Infection of the human body with fungi occurs as a result of the penetration and development of various types of pathogens. The most common localization of this infection is the skin and. Less commonly, this disease affects the scalp and internal organs. Therefore, when the first symptoms appear, it is necessary to immediately go to specialized clinics and proceed to the complex treatment of this ailment.

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Antifungal drugs: classification

- these are medicines in any form of release, which are used in the treatment of a fungal infection that affects the human body in various places. These include substances of various chemical compounds that occur naturally and as a result of pharmaceutical manipulations. They have a local and systemic effect on various types of pathogenic fungi.

In modern medicine, in the treatment of any type of mycosis, antimycotic drugs are used, which are classified according to various criteria.

• According to the method of use: external (local) and systemic (oral and intravenous).
• By type of antimycotic effect: specific, suppressing only fungi and non-specific, destroy many pathogens.
• According to the type of antifungal action: fungicidal and fungistatic, which ensure the elimination of any type of pathogens or prevent the process of their reproduction.
• According to the level of antimycotic activity: a wide spectrum of action, in which the active components of drugs are active against most types of pathogenic fungi, as well as a small spectrum, acting exclusively on specific types and types of pathogens of fungal infection.
• According to the method of manufacture and composition: natural origin - these are groups of polyene and non-polyene antibiotics, as well as synthetic antifungal drugs.

The principle of action of many antimycotic agents is based on the effect on the main enzymes that affect the connection process and the production of egoserol, which is located in the structure of the membrane membrane of pathogenic fungus cells. Depending on the type of drug, a different level of intensity of exposure is carried out.

In modern medicine, in accordance with the chemical composition and structure, there are four subspecies of this group of drugs used in systemic therapy:

• Antibiotics: polyene, griseofulvin.
• pyrimidine derivatives.
• Azoles: imidazole, triazole.
• Other medicinal compounds: morpholines, allylamines.

An extensive classification of antifungal agents allows, in the treatment of various forms, to select the most suitable complex of drugs under the influence of which it will be possible not only to suspend the process of reproduction of pathogenic fungi, but also to completely eliminate them from the body. Taking systemic drugs will ensure that there is no recurrence of this pathology.

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Broad spectrum antifungals

The main pharmacological action of this group of drugs is to provide a fungicidal and fungistatic therapeutic effect. In practice, it manifests itself in the ability of drugs to ensure the elimination of cells of pathogenic fungi, creating all the conditions for them to die, namely, destroying their cell membrane.

When providing a fungistatic effect in the process of activating the active components of medicinal preparations, protein synthesis is inhibited and the process of reproduction of pathogens in the body as a whole is suppressed. This is all due to the concentration of pathogenic fungi in the biological fluids of the body and the level of sensitivity to certain types of pathogens.

The main types of pathogens of fungal infections that are affected by broad-spectrum antifungal drugs:

• Dermatophytes: trichophytosis, microsporia, epidermophytosis.
• Yeast Candida.
• Mold: blastomycosis, cryptococcus.
• Separate types of aspergillus and histoplasm.

Broad-spectrum antimycotic drugs are characterized by high specificity and activity, which do not depend on the duration of their use. This group of drugs are fungistatics, which ensures easy penetration of all therapeutic components into the stratum corneum, cerebrospinal fluid, sebaceous and sweat glands and hair follicles, but at the same time they are characterized by low toxicity to the human body.

It should be noted that taking systemic antifungal drugs has a number of side effects and contraindications. This is due to the fact that, with a wide spectrum of action, the active components of antimycotic agents have a depressing effect not only on the cells of pathogenic fungi, but, unfortunately, on some systems of the human body.

The appointment and intake of such drugs should be carried out exclusively by the attending physician, taking into account the clinical picture of the disease and the general health of the sick person. Self-cessation of the course of therapy or replacement of broad-spectrum drugs in the treatment of a fungal infection is strictly prohibited.

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Top 3 antimycotic drugs

During the treatment of a fungal infection, it is recommended to use a variety of dosage forms of antimycotic agents of the same brand. This approach to therapy, due to the presence of the same pharmacological composition, will have a positive effect, both externally and orally.

