Efinaconazole

Efinaconazole is an azole antifungal medication. It is used as a topical treatment of onychomycosis of the toenails caused by Trichophyton rubrum and Trichophyton mentagrophytes. US FDA approved it as a 10% topical solution for the treatment of onychomycosis, a fungal infection of the nail. It does this by inhibiting 14α-demethylase. Efinaconazole is not very effective, but it is still the best contemporary topical treatment there is. It has a cure three times better than the best next best topical treatment called Ciclopirox. It is considered good for patients with mild cases or who can not take oral treatment. Efinaconazole is sold under the brand names Jublia and Clenafin amongst others. Valeant Pharmaceuticals International Inc holds the current license for this drug after it acquired Jublia through its purchase of Dow Pharmaceutical Sciences in 2008. The U.S. Food and Drug Administration approved the New Drug Application in 2014.

Dosage and administration

Efinaconazole is sold as a topical solution on the ointment. The method to use it is as follows. Wash and dry the toenail, thoroughly, in case of a shower or soaking feet in the water, wait for 10 minutes to dry out. This should be applied using the brush, only on the infected toenail, and strictly as directed by your doctor. The standard recommends the duration is 48 weeks. Be sure to completely cover the toenail folds, bed, and under its edges and wash your hands after use. Avoid any other part of your body touching this medication. The best way to use it is to use it daily. It should be used till the time healthy nails grow back