Medication Monitoring: Can Diabetics Take Lamisil for Toenail Fungus or Athlete’s Foot?

More than 1 in 4 seniors gulp down at least five medications daily, according to US News & World ReportDiabetics are among those patients taking multiple medications, in addition to injecting themselves with insulin if their disease is particularly difficult to manage. They must take heed before treating any malady, as the addition of a new drug may interfere with one of their other prescriptions. If you are a diabetic dealing with toenail fungus, you may be wondering if it’s safe to take the popular oral drug terbinafine (a.k.a. Lamisil).

diabetes drug interaction

Many diabetics take multiple pills to manage their condition each day, which increases the risk of interaction with antifungal drugs.
Image Source: WebMD.com

People with Diabetes Are More Resistant to Antifungal Treatment

Podiatry Today reports that diabetics are more resistant to antifungal treatment because their high glucose levels and inability to maintain clean, dry feet (due to comorbidities like obesity and/or retinopathy) — which both foster fungal growth. Oral itraconazole is often avoided because it interacts with medications like tolbutamide, glibenclamide, and glipizide to cause hypoglycemia. Itraconazole also interacts with HMG-CoA reductase inhibitors, calcium channel blockers, warfarin, cyclosporine, and benzodiazepines. Terbinafine is considered the safer and more effective option for people taking insulin or hypoglycemic meds, but it still has the potential to interact with “tricyclic antidepressants, beta blockers, selective serotonin reuptake inhibitors, certain anti-arrhythmic agents, and monoamine oxidase inhibitors,” says Podiatry Today.  Risks of hepatitis, congestive heart failure and liver disease may be too great for diabetic patients. Therefore, medical professionals often advocate topical therapies where there is less potential for side effects. Unfortunately, these medications also do not work as well.

diabetes toenail fungus

Topical treatments may be slightly safer for diabetics, but they may also be less efficient.
Image Source: LindaRandall.Wordpress.com

Terbinafine Interacts with Warfarin

Patients taking warfarin need to be vigilant about the other drugs they take because a loss of anticoagulation control can lead to death. In 1995, a 68-year-old woman had been taking 5.5 mg of warfarin to treat mitral valve disease for more than 20 years. When she was prescribed terbinafine to treat athlete’s foot, it was discovered that she needed to increase her dose of warfarin to as much as 8 mg to maintain its effectiveness. According to the British Medical Journal, “Warfarin binds readily to albumin” and “induce hepatic microsomal enzymes,” which increases warfarin metabolism.

Terbinafine Has Good Safety Profile in Treating Toenail Fungus

A review of existing literature published in the American Diabetes Association’s official journal of Clinical Diabetes specifies that terbinafine is considered the “first-line agent for treating onychomycosis” toenail fungus. Diabetics had a cure rate of 82% with 250 mg taken daily for three months, the review states. Best of all, there were no reports of hypoglycemia. Another study found that just over 9% of diabetics had serious adverse events while taking terbinafine, but no causal link was found. Headaches, diarrhea, rashes, and dyspepsia were common side effects. Liver enzyme abnormalities occurred in 3.3% of patients, so a liver function test is recommended before diabetics begin oral therapy for toenail fungus treatment.

Diabetic Patients Use the SteriShoe Sanitizer as Part of Daily Routine

In addition to taking oral antifungal drugs like Lamisil, diabetics also want to prevent recurrence of toenail fungus. The best way to do this is to sanitize socks, sheets, and towels by running them through the laundry cycle — and sanitize all footwear with the SteriShoe UV shoe sanitizer. Our device uses ultraviolet rays — just like hospitals — to eradicate the bacteria and fungi harbored in the shoes. Why treat the fungi but fail to stop its reproduction? Buy a shoe sanitizer here!

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