So one of the most common drug complexes are drugs. They have the following dosage forms: tablets, spray and cream. The pharmacological action of these drugs is based on the provision of a fungicidal and fungistatic therapeutic effect on the effects of many types of fungi. The active component of lamisil is terbinafine, an allylamine derivative, which is active against dermatophytes, molds and some dimorphic fungi.

Binafin. In the modern pharmaceutical industry, it is available in the following forms of oral capsules, creams, solution, spray and powder for local use. As a result of exposure to the active components of the drug, the cell membrane of the fungus is destroyed. At the same time, it inhibits the synthesis of sterols in the early stages.

Subsequently, a lack of ergosterol and the accumulation of a large amount of squalene are formed. All this in combination contributes to the death of pathogenic fungi and the complete elimination of fungal infections in the body. The complex use of oral medications and parallel local treatment of foci of infection contributes to a quick recovery.

Candide. This antimycotic drug contributes to the fact that the process of connecting cells of ergosterol, which is part of the structure of the cell membranes of pathogens, is disrupted. This ensures changes in its permeability and ensures the dissolution of cells and their systems as a whole. The active ingredient in this group of antimycotic drugs of any medicinal type is clotrimazole.

It is able to eliminate dermatophytes, various mold and yeast-like pathogenic fungi, versicolor and pseudomycosis pathogens. In addition to the antimycotic effect, Candide has an antimicrobial therapeutic effect on gram-positive and gram-negative anaerobic pathogens.

Broad-spectrum antifungal drugs are an integral part of complex therapy for systemic therapy of these pathological processes in the human body.

) can appear as an independent disease or accompany a fungal infection of the skin of the legs. These diseases are caused by the same types of fungi, but their treatment has some differences, since the penetration of drugs into the nail plate is somewhat difficult.

Antifungal drugs are used to treat fungal infections of the nails. We present to the reader's attention an overview of the means of this pharmacological group.

Dosage forms of drugs for the treatment of onychomycosis

Before the appointment of an antifungal drug, it is necessary to determine the sensitivity of the pathogen to the active component of the antimycotic agent. To do this, the patient passes a special analysis (scraping from the nail plate), with the help of which the type of bending that caused the disease can be determined.

For the treatment of onychomycosis can be used:

• local remedies (gels, varnishes, creams, ointments, sprays);
• systemic agents (tablets, capsules for oral administration).

The use of ointments, sprays, gels or creams does not always guarantee success, because these dosage forms do not penetrate well into the nail plate, and subsequently the patient may experience relapses of the disease. Before their appointment, it is advisable to file or remove the nail, and this invasive procedure, which entails a cosmetic defect, always upsets patients.

New antifungal agents have become an alternative to such dosage forms: medicated nail polishes. Their effect on the nail plate is in several directions and differs significantly from the mechanism of action of other local dosage forms.

Features of the therapeutic effect of antifungal nail polishes:

• the composition of the drug includes various substances with a drying effect (alcohol, oil extracts, etc.);
• a liquid agent is able to penetrate deep into the nail plate and fills all its layers;
• after hardening of the varnish, air does not enter the nail and such an environment causes the death of the fungus and stops its reproduction;
• the active antifungal component of the varnish destroys the membranes of fungi and the substances (enzymes) that they produce;
• The protective film that forms on the nail plate prevents re-infection.

In cases of chronic and severe onychomycosis, in addition to local drugs, systemic antifungal drugs are also prescribed for treatment. Their selection is always individual and depends not only on the type of pathogen, but on many other features of the body (these drugs are toxic and have a number of contraindications). The treatment regimen is determined for each patient, and its principle is to conduct short courses of therapy with loading doses. After a long break, the course is re-appointed, and their number is determined individually.

Antifungal nail polishes

These drugs can be used alone or as part of complex therapy at various stages of onychomycosis.

The most popular antifungal varnishes are:

• Mycosan: can be used even with extensive lesions and gives excellent results in the treatment of nail fungus;
• Loceryl: can be used even in the advanced stages of onychomycosis, quickly eliminates the symptoms of inflammation and skin irritation, has a pleasant smell;
• Batrafen: can be used to treat advanced forms of onychomycosis, quickly eliminates skin inflammation, cools and has a pleasant smell;
• Neil Expert: used when nails are affected by yeast-like fungi, slows down their growth and spread to neighboring areas of the skin and nail;
• Demicten: can be used in parallel with antifungal solutions or creams, effective for extensive mycotic lesions;
• Belvedere: used for disinfection after the completion of the treatment of onychomycosis, eliminates unpleasant odor and signs of skin inflammation.

