Introduction

Antifungal medicines are used to treat fungal infections, which are most commonly found on the skin, hair and nails.

You may be given an antifungal medicine to treat common fungal infections, such as:

• Tinea cruris a ring-like red rash on the skin of the body or scalp
• athlete's foot which affects the skin on the feet, causing it to become red, flaky and itchy
• fungal nail infection whichcausesthe toenails or fingernails to become thickened, discoloured and sometimes brittle, with pieces of nail breaking off
• vaginal thrush which causes irritation and swelling of the vagina and vulva (the female external sexual organs)
• some kinds of severe dandruff which causes flakes of skin to peel on the head

Invasive fungal infections

Invasive fungal infections are less common but more serious. They are infections that occur deep inside the body's tissue or in one of the internal organs. Invasive fungal infections can affect the:

• lungs for example, aspergillosis , where a fungus called aspergillus infects the lining of the lungs
• brain for example, fungal meningitis , where a fungus infects the protective membranes surrounding the brain and spinal cord

People with a weakened immune system (the body's natural defence system) are particularly vulnerable to invasive fungal infections. Those at risk include:

• people with HIV and AIDS
• people having high-dose chemotherapy to treat cancer
• people who are taking medicines to suppress the immune system, such as corticosteroids; in particular, people who have had an organ transplant will be taking immunosuppressants, making themmore vulnerable to fungal infections

Howantifungal medicineswork

Antifungal medicines work by either:

• killing the fungal cells for example, by affecting a substance in the cell walls, causing the contents of the fungal cells to leak out and the cells to die
• preventing the fungal cells from growing and reproducing

Types of antifungal medicines

Antifungal medicinesare used in several ways, depending on your specific fungal infection. The main types of antifungal medicines include:

• topical antifungalsapplied directlyto the skin, hair or nails
• oral antifungalswhich are swallowed in capsule, pill or liquid form
• intravenous antifungalswhich are injected into your bloodstream
• intravaginal antifungal pessaries small, soft tablets inserted into the vagina to treat conditions such as vaginal thrush

Commonly used antifungal medicines

There are many different types of antifungal medicines, and you may be familiar with some of the advertised brand names. Many of these brands will contain the same generic antifungal ingredients (alone or in combination). Some of the most common include:

• clotrimazole
• econazole
• miconazole
• terbinafine
• fluconazole
• ketoconazole
• amphotericin

The packaging should say which antifungal medicine the product contains. It should also say how strong the antifungal medicine is, usually shown as a percentage of the product or in milligrams for example, "cream containing 1% clotrimazole" or "capsules containing 50mg of fluconazole".

Getting the right dose of antifungal treatment

Your GP or pharmacist should advise on how to take or use your antifungal medicine. The patient information leaflet that comes with your medicine will also contain advice on using your medicine.

Speak to your GP or pharmacist if you take too much of your antifungal medicine. You may be advised to visit your nearest hospital's accident and emergency (A&E) department .

If you are advised to go to hospital, take the medicine's packaging with you so the healthcare professionals who treat you know what you have taken.

Antifungal medicines for children

Some antifungal medicines can be used on children and babies. For example, miconazole oral gel can be used to treat oral thrush in babies.

Check the patient information leaflet that comes with your medicine to see if it's suitable for children, or ask your pharmacy. Different doses are usually needed for children of different ages.

Taking antifungal drugs

Before taking antifungal medicines, you should consider:

• any existing conditions or allergies that may affect your treatment for fungal infection
• the possible side effects of antifungal medicines
• how an antifungal medicine may interact with other medicines you may be taking(known as drug interactions)

You can discuss allergies, side effects and your existing health problems with the pharmacist dispensing your medicine or, if applicable, the doctor who prescribed it.