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Before taking a course of tablet treatment for fungal nail infection, diagnosis has to be confirmed by the doctor taking nail clippings from one or more of the affected nails and sending it to the hospital lab for fungal, stain and culture. It usually takes a month to get the full results back as fungus grows very slowly in the lab.

If the nail clippings confirm that there is a fungal nail infection which is sensitive to Lamisil tablets, the doctor will arrange to take routine bloods from you before starting a three month course of Lamisil tablets. It is important that you have your bloods checked before starting the course of treatment and have the bloods repeated one month into the course of treatment to ensure the tablets are not causing any side effects. Side effects from Lamisil tablets are rare but occasionally they can cause nausea, a generalised rash or liver problems. Should you develop any new symptoms that you feel may be as a result of the Lamisil tablets, please stop the tablets immediately and let the doctor who prescribed the tablets know.

The doctor will usually give you a prescription for the first month of the tablets and will not give you the prescription for the last two months until your bloods have been checked after completing the first month of tablet treatment.

On completion of the three month course of treatment your nails will still look unsightly and perhaps crumbly. It will take a further nine months for the nails to grow out clear.

Lamisil tablets are usually about 85% effective at clearing trichophyton rubrum which is the most common fungus to infect toenails. Some patients may get re-infected by the fungus a few years later. The chances of this can be reduced by wearing leather shoes in winter and open toe sandals in the summer to let the air at the feet.  You should also be careful not to walk around barefooted anywhere. Wear shoes, slippers or flip-flops in the family home, in public places such as swimming pools, changing rooms, gymnasiums and hotels.

If you are worried that there may be fungal residue in your footwear, please sprinkle Daktarin powder into all your shoes once at night for seven days at the start of the three month course of Lamisil tablets.

In summary, this is the normal schedule for treating fungal nail infections:

On your first visit, the doctor will take nail clippings for fungal, stain and culture and will also take routine blood tests.

After one month, you can phone for the results. If the fungal clippings grow fungus which is sensitive to Lamisil tablets and if your routine blood tests are normal, the doctor will post you out a prescription for one month of Lamisil tablets, 250mg once daily. You should also sprinkle you shoes with Daktarin powder daily for one week.

After completing one month of the tablets, you return to the nurse in The Ashe Street Clinic for routine blood tests. The nurse will organise for the doctor to issue another two months supply of Lamisil tablets on the same day (i.e. three months in total).

It will take nine to twelve months after finishing the tablets before you notice the nails growing clear.

Should you require any further information please talk to any of the doctors or nurses in The Ashe Street Clinic.

Z: My Docs/derm papers / Treating Fungal Nail Infections with Lamisil Anti-fungal Tablets Jan 18