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Antifungals

Antifungals are medications that treat fungal infections, including athlete’s foot, ringworm, fungal nails and vaginal thrush.

  1. Treat fungal infections
  2. Are available in various forms
  3. Occasionally treat deep body tissue infections and severe dandruff

If you are concerned about a fungal infection, you can speak with one of our registered clinicians via our online video consultation service. Our clinicians are available from 9.30am-4.30pm, five days a week.  

  • UK prescribers
  • 24 hour delivery
  • Secured payment
Product information

What are antifungals?

Antifungals are prescribed to treat various forms of fungal infection, most commonly athlete’s foot, fungal nail infections, vaginal thrush and ringworm. They are available in different forms, including topical creams, tablets, oral suspensions, sprays, powders, intravenous injections and intravaginal pessaries (tablets that can be inserted into the vagina).

What is athlete’s foot?

Athlete’s foot is a common infection that affects the feet, typically between the toes. Symptoms include itchy patches of skin that appear white or red and can be extremely sore. It may also crack and bleed in more severe cases. Athlete’s foot is contagious, meaning it can be spread from one person to the next, usually by walking barefoot in areas where there are showers, such as swimming baths. 

How is athlete’s foot treated?

Treatment for athlete’s foot consists of keeping the feet dry, and dabbing affected areas of skin with a towel, instead of rubbing them. Using a separate towel for the feet is important to prevent the spread of infection, as is keeping the feet clean. Changing your socks daily will also help, with cotton socks preferable to other materials. Treatments are available from local pharmacies, and creams, sprays and powders are common antifungal treatments. With treatment, the infection should clear up within a few weeks.

What are fungal nail infections?

Fungal nail infections are similar to athlete’s foot in many ways, although they can take longer to treat. Symptoms include the nail becoming discoloured at the edges, with the infection spreading to the rest of the nail over time, which often results in the nail lifting off the toe completely. In other cases, the nail becomes brittle and breaks. If you are prone to these infections, preventive measures such as keeping your feet clean and dry are essential. You should also discard of any old shoes and make sure you do not walk barefoot in communal bathing areas. 

How are fungal nail infections treated?

Treatment for fungal nail infections is similar to measures used for athlete’s foot. Antifungal and nail softening creams can be applied over a six-month period to fully treat the condition. You will know when a fungal nail infection has cleared up, as the nail will appear healthy again. Another option is laser treatment, which destroys the infection, although there is little evidence to support its effectiveness beyond a three-month period.

What is vaginal thrush?

Vaginal thrush is another common fungal infection which, whilst uncomfortable, is not dangerous to your health. Symptoms include white discharge that looks similar to cottage cheese, irritation around the vagina, stinging during urination and discomfort during sexual intercourse. You should see a doctor if you develop thrush and it is the first time you have had the infection, if you get repeated infections, if you are pregnant or breastfeeding, are under 16 or over 60 or if you have a weakened immune system. 

How is vaginal thrush treated?

Thrush is not a sexually transmitted infection but it can be spread during sex. It is caused by the fungus candida. Because thrush, like other fungal infections, thrives in warm and moist conditions, it is important to make sure the area is kept dry. Cotton underwear, which helps the skin breathe, is recommended in preventing or controlling the infection, while avoiding wearing tight underwear or tights is also vital. You should not engage in sexual activity until the infection has properly cleared up. You can purchase antifungal medications, which are highly effective in clearing up the condition, from your local pharmacy.

What is ringworm?

Ringworm, despite its name, is caused by a fungal infection and not worms. It’s a very common infection and isn’t a cause for a concern. The main symptom associated with the condition is a ring shaped rash that can be swollen, dry, flaky and itchy. It can appear anywhere on the body, with the scalp (tinea capitis) and groin (jock itch) some of the most common areas. Like the fungal infections listed above, it’s caused by contact with a type of fungi, which spreads from  people, animals, objects and, in rare cases, soil. 

How is ringworm prevented and treated?

Preventing the infection from spreading is the first step, which requires frequent washing of clothing, bed clothes and towels. If your pet has missing patches of fur, this may be a sign of ringworm and you should take your pet to the vets for treatment.

Most ringworm infections can be well treated with over the counter antifungals from your local pharmacy in the form of sprays, gels and creams, depending on where the rash has developed on the body. If the infection does not clear up within two weeks you should speak with your doctor, who may be able to give you a prescription for stronger antifungal shampoos or tablets. Prescription shampoos may be necessary if the infection is on the scalp.

If you would like to discuss a fungal infection with a doctor, our GPhC-registered clinicians are available for appointments via our online video consultation service, from 9.30am-4.30pm, Monday to Friday. They can also offer referral to specialists for treatment and fit notes, where suitable.

Page last reviewed:  22/06/2020
Side effects and warnings

What side effects can antifungals have?