During the first application of antifungal varnish, damaged areas of the nail plate are removed (cut off) using a disposable nail file. The nail is degreased with alcohol and only after that the varnish is applied, which dries within 5 minutes. The frequency of application of such therapeutic compositions is determined individually.

Antifungal ointments, gels and creams

These local remedies are used in the initial stages of the disease and have less systemic effects on the body. That is why it is necessary to start treatment of onychomycosis at the first symptoms. The composition of ointments, creams and gels includes antifungal agents from the groups of azoles and allylamines.

Local azole preparations include:

Local allylamine preparations include:

• Exoderil cream;
• Lamisil cream or gel;
• Terbinox cream;
• Atifin cream;
• Thermikon cream;
• Myconorm cream;
• Terbizil cream;
• Terbized-Agio cream;
• Terbinafine ointment.

Creams, gels or ointments should be applied after cleansing the skin, gently rubbing, once a day for 7-10 days. The tool is applied not only to the affected nail, but also to the skin area around it.

Antifungal solutions (drops) and sprays

These dosage forms can be used alone or as part of complex therapy at various stages of onychomycosis. The composition of sprays and drops also includes antifungal agents from the groups of azoles and allylamines.

Antifungal drops:

• Mycospor;
• Clotrimazole;
• Candide;
• Exoderil.

Antifungal sprays:

• Lamitel;
• Lamisil;
• Thermikon;
• Terbix;
• Bifosin.

Antifungal solutions and sprays are applied 1-2 times a day in sufficient quantities (until completely moistened) on the cleaned surface of the nail and the skin around it. The duration of treatment is determined individually.

Systemic antifungals

These drugs come in the form of tablets or capsules and are prescribed for long-term use (about 4-6 months). The selection of a particular drug can be carried out only after determining the type of fungus and eliminating possible contraindications for its use. The scheme of their administration is determined individually and is carried out according to the principles of pulse therapy (short courses with long breaks and in high doses).

For the treatment of onychomycosis, systemic antifungal agents with the following active ingredients can be used:

Most often, Diflucan, Lamisil and Orungal are prescribed by specialists. In 95% of cases, these drugs effectively eliminate onychomycosis.

The main contraindications to the appointment of systemic antifungal drugs:

• chronic and;
• pregnancy and lactation;
• children's age (depending on the drug);
• glucose-galactose malabsorption;
• lactose intolerance;
• taking certain other medicines;
• hypersensitivity to one of the components of the drug.

When prescribing a systemic antifungal, be sure to let your doctor know that you are taking other medicines.

A sharp surge in diseases caused by a fungal infection has become the reason for the development and implementation of modern effective treatments. Antimycotics or antifungal drugs in tablets refer to systemic therapy, which, along with local species, are used in the complex treatment of mycoses. The action of drugs is based on the destruction of pathogenic fungal species (fungicidal) or stopping the process of its reproduction (fungistatic). Each of the drugs has its own indications, contraindications for use, dosage, method of application.

Medicine knows more than 500 types of pathogenic fungi that can cause mycoses of varying severity in humans. Fungal diseases can be superficial, with damage to the skin, nails, hair, as well as with internal damage to organs and systems.

The treatment of mycoses is often long and is characterized by a high percentage of relapses, therefore, systemic antimycotics or antifungal tablets for oral administration are prescribed in complex therapy.

Before taking drugs for a fungus, it is necessary to establish the type of pathogen, since for each type there is an effective remedy and a certain dosage. For differential diagnosis, laboratory analysis under a microscope of the biological media of the body (scales, skin, smear from the mucous membrane), as well as other laboratory tests, is used.

Modern antifungal drugs are divided into generations, depending on the time of their discovery and the mechanism of action.

