The Medical Letter on Drugs and Therapeutics
Efinaconazole Topical Solution (Jublia) for Onychomycosis
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The FDA has approved efinaconazole 10% solution (Jublia – Valeant) for topical treatment of toenail onychomycosis due to Trichophyton rubrum and/or Trichophyton mentagrophytes. It is the first topical triazole antifungal drug to be approved for this indication. A topical oxaborole antifungal solution, tavaborole 5% (Kerydin – Anacor), also recently approved by the FDA for the same indication will be reviewed in a future issue.

STANDARD TREATMENT — Toenail onychomycosis is most often caused by the dermatophytes T. rubrum and T. mentagrophytes, and rarely by yeasts and nondermatophyte molds. Oral terbinafine or oral itraconazole is the drug of choice for treatment of dermatophyte toenail onychomycosis, but even with prolonged treatment, cure rates are low and relapse rates are high, and adverse effects and drug interactions are common. ... more      

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