Sertaconazole nitrate (Ertaczo - OrthoNeutrogena), an imidazole antifungal similar to clotrimazole and miconazole, has been approved by the FDA as a 2% cream for topical treatment of interdigital tinea pedis infection. It has been available in Europe for many years.

Butenafine hydrochloride 1% cream (Mentax - Penederm), a benzylamine antifungal drug similar to the allylamines terbinafine (Lamisil) and naftifine (Naftin), is now available in the USA for topical treatment of tinea pedis, tinea corporis and tinea cruris.

Naftifine hydrochloride 1% cream (Naftin - Herbert Laboratories), was recently approved by the US Food and Drug Administration (FDA) for topical treatment of tinea cruris and tinea corporis. It is available only by prescription.

Terbinafine 1% cream (Lamisil - Sandoz), an allylamine synthetic antifungal drug chemically related to naftifine (Naftin - Medical Letter, 30:98, 1988), is now available in the USA for topical treatment of tinea pedis, tinea cruris, and tinea corporis infections. An oral formulation is available in Europe and is under investigation here.

A Medical Letter reader recently received a diagnosis of athlete’s foot and a prescription for Naftin gel, for which his pharmacy charged $145, and his insurance company required a $70 copay because this formulation was not included in its formulary. Do patients need to pay prices like these to treat tinea pedis?