Agents most effective and better tolerated in management of onychomycosis ?: (A) Griseofulvin and caspofungin, (B) Griseofulvin and ketoconazole, (C) Itraconazole and terbinafine, (D) Ciclopirox and griseofulvin
Answer is C. Onychomycosis does not respond to topical therapy, although ciclopirox olamine (recent NEET) nail lacquer applied daily for a year is occasionally beneficial. The 3 anti-fungals being increasingly used for Rx of onychomycosis are: Drug for Rx onychomycosis Dose Terbinafine 250 mg/day for 6 and 12 wks in fingernail and toenail onychomycosis respectively. Itraconazole Pulse therapy: 200 mg twice daily for 1 wk/month for 2 and 3 consecutive months for finger and toenail onychomychosis respectively. Continuous regimen: 200 mg/day for 6 wks. Fluconazole 150 mg wkly for maximum period of 12 months