{ "schema_version": 1, "kind": "condition", "id": "onychomycosis", "name": "Onychomycosis (Fungal Nail Infection)", "category": "infectious", "sources": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Itraconazole monograph (chapter PDF p55) · Egyptian National Drug Formulary - antimicrobial-2023.pdf, Terbinafine monograph (chapter PDF p415) · Egyptian National Drug Formulary 2023 — Antimicrobial, Itraconazole monograph, Onychomycosis (antimicrobial-2023.pdf, page index 55, printed p46) · Bodman MA, Syed HA, Krishnamurthy K. Onychomycosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Updated 2025 Nov 6. Bookshelf ID: NBK441853.", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Terbinafine monograph (chapter PDF p415) · Egyptian National Drug Formulary 2023 — Antimicrobial, Itraconazole monograph, Onychomycosis (antimicrobial-2023.pdf, page index 55, printed p46) · Bodman MA, Syed HA, Krishnamurthy K. Onychomycosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Updated 2025 Nov 6. Bookshelf ID: NBK441853.", "verified_date": "2026-08", "treatments": [ { "id": 1287, "generic": "Terbinafine", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "250 mg orally once daily.", "adult_duration": "6 weeks for a fingernail infection, or 12 weeks for a toenail infection.", "dose_source": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Terbinafine monograph (chapter PDF p415)", "rationale": "Terbinafine is the formulary's oral first-line agent for dermatophyte onychomycosis, the most common cause of thickened, discoloured nails, and its own text notes other agents are preferred only when the cause is not a dermatophyte.", "cautions": [ "Confirm the diagnosis with nail clipping microscopy/culture before committing to a multi-week course.", "Hepatotoxicity risk - baseline and periodic liver function tests are advisable for a course this long; avoid in active liver disease.", "A diabetic patient with nail or surrounding skin infection needs closer monitoring for complications.", "Spreading cellulitis around the nail needs antibacterial treatment and reassessment, not an antifungal alone." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Paediatric dosing is specialist-set and is not reproduced here.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "TRERBI 250 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE", "price_egp": 26.4, "pack_count": 10, "unit_price": 2.64, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MYCOMIC 250 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "FUTURE PHARMACEUTICAL INDUSTRIES (FPI) > TABUK PHARMA", "price_egp": 26.5, "pack_count": 10, "unit_price": 2.65, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MYCOMIC 250 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "FUTURE PHARMACEUTICAL INDUSTRIES (FPI) > TABUK PHARMA", "price_egp": 53.0, "pack_count": 20, "unit_price": 2.65, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "UNITOPFIN 250 MG 7 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA CO. > UNIPHARMA", "price_egp": 25.2, "pack_count": 7, "unit_price": 3.6, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FUNGISAFE 250MG 7 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 32.0, "pack_count": 7, "unit_price": 4.57, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LAMIFEN 250 MG 14 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI", "price_egp": 112.0, "pack_count": 14, "unit_price": 8.0, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TERBINASIL 250 MG 7 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JAMJOOM PHARMACEUTICALS-K.S.A", "price_egp": 68.0, "pack_count": 7, "unit_price": 9.71, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LAMISIL 250MG 14 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "NOVARTIS", "price_egp": 146.5, "pack_count": 14, "unit_price": 10.46, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LAMISIL ONCE 4G FILM FORMING SOLUTION.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "NOVARTIS", "price_egp": 50.0, "pack_count": null, "unit_price": null, "strength_mg": 4000.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "onychomycosis" }, { "id": 1288, "generic": "Itraconazole", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "Continuous dosing: 200 mg orally once daily for 6 weeks or 12 weeks. Alternative pulsed dosing: 200 mg orally twice daily for 1 week, repeated every 4 weeks, for 2 months or 3 months.", "adult_duration": "6 or 12 weeks continuous, or 2 or 3 pulsed months — the formulary gives both figures without saying which nail gets which", "dose_source": "Egyptian National Drug Formulary 2023 — Antimicrobial, Itraconazole monograph, Onychomycosis (antimicrobial-2023.pdf, page index 55, printed p46)", "rationale": "The formulary itself notes other agents (i.e. terbinafine) are preferred for dermatophyte onychomycosis, making itraconazole the second-line oral option, useful when terbinafine is unsuitable or the infection is non-dermatophyte.", "cautions": [ "Capsules and oral solution are not interchangeable; give capsules after food, swallowed whole, and not with antacids.", "Obtain liver function tests in patients with pre-existing liver disease and in anyone treated for longer than a month.", "Contraindicated for onychomycosis in anyone with ventricular dysfunction or a history of congestive heart failure, and in women who are pregnant or contemplating pregnancy.", "The formulary notes other agents are preferred for dermatophyte onychomycosis.", "The formulary does not state which duration is for fingernail and which for toenail. Longer courses are conventionally used for toenail, but the formulary does not say so.", "Numerous drug interactions via CYP3A4 (some statins, benzodiazepines, and other drugs) - review all concurrent medications before prescribing.", "Contraindicated in heart failure with reduced ejection fraction; discontinue if signs or symptoms of heart failure occur.", "Hepatotoxicity risk - monitor liver function on longer or repeated courses.", "Avoid in pregnancy.", "A diabetic patient with nail or surrounding skin infection needs closer monitoring for complications." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Paediatric dosing is specialist-set and is not reproduced here.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "FUNGITRANAZOLE 100 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DEBEIKY", "price_egp": 32.0, "pack_count": 10, "unit_price": 3.2, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ITRAFUNGIZOLE 100 MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AL ROWAD PHARMACEUTICAL INDUSTRIAL CO.", "price_egp": 42.0, "pack_count": 12, "unit_price": 3.5, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FUNGITRANAZOLE 100 MG 4 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DEBEIKY", "price_egp": 15.6, "pack_count": 4, "unit_price": 3.9, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AROZOLE 100MG 4CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALFACURE PHARMACEUTICALS", "price_egp": 19.2, "pack_count": 4, "unit_price": 4.8, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ITRANOX 100 MG 5 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ADWIA", "price_egp": 36.0, "pack_count": 5, "unit_price": 7.2, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ITRAFUNGEX 100 MG 4 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "FUTURE PHARMACEUTICAL INDUSTRIES (FPI) > UTOPIA", "price_egp": 33.0, "pack_count": 4, "unit_price": 8.25, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ITRAPEX 100 MG 4 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MULTI-APEX", "price_egp": 38.0, "pack_count": 4, "unit_price": 9.5, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SPORANOX 100MG 4 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JANSSEN CILAG > SOFICOPHARM", "price_egp": 42.0, "pack_count": 4, "unit_price": 10.5, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "onychomycosis" } ] }