List of Antifungal Medications

Updated September 12, 2017 by eMedExpert team

Allylamines

Generic name Brand name
Amorolfin Locery® (nail lacquer)
Butenafine Lotrimin® Ultra (cream, spray), Mentax® (cream)
Naftifine Naftin® (cream, gel)
Terbinafine Lamisil® (cream, gel, spray, solution, oral granules, tablets)

Allylamines are synthetic antifungals with activity against a wide range of dermatophytes. Allylamines act via inhibition of the squalene epoxidase formation, which blocks the synthesis of ergosterol.

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Allylamines (with the exception of terbinafine) are used as topical treatments. Oral terbinafine is extensively used for the treatment of onychomycosis (fungal infection of the nail). It acts at an earlier stage by inhibiting the formation of squalene epoxide, a precursor of lanosterol. Oral terbinafine is the first choice for treating infections of fingernails and toenails.

Azoles

Generic name Brand name
Imidazoles
Bifonazole Canespor® (cream)
Butoconazole Femstat® 3 (vaginal cream), Gynazole® 1 (vaginal cream)
Clotrimazole Canesten ® (cream, solution), Clocreme® (cream), Cruex® (spray powder), Desenex® (cream) , Femcare® (vaginal), Fungoid® (solution), Gyne-Lotrimin® (cream), Gynix® (vaginal tablets), Lotrimin (cream), Mycelex® (solution, troches), Pedesil® (ointment), Trivagizole® (cream)
Econazole Ecoza® (foam), Spectazole® (cream)
Fenticonazole * Lomexin®, Gynoxin®
Ketoconazole Nizoral® (oral tablets, cream, shampoo), Extina® (foam), Ketodan (foam), Kuric® (cream), Xolegel® (gel)
Isoconazole* Icaden®, Travogen®
Luliconazole Luzu® (cream)
Miconazole Cavilon® (antifungal cream), Cruex® (spray), Desenex® (topical powder), Fungoid® (cream, tincture), Lotrimin® AF Athlete's Foot Spray (deodorant powder, powder, liquid), Lotrimin® AF Athlete's Foot powder, Lotrimin® AF Jock Itch spray powder, Micatin® (cream), Monistat® 1, Monistat® 3, Monistat® 7, Ting® (antifungal spray powder, spray liquid), Vagistat® 3, Zeasorb® AF (powder, lotion)
Omoconazole* Fongamil®
Oxiconazole Oxistat® (cream, lotion)
Sertaconazole Ertaczo® (cream)
Sulconazole Exelderm® (cream, solution)
Tioconazole Monistat® 1 Simple Therapy, Vagistat® 1
Terconazole Terazol® 3 (vaginal cream, vaginal suppositories), Terazol® 7 (vaginal cream), Terconazole® (vaginal cream, vaginal suppositories), Zazole® (vaginal cream, vaginal suppositories)
Triazoles
Albaconazole Under® investigation
Efinaconazole Jublia® (topical gel, solution)
Fluconazole Diflucan® (tablets, capsules, injection)
Isavuconazole Cresemba® (capsules, injection)
Itraconazole Sporanox® (capsules, oral solution, injection), Onmel® (tablets)
Posaconazole Noxafil® (tablets, oral suspension, injection)
Ravuconazole Under investigation
Terconazole Terazol® 3, Terazol® 7 (vaginal cream, vaginal suppositories)
Voriconazole Vfend® (oral suspension, injection)
Arylguanidines (Thiazoles)
Abafungin* Abasol® (cream, gel)
* Not available in U.S.

Azoles (imidazole and triazole derivatives) are a large group of synthetic antifungal agents. Azoles are essentially fungistatic, and have a relatively broad antifungal spectrum. The azole antifungals have many drug-drug interactions because of their interference with cytochrome P-450 enzymes.

Imidazoles are considered first-line agents for most dermatophyte infections. Topical formulations are widely used for the treatment of superficial fungal infections and vaginal candidiasis. Imidazoles are very toxic when taken orally, so they are available only as topical formulations.

Triazoles are generally used for prophylaxis and treatment of invasive fungal infections and systemic mycosis.

Arylguanidines are a novel class of synthetic antifungal drugs.

Polyenes

Generic name Brand name
Amphotericin B Fungilin® (lozenges, oral suspension)
Nystatin Nilstat® (oral drops, capsules, powder, tablets)
Natamycin (pimaricin)
Trichomycin (hachimycin)

The polyenes are naturally occurring compounds with a very broad antifungal spectrum. Polyenes act by binding to sterols in the fungal cell membrane, thereby interfering with membrane integrity and causing leakage of essential metabolites. Most polyenes are used topically, but intravenous amphotericin remains an important agent for the treatment of systemic fungal infections. The risk of nephrotoxicity limits the use of amphotericin B.

Echinocandins

Generic name Brand name
Anidulafungin Eraxisin® injection
Caspofungin Cancidas® injection
Micafungin Mycamine® injection

Echinocandins are the most recently developed class of antifungals. Echinocandins are used mainly for the treatment of severe, invasive Candida infections. Echinocandins are safer than other classes of antifungals and have a broad spectrum, and synergistic effect in combination therapy.

Miscellaneous Antifungal Drugs

Generic name Brand name
Thiocarbamates
Tolnaftate Tinactin®, Aftate®, Breezee®, Ting®
Antimetabolites
Flucytosine
Benzylamines
Butenafine Mentax® (cream), Lotrimin® (cream)
Other antifungals
Griseofulvin Gris-PEG® (tablets), Grifulvin® V (tablets), Grisactin®
Ciclopirox Ciclodan® (cream, solution, topical suspension), Loprox® (cream), Penlac® (solution, nail lacquer), Loprox® (topical suspension, gel, shampoo)
Selenium sulfide Selsun®, Exsel®
Tavaborole Kerydin®


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Originally published: September 12, 2017

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