• Polyene antimycotics of the 1st generation - Nystatin, Levorin, Griseofulvin, Amphotericin B. They are used to treat thrush and ringworm.
• 2nd generation antimycotics or inidazole derivatives - Clotrimazole, Ketoconazole, Miconazole.
• 3rd generation antimycotics or triazole derivatives - Intraconazole, Fluconazole, as well as allylamine derivatives - Naftifin, Terbinafine.
• 4th generation antimycotics - Voriconazole, Posaconazole, Ravuconazole, Caspofungin. Many of them are still in clinical trials.
• Antimycotics of the 5th generation, which are under development or research - Fuzakandin, Sordarins, Corinecandin, Cispentacin, Azoxibacillin.

If the drugs of the 1st generation had a fungicidal mechanism of action and acted against some fungi (candida), then the subsequent ones were created taking into account the many varieties of fungal infection. So, for example, broad-spectrum antifungal drugs are derivatives of triazole and imidazole, and the mechanism of action of these drugs is fungistatic.

Due to the fact that the clinical picture of many mycoses is different, all antifungal drugs are divided into 3 main groups:

• means for the treatment of trichophytosis and epidermophytosis;
• agents for the treatment of systemic mycoses;
• funds for candidiasis.

Indications for use

The local use of therapeutic antifungal agents has practically no contraindications, since a large amount of the active substance does not penetrate the skin. Antifungal agents in tablets have their own indications and contraindications for use.

Indications for admission are as follows:

• candidiasis of the mucous membranes and skin;
• fungal infection of the nails and nail bed;
• dermatophytosis;
• keratomycosis;
• epidermophytosis;
• microsporia;
• lichen.

Ingestion of systemic antifungal agents in tablets can cause adverse reactions in the form of disorders of the stomach and intestines, as well as nervous disorders, changes in blood composition, and allergic reactions.

Application features

Of all the fungal infections, foot diseases occupy the first place, since walking in shoes and excessive sweating create all the conditions for their reproduction and vital activity. In addition, foot mycoses are very easy to earn, especially for those who lead a healthy lifestyle, that is, they visit the pool, sauna, and relax at sea. It is not difficult to get infected with bare feet, and it takes a long time to be treated.

Pills for foot fungus are used on a par with local therapy, since many of its types penetrate through the nail bed into deep layers and tissues. Mycoses of the feet often relapse precisely because many patients, having found local remedies in pharmacies, do not carry out diagnostics and systemic therapy. Therefore, reviews on antifungal drugs for the legs are sometimes negative, although a doctor's examination, laboratory tests and complex therapy are sufficient for successful therapy.

There are features of the use of antimycotics for treatment in pediatric practice. Systemic drugs are used only when indicated, and dosages are calculated based on the weight of the child and the severity of the disease. Antifungal drugs for children are best used in the form of ointments, powders, creams and other local remedies.

The dosage of drugs for adults is carried out taking into account the severity of the course, the type of fungus and the age of the patient.

Combined funds

Since fungal infections are often accompanied by other types of infections, it is important to use combined agents, which include not only antimycotics, but also specific drugs (antiviral, antimicrobial, for the treatment of protozoa).

The most commonly used:

• Vagiferon - contains interferon, metronidazole, fluconazole;
• Klion-D - contains miconazole and metronidazole;
• Mycospor - contains urea and bifonazole;
• Safocid - contains secnidazole, fluconazole, azithromycin;
• Mycozolon - miconazole and mazipredone.

In conclusion, it should be noted that treatment with systemic drugs is long, at least several weeks and even months. Treatment with antifungal drugs for foot fungus must be comprehensive, in compliance with all measures to prevent re-infection.

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Liver or effects on estrogen levels, many antifungal drugs can cause allergic reactions in humans. For example, drugs in the azole group are known to cause anaphylactic shock. Many drug interactions are also possible. Patients should carefully read the enclosed product data sheet. For example, azole antifungals such as ketoconazole or itraconazole can be substrates and inhibitors of P-glycoprotein, which, among other functions, promotes the release of toxins and drugs from the intestines. Azole antifungals are also substrates and inhibitors of the cytochrome P450 group CYP3A4, which causes an increase in concentration when administered, for example, calcium channel blockers, immunosuppressants, chemotherapy drugs, benzodiazepines, tricyclic antidepressants, macrolides and SSRIs (selective serotonin reuptake inhibitors).

