{"id":51,"date":"2012-02-08T14:49:19","date_gmt":"2012-02-08T22:49:19","guid":{"rendered":"https:\/\/phcprimarycare.org\/?p=51"},"modified":"2014-02-19T13:45:45","modified_gmt":"2014-02-19T21:45:45","slug":"cost-effective-treatment-for-onychomycosis","status":"publish","type":"post","link":"https:\/\/phcprimarycare.org\/?p=51","title":{"rendered":"Cost-effective treatment for onychomycosis"},"content":{"rendered":"<p>Onychomycosis is a very common condition leading patients to seek advice from their primary care clinician.<\/p>\n<p>Systemic treatment is the most effective: oral terbenifine is off patent and very <!--more-->inexpensive ($4 per month at Walmart). Its cure rate is 76%. I recommend sending a nail clipping for PAS stain if there is any doubt of the diagnosis. Education about the length of treatment is important. There is a chance of hepatotoxicity, and a few drug interactions to keep in mind as well.<\/p>\n<p>For topical treatment, Vicks VapoRub\u00ae has a cure rate of 30% in this FP residency study: <a href=\"https:\/\/mail1.partnershiphp.org\/owa\/redir.aspx?C=a1b302f05d2b4076b4c009c407e3febc&amp;URL=http%3a%2f%2fwww.ncbi.nlm.nih.gov%2fpubmed%2f21209346\" target=\"_blank\">http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21209346<\/a><\/p>\n<p>There was visual improvement in the nails in 70% of patients.<\/p>\n<p>For comparison, this study of ciclopirox nail lacquer (<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11051136\">http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11051136<\/a>) also shows a 30% cure rate.<\/p>\n<p>Vicks VaboRub\u00ae is much cheaper (and over the counter) compared to ciclopirox. I recommend\u00a0Vicks VapoRub\u00ae\u00a0when you and your patient decide topical treatment is the best option.<\/p>\n<p>Robert Moore, MD, MPH<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Onychomycosis is a very common condition leading patients to seek advice from their primary care clinician. Systemic treatment is the most effective: oral terbenifine is off patent and very<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[6],"tags":[],"class_list":["post-51","post","type-post","status-publish","format-standard","hentry","category-formulary-pharmacy-issues"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.2 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Cost-effective treatment for onychomycosis - PHC Primary Care Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/phcprimarycare.org\/?p=51\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cost-effective treatment for onychomycosis - PHC Primary Care Blog\" \/>\n<meta property=\"og:description\" content=\"Onychomycosis is a very common condition leading patients to seek advice from their primary care clinician. 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