TA9. O unica si globala strategie pentru tratamentul infectiilor fungice superficiale
TA9. A unique and global experience in the treatment of superficial fungal infections
Orungal is a triazole antifungal that is extremely lipophilic and keratophilic. It achieves high levels of concentrations in the skin, hair, nails. Orungal reaches the distal portion of the nail within 7 – 14 days of commencing therapy via uptake in the nail matrix and the nail bed. Therapeutic concentrations are achieved in the skin within a few days and in the hair within 7 days of starting Orungal. Orungal persists in the skin for 2-4 weeks in the hair more than 4 weeks, and in the nail for 6-9 month after discontinuation of therapy. The pharmacokinetic profile of Orungal allows for the development of short duration treatment schedules for dermatomycoses. From this, a one week regimen was developed for treating dermatomycoses. In tinea pedis, Orungal, 400 mg/day for one week is at least as effective as either 200 mg/day x 15 day or 100 mg/day x 30 days. For fingernail onicomycoses two "pulses" of Orungal 200 mg twice daily for one week given for the first week of two consecutive month have been shown to be an effective form of therapy; for toenail onicomycoses, three "pulses" are generally required. In onicomycoses, "pulse" therapy is more cost-effective than continuous dosing.
Orungal when given as a one week "pulse" for tinea pedis (400 mg) may be an effective therapy; furthermore, "pulse" therapy has been shown to be effective for treating onicomycoses (two "pulses" for fingernails, three "pulses" for toenails).
In general, short duration pulse therapy for dermatomycoses is effective, well tolerated, may lead to better compliance and has a low incidence of adverse events.