Classes of antifungals

Polyene

A polyene is a molecule with multiple conjugated double bonds. Polyene antifungals are macrocyclic polyenes with highly hydroxylated regions on the ring opposite the conjugated system. This makes polyene antifungals amphiphilic. Polyene antimycotics bind to sterols in fungal cell membranes, mainly ergosterol. This leads to a change in the permeability temperature (Tg) of cell membranes, thereby contributing to a decrease in the liquid in the cell, the transition to a more crystalline state. As a result, the contents of the cell, including monovalent ions (K+, Na+, H+, and Cl-), small organic molecules, are released, and this is considered one of the main ways of destroying the cell. Animal cells contain cholesterol, not ergosterol, so they are much less susceptible. However, at therapeutic doses, amphotericin B can bind to animal cell membrane cholesterol, suggesting a risk of poisoning for humans as well. Amphotericin B is nephrotoxic (impairs kidney function) when administered intravenously. When the hydrophobic chains of polyenes are shortened, their ability to bind sterols increases. Thus, further reduction of the hydrophobic chain can lead to its binding to cholesterol, making it toxic to animals.

• Amphotericin
• Candicidin
• Filipin - 35 carbons, binds cholesterol (toxic)
• Hamycin
• Natamycin - 33 carbon atoms, binds well to ergosterol
• Nystatin
• Rimocidin

Imidazole, triazole and thiazole antifungals

Azole antifungals inhibit the enzyme lanosterol 14 α-demethylase, which is required to convert lanosterol to ergosterol. With a decrease in the content of ergosterol in the membranes of fungal cells, the structure and many functions of the membranes are disturbed, which leads to inhibition of fungal growth.

Imidazoles

• Bifonazole
• Butoconazole
• clotrimazole
• Econazole
• Fenticonazole
• Isoconazole
• Ketoconazole
• Miconazole
• Omoconazole
• Oxyconazole
• Sertaconazole
• Sulconazole
• Thioconazole

Triazoles

• Albaconazole
• Fluconazole
• Isavuconazole
• Itraconazole
• Posaconazole
• Ravuconazole
• Terconazole
• Voriconazole

Thiazoles

• Abafungin

Allylamines

Allylamines inhibit the action of squalene epoxidase, an enzyme necessary for the synthesis of ergosterol:

• Amorolfine
• Butenafine
• Naftifin
• Terbinafine

Echinocandins

Echinocandins can be used to treat systemic fungal infections in immunocompromised patients, they inhibit cell wall glucan synthesis via the 1,3-β-D glucan synthase enzyme:

• Anidulafungin
• Caspofungin
• Micafungin

Echinocandins are poorly absorbed when taken orally. When administered by injection, they reach a maximum concentration in tissues and organs sufficient to treat localized and systemic fungal infections.

Other means

• Benzoic acid - has antifungal properties, but must be used in combination with a keratolytic agent, such as in Whitfield's ointment.
• Cyclopirox (Ciclopirox Olamine) is a hydroxypyridone antifungal agent that interferes with the active transport of substances across the cell membrane, disrupts the integrity of the cell membrane, and the respiratory processes of the fungal cell. It is most effective against herpes zoster.
• Flucytosine or 5-fluorocytosine - antimetabolite, pyrimidine analogue
• Griseofulvin - binds to polymerized microtubules and inhibits mitosis (division) of fungal cells.
• Haloprogin - currently not used due to the emergence of more modern antifungal drugs with fewer side effects.
• Polygodial is a strong and fast-acting (in-vitro) drug that has antifungal activity against candida albicans.
• Tolnaftal is a thiocarbamate antifungal drug that inhibits fungal squalene epoxidase (similar mechanism to allylamines such as terbinafine).
• Undecylenic acid is an unsaturated fatty acid derived from natural castor oil. It has a fungistatic, antibacterial, antiviral effect and inhibits morphogenesis in fungi Candida.
• Crystal violet is a triarylmethane dye that has antibacterial, antifungal, and anthelmintic properties and was formerly used as a topical antiseptic.

