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Risk/benefit ratio of modern antifungal therapy: focus on hepatic reactions
1Department of Dermatology, UMDS Guy's Hospital, London, United Kingdom.
Abstract:
The purpose of this article is to review the risk/benefit ratio of the oral antifungals: griseofulvin, ketoconazole, fluconazole, itraconazole, and terbinafine. The reported side effects of each drug have been listed with particular emphasis on the possibility of hepatic damage. All oral antifungal agents cause minor gastrointestinal upset, as well as headache and skin reactions. There is also a rare incidence of reversible hepatic damage. Although the incidence of abnormal liver function tests from oral antifungal therapy is extremely low, patients should be advised to inform their physician if any warning symptoms are noticed.
Insights
This review examines the risk/benefit of oral antifungals like griseofulvin and fluconazole, noting rare but reversible liver damage. Patients should report any warning symptoms of side effects.
Area of Science:
- Pharmacology
- Hepatology
- Infectious Diseases
Background:
- Oral antifungal medications are crucial for treating various fungal infections.
- Understanding their safety profiles is essential for effective patient management.
- Key drugs include griseofulvin, ketoconazole, fluconazole, itraconazole, and terbinafine.
Purpose of the Study:
- To review the risk/benefit ratio of commonly prescribed oral antifungal agents.
- To detail the side effects associated with each drug, focusing on hepatic risks.
- To inform clinical practice regarding patient monitoring and adverse event reporting.
Main Methods:
- Literature review of clinical studies and case reports on oral antifungals.
- Analysis of reported side effects, with emphasis on hepatotoxicity.
- Evaluation of the incidence and reversibility of liver function abnormalities.
Main Results:
- All oral antifungals can cause gastrointestinal upset, headache, and skin reactions.
- A rare incidence of reversible hepatic damage is associated with these agents.
- Abnormal liver function tests are infrequent, but patient monitoring is warranted.
Conclusions:
- The risk/benefit ratio for oral antifungals is generally favorable when used appropriately.
- Awareness of potential side effects, particularly hepatic, is crucial.
- Patients must be educated to report any warning symptoms to their healthcare provider.