Each antifungal has its own side effects and instructions, so it’s essential that you read the patient leaflet that comes with your medication before starting treatment. One of the most common antifungal treatments is itraconazole, which is available in tablet form. 

Side effects of itraconazole include:

Common (may affect up to 1 in 10 people): stomach ache and nausea. 

Uncommon (may affect up to 1 in 100 people): problems with periods, headache, dizziness, constipation, diarrhoea, wind, vomiting, indigestion, taste changes, swelling, alopecia, reddened skin, itchiness and flaking or peeling skin. 

Rare (may affect up to 1 in 1000 people): altered liver function tests, blood disorders, increased the risk of bleeding, bruising and infections, tinnitus, stomach pain with nausea and vomiting and fever.

The following side effects have been reported, but there is not enough data to indicate how common they are: high levels of triglycerides in the blood, muscle and joint pain, erection difficulties, sensitivity of the skin to light, hearing loss, low levels of potassium in the blood, incontinence or needing to urinate frequently and altered vision.

Can use of antifungals lead to an allergic reaction? 

If you notice any of the following side effects when using itraconazole you should stop using the medication and seek immediate medical attention as this may be a sign of a severe allergic reaction: Rashes, hives, severe irritation of your skin and swelling of the face, lips, tongue or other parts of the body.

Other symptoms that require immediate medical attention include: Severe skin disorders and a fever, blistering of the skin, mouth, eyes and genitals, with fever, chills, aching muscles and generally feeling unwell, tingling sensations, numbness or weakness in your limbs, a lack of appetite, vomiting, unusual fatigue, stomach pain, muscle weakness, yellowing of your skin or whites of your eyes, dark urine, pale stools, hair loss, shortness of breath, weight gain, swelling of the legs or abdomen and waking up short of breath.

Warnings and precautions when using antifungals 

It is important that you inform your doctor about any conditions you are currently or have previously suffered from before you start any treatment. In the case of itraconazole, the most relevant of these include problems of the liver, kidney or heart. You may also require blood tests if this treatment is taken for longer than a month. 

Is it safe to take antifungals alongside other treatments?

Many antifungals entail very few risks when taken alongside other medications, but it’s still important that you inform your doctor if you suspect that they may interact with any existing treatment you are taking, or have recently taken. 

In the case of itraconazole, the following medications should not be used: medicines to treat hay fever, high cholesterol, irregular heart beat, angina, high blood pressure, migraine headaches, digestive problems, postpartum medications, drug abuse, anxiety, insomnia and medications for conditions affecting thoughts, feelings and behaviour. 

The following treatments may also interact with itraconazole: medicines for tuberculosis, epilepsy called phenytoin, carbamazepine or phenobarbital, herbal antidepressants, indigestion, stomach ulcers, heartburn, cancer, blood clots, HIV, infections called clarithromycin or erythromycin, heart disease and blood vessels, inflammation, asthma, allergies, medications given after an organ transplant, severe pain, allergies, malaria depression and diabetes.

What types of antifungal treatment are there? 

Besides sprays, gels, powders, tablets, capsules and injections, there are various types of antifungal treatment that can be used. Active ingredients include miconazole, clotrimazole, ketoconazole, econazole, terbinafine and amphotericin.

Page last reviewed:  22/06/2020
Questions and Answers

Is it safe to drive and use antifungals? 

Most antifungals will have no effect on your ability to drive, but you should ask your pharmacist or prescribing doctor, or read the patient leaflet included in the medication’s packaging, in order to confirm that the treatment is safe to use in these circumstances. 

Are antifungals safe to use during pregnancy?

It depends on the treatment you are taking. Some medications are topical treatments that offer no risks during pregnancy or breastfeeding, while others, such as prescription tablets, may not be safe to use. You should therefore always inform your doctor if you are pregnant or breastfeeding before the start of your treatment course. 

Some antifungals may also stay in the system for a prolonged period of time, so you should ensure that you discuss this treatment with your prescribing doctor if you are planning on becoming pregnant in the near future. 

Is alcohol safe to consume alongside antifungals?

You should speak to your prescribing clinician about interactions with alcohol before starting treatment with antifungals.

Can antifungals cause an allergic reaction?

All drugs carry a risk of causing an allergic reaction, and as such, you should check the ingredients in the medication before starting treatment. This can be found in the patient leaflet inside the packaging of your treatment. If you are concerned about allergies, you should speak to your prescribing doctor or pharmacist. 

Can antifungals be purchased over the counter? 

Most antifungal medications are available to buy from your local pharmacy without a prescription. However, some tablets and shampoos are prescription only treatments. 

Can I buy antifungals online?

To discuss antifungals with a doctor, you can make an appointment using our online video consultation service. Our GMC-registered clinicians can provide input on antifungals from 9.30am-4.30pm, Monday to Friday.  They can also issue fit notes and referral to specialists for treatment, where appropriate. 

Page last reviewed:  22/06/2020

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