Alternative means

Studies conducted in 1996 indicate the presence of antifungal properties in the following substances or essential oils:

• Oregano - the most powerful antifungal agent containing essential oils, has significant activity against candida albicans. It was found that the minimum inhibitory concentration against C. albicans less than 0.1 μg per ml. Unlike caprylic acid (a mixture of calcium and magnesium fatty acid salts, a natural antifungal agent), the inhibitory concentration of which is 0.5 μg.
• Allicin - created by crushing garlic
• Citronella oil - obtained from the leaves and stems of various types of cymbopogon (lemongrass)
• Coconut oil - medium chain triglycerides contained in the oil have antifungal activity
• Iodine - Lugol's solution
• lemon myrtle
• Neem seed oil
• olive leaf
• orange oil
• palmarosa oil
• Patchouli
• Selenium - found in dietary supplements or natural food sources, especially Brazil nuts
• Tea tree oil - ISO 4730 ("tea tree oil, terpinen-4-ol")
• Zinc - found in dietary supplements or natural food sources, including pumpkin and chickpea seeds
• Horopito leaves ( Pseudowintera colorata) - New Zealand pepper tree, contain antifungal components - polygodials

Researchers from the Department of Plant Sciences at Tel Aviv University published the results of a study in 2009 that indicates that carnivorous plants such as the Venus flytrap contain compounds that could be used in the development of a new class of fungicides that act against fungal infections that are resistant to existing funds.

Mechanism of action

The action of antifungal drugs is based on the differences between mammalian and fungal cells, in order to destroy fungal organisms without causing a dangerous effect on the host organism. Unlike bacteria, fungi and humans are eukaryotes. Thus, fungal cells and human cells are similar at the molecular level. This creates difficulties in the search or development of drugs that purposefully destroy fungal cells without affecting human cells. As a result, many antifungal drugs cause side effects. Some of these side effects can be life-threatening if the drugs are not used properly.

antifungal dandruff shampoos

Antifungal medications (such as ketoconazole) are often used in shampoos to treat dandruff. Antifungals suppress yeast Malassezia Globosa that cause seborrheic dermatitis and shingles.

Therapy of any fungal lesions is impossible without the use of medicines, but for effective healing it is recommended to use only effective and high-quality antifungal drugs. The combination of efficiency and quality does not mean the purchase of expensive medicines. On the pharmacy shelves, there are quite inexpensive medicines against the fungus, which are characterized by fast action and high efficiency. In the treatment of mycosis, analogues of expensive drugs can be used, which give the same result as the original drugs.

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Differences and features of antifungal medicines

Depending on the duration of mycosis, the presence of a concomitant disease, the volume of the affected skin surface and the nature of the manifestations of the fungus, antimycotic drugs are selected.

The forms of release of such medicines are quite diverse - they are available in the form of ointments, tablets, solutions, gels and suppositories. This diversity allows for the treatment of both external forms of mycosis (nail plates on the hands and feet, feet, genitals), and internal fungal manifestations. Antifungal agents in tablets can have a systemic effect; creams, gels, sprays and ointments are used for local therapy.

Treatment of a fungus with one drug most often does not bring the expected result, because several types of pathogens often settle on the body at the same time. For this reason, the doctor usually prescribes complex therapy for the fungus.

The cost of some drugs is relatively low due to the absence of costs for the invention of the active ingredient or the original formula, brand markup, etc. Domestic products are cheaper than foreign counterparts

Groups of the most effective antifungal drugs

Depending on the antifungal agents present in the composition and their pharmacological effects, several groups of antifungal drugs are distinguished.



Polyena

The first group of antimycotics are polyenes, which act on most of the pathogenic microflora.

Preparations included in the polyene group of antimycotics for internal use:

