E. Intermittent therapy with terbinafine for dermatophyte toe-onychomycosis: a new approach. J Dermatol 1996;23:259-62.
  2. Tosti A, Piraccini BM, Stinchi C, Venturo N, Bardazzi F, Colombo MD. Treatment of dermatophyte nail infections: An open randomized study comparing intermittent terbinafine therapy with continuous terbinafine treatment and intermittent itraconazole therapy. J Am Acad Dermatol1996;34:595-600.