Efinaconazole solution 10%: topical antifungal therapy for toenail onychomycosis

Toenail onychomycosis is a common disease with limited treatment options, as treatment failures and relapses frequently are encountered. Many patients experience long-term disease that affects multiple toenails and causes substantial discomfort and pain. Although many patients prefer topical therapies, treatment efficacy with ciclopirox and amorolfine lacquers has been disappointing. Efinaconazole solution 10% is a new triazole antifungal agent specifically developed for the treatment of onychomycosis. Efinaconazole has shown a broad spectrum of antifungal activity in vitro and is more potent than ciclopirox against common onychomycosis pathogens. It has lower keratin binding and quicker drug release from keratin than ciclopirox and amorolfine and exhibits remarkably greater in vivo activity. Efinaconazole has limited or no potential for drug interactions and a low resistance potential. Efinaconazole provides a viable alternative to oral therapy for the treatment of toenail onychomycosis.