Name of the drug	Tool Description	Price	Photo of medication
Nystatin	One of the cheapest preparations of the polyene group. The tool is very effective in the treatment of mycotic lesions such as Candida of the gastrointestinal tract, epithelium and mucous membranes of the larynx, resulting from prolonged use of antibiotics or after surgery. Contraindication - hypersensitivity to the drug. Very rarely, adverse reactions such as fever, histamine reaction and a painful condition of the gastrointestinal tract may occur.	from 60 rub
Levorin	A modern antifungal medicine that also acts on amoebas, Trichomonas and Leishmania. It is used for the treatment of mucous membranes of the gastrointestinal tract, candidiasis of the epithelium, larynx and oral cavity, and in the complex therapy of prostatic hypertrophy in men. It is forbidden to take patients with liver or kidney failure, inflammation of the gallbladder and exacerbation of peptic ulcers, as well as women during pregnancy. Adverse reactions are loss of appetite, nausea, diarrhea and vomiting. In rare cases, allergic reactions to individual components of the product may occur.	100 - 130 rubles
Pimafucin	The antibiotic effectively affects yeast mycoses Penicillium, Candida, Cephalosporium, Fusarium. It is used to treat candidiasis of the gastrointestinal tract, ears, vagina and atrophic candidiasis while taking antibacterial drugs and hormonal agents. When taken orally, Pimafucin tablets act only in the stomach, without systemic effects in the body. May be used during breastfeeding and pregnancy. Side effects are minor - nausea, indigestion, which disappear after 1-2 doses.	about 250 rubles
Amphotericin B	The release form of the drug is a powder for the preparation of infusions. A strong antimycotic drug that is prescribed for severe forms of life-threatening mycotic lesions - peritonitis, disseminated varieties of candidiasis, sepsis provoked by a fungus, inflammation and infection of internal organs. It has a fungistatic and fungicidal effect. Violates the permeability of the membrane, resulting in the release of intracellular substances into the extracellular space and lysis of the fungus	from 30 to 50 rubles



Azoles

Drugs included in the azole group of antimycotics are inexpensive antifungal agents of synthetic origin.

Medicine name	Tool Description	Price	Photo of the preparation
Ketoconazole	One of the very cheap drugs for fighting fungi. It belongs to the group of azoles (the best medicines for the fungus of the nail plates of the epithelium, individual strains of lichen and hair). As part of the drug, such an active substance as imidazoledioxolane. This antibiotic is effective in the treatment of higher, yeast-like, dimorphic mycoses and dermatophytes. The use of antifungal tablets is recommended for chronic forms of candidiasis, folliculitis, recurrent vaginal mycosis and versicolor. The drug is more effective in the fight against a fungus that is resistant to other antimycotics. Contraindication - chronic diseases of internal organs. Adverse reactions such as jumps in blood pressure and allergic reactions in the form of rashes, indigestion and nausea, drowsiness and dizziness were observed.	from 100 rubles for 10 tablets
Itraconazole	Chemical antimycotic capsules are effective against a wide range of fungal strains such as yeasts, molds and dermatophytes. Using the remedy, it is possible to defeat vaginal and vulvocandidiasis, ringworm, keratomycosis, multi-colored lichen and candidiasis of the oral mucosa, mycosis of the nail plates and cryptococcosis, blastomycosis and sporotrichosis, as well as histaplasmosis. It is contraindicated to take the medicine during pregnancy and lactation. Possible adverse reactions in the form of vision problems and skin rashes, as well as menstrual irregularities in women	about 285 rubles for 14 capsules
Fluconazole	One of the most effective antifungal agents, preventing the growth of the fungus in the body and opposing their replication. Recommended for the treatment of candidiasis of the genitourinary system, candidiasis of the respiratory tract, generalized candidiasis of the gastrointestinal tract, sepsis, candidiasis of the mucous eyes, meningitis caused by Cryptococcus fungi, candidiasis of the larynx, mouth and lower respiratory systems, candidiasis of the genitals, onychomycosis and mycosis of the skin of the feet, mycosis of the epithelium and pityriasis versicolor . It is not recommended for use during lactation, it is prescribed with caution to women during pregnancy and people with heart disease. Possible side effects - an allergic reaction and digestive problems, if there is an individual sensitivity	about 24 rubles for 7 tablets
Mycomax	The antifungal drug disrupts the synthesis of the cell walls of the pathogenic fungus, as a result of which the development of the infection stops. The drug is effective in case of damage to the body by fungi of the genus Candida (Candida), Mycosporum, Cryptococcus or Trichophyton. Mycomax is prescribed for the treatment of thrush, mycoses of the feet, body, groin, pityriasis versicolor and nail fungus. Effective in the fight against candidomycosis of the mucous membranes of the mouth, esophagus, meningitis. Contraindicated in pregnancy, lactation, the presence of hypersensitivity to the components of the drug and the age of up to 3 years (capsules)	from 230 rubles for 3 capsules

It is important to remember that the preparations of the azole group are recommended to be taken with food, drinking plenty of water. Antimycotics are incompatible and prohibited for simultaneous administration with Terfenadine, Pimozide, Quinidine, Astemizol and Lovastatin.

alliamids

This group includes synthetic drugs that can remove the fungus from the body. Alliamids affect dermatomycosis - infectious fungi of the epithelium, nail plates and hairline.

