Signs You Need a Prescription Foot Fungus Medication

You May Need to Take Oral Antifungal Medications

Woman applying foot cream
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Once irritating, now agonizing, your athlete's foot symptoms won't let up. After applying over-the-counter (OTC) ointments for several weeks, the skin between your toes is still peeling and itchy, and it's beginning to swell and blister. Before it gets worse, you might need to see a physician for some prescription foot fungus medication.

Signs You Need Prescription Foot Fungus Medication

If you have athlete's foot and diabetes, you should see your physician right away; don't bother with any home treatment.

Otherwise, prescription medication to heal your athlete's foot (also called tinea pedis) is in order if:

  • It hasn't cleared up after four weeks of self-treatment.
  • It goes away but comes back.

Your physician can give you prescription-strength versions of OTC topical ointments such as Lamisil(terbinafine), Spectazole (econazole), Mentax (butenafine), Lotrimin (clotrimazole), Micatin (miconazole) or Naftin (naftifine).

Sometimes the fungal infection can become super-infected with bacteria in the skin, soft tissues and sometimes even deeper, and you may need antibiotics. See your physician if you notice:

  • Your foot is swollen, warm and has red streaks
  • It's discharging pus or other fluid
  • You have a fever along with your foot fungus

Possible Adverse Effects of Foot Fungus Medications

Though topical creams have been shown to be effective, oral agents are sometimes necessary when infections are extensive, there is nail involvement or the infection fails to clear with the use of topical antifungals alone.

Your physician may recommend oral versions of terbinafine or other antifungal antibiotics. All of them must be carefully chosen because of serious possible side effects. They include:

Lamisil (terbinafine): The livers of some patients have become so damaged after taking oral terbinafine that it has resulted in liver transplant or even death.

It's not clear if the drug caused or worsened liver decline, but most of those who sustained liver damage already had liver conditions.

Sporanox (itraconazole): You should not take itraconazole if you've had congestive heart failure. Let your physician know if you have heart disease, circulation problems, a breathing disorder, cystic fibrosis, kidney or liver disease, or long QT syndrome (an electrical rhythm disorder of the heart) or a family history of long QT.

Diflucan (fluconazole): Before taking fluconazole, tell your physician if  you have long QT syndrome, heart rhythm disorder or liver or kidney disease.

Other Precautions

If you are pregnant or nursing, discuss all topical and oral medications with your medical provider. Many times, topical treatment may be a reasonable alternative to oral agents. In particular, fluconazole or itraconazole are not options while you are pregnant, nursing or considering pregnancy.

All oral antifungal antibiotics interact with a variety of other drugs.

Give your physician a complete list of medications you are taking before adding any of these medicines.

The longer athlete's foot lingers, the greater the chance of it spreading to your toenails and fingernails. This spread results in a difficult-to-treat infection that leaves nails thick, discolored and crumbly until the condition is cured and a new nail replaces the damaged one.

Further Reading

What Does Athlete's Foot Look Like?
Preventing Athlete's Foot
Diabetes Foot Care


"Athlete's Foot." 12 Apr. 2007. National Institutes of Health. 16 Feb. 2009. 
"Butenafine Topical." 13 Feb. 2004. University of California San Diego. 16 Feb. 2009.
"Clotrimazole Topical." 15 Mar. 2006. University of California San Diego. 16 Feb. 2009.
"Econazole Topical." 13 Feb. 2004. University of California San Diego. 16 Feb. 2009.
"Fluconazole." 30 Nov. 2007. University of California San Diego. 16 Feb. 2009.
"Itraconazole." 5 Mar. 2008. University of California San Diego. 16 Feb 2009.
"Long QT Syndrome." 21 Sep. 2007. American Heart Association. 16 Feb. 2009.
"Miconazole Topical." 13 Feb. 2004. University of California San Diego. 16 Feb. 2009.
"Naftifine Topical." 13 Feb. 2004. University of California San Diego. 16 Feb. 2009.
"Terbinafine." 29 Jan. 2008. University of California San Diego. 16 Feb. 2009.

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