Terbinafine is a synthetic broad-spectrum drug used in the treatment of fungal infections of the epidermis, nails and hair caused by fungi and dermatophytes of filamentous fungi. Even a low concentration of the agent can completely kill all types of dermatophytes and molds, as well as types of dimorphic, yeast-like (Candida albicans), yeast fungi.

The drug acts on yeast fungi both in a fungicidal (completely destroying mycosis) and fungicidal (slowing down their growth) method, depending on the variety of microorganisms being destroyed.




It is contraindicated to take the drug to persons with chronic diseases of the kidneys and liver, women during lactation and pregnancy. Possible side effects in the form of allergic rashes, taste bud disorders, headaches and problems with digestion. The drug is taken orally, regardless of the meal. The product is incompatible with alcohol. The price of the drug is from 48 rubles.

Antifungal capsules and tablets require prior appointment by a specialist. During treatment, it is possible to control blood biochemistry. Self-reducing the dose of the drug and stopping therapy is unacceptable. This can provoke the development of resistant strains of the fungus, causing a relapse of the disease.

Echinocandins

The mechanism of action of this group of drugs is unique among antifungal drugs. The powerful action of echinocandins is directed at the cell wall of the fungus, which gives them an advantage because they do not have cross-resistance with other drugs.

Preparations of this group are used in the treatment of various forms of candidiasis, aspergillosis and other mycoses. Available only for intravenous administration. The most common are Caspofungin (used for severe forms of candidiasis as prescribed by a doctor, as it has many contraindications) and Anidulafungin (prohibited for use under 18 years of age, during pregnancy, with liver diseases).



Caspofungin

pyramids

Antimycotics of this group have a wide spectrum of action. They penetrate inside the fungal cell and disrupt the synthesis of proteins important for fungi, destroying their DNA. Pyramids are used to treat complicated candidiasis, cryptococcosis, aspergillosis, chromoblastomycosis.

The representative of this group is the drug Flucytosine (Ankotil), produced in the form of tablets and solution for injection. The drug is usually used together with amphotericin B in the treatment of complicated fungal diseases. Price from 224 rubles.



flucytosine

A remedy for severe forms of mycosis - a natural antimycotic from the group of grisans

Means Griseofulvin belongs to the group of grisans (non-polyene antibiotics), effective in the fight against dermatomycetes. This is the best cure for fungus. Treatment with the drug is effective in the most severe forms of fungal diseases. But the treatment of mild mycotic manifestations with this remedy is not justified.



The following strains are susceptible to Griseofulvin:

• Achorionum;
• Trichophyton;
• epidermophyton;
• microsporum.

A medicine is prescribed for the treatment of microsporia of nails and hair, epithelium, trichophytosis, dermatomycosis, epidermophytosis. Do not take children under 2 years of age and patients with chronic diseases of the gastrointestinal tract and blood, with oncology, during pregnancy and breastfeeding. Side effects are possible from the nervous and digestive systems, with individual sensitivity to the ingredients of the drug, allergic manifestations are possible. Price - from 250 to 350 rubles.

You cannot self-medicate. If the antimycotic is chosen incorrectly, then it will not bring the expected effect, and its long-term use can cause skin rashes and damage to internal organs.

Medicines for children

If there is candidal stomatitis (thrush) in a child, then drugs are usually prescribed in the form of tablets or plates. When treating a fungal infection in the organs of vision, the doctor will rely on the use of a suspension containing nystatin. Mycosis of the nail plates in a child is treated with a special varnish that neutralizes fungal colonies, creating a protective film on the nail.

If large lesions of the fungus occur in children, systemic therapy is used. Systemic drugs include:

• Terbinafine (from 48 rubles);
• Fluconazole (from 24 rubles);
• Mikoseptin (from 348 rubles).

In pediatrics, self-treatment with antifungal agents is not allowed, because drugs have a number of contraindications and side effects. The optimal treatment plan should be drawn up only by a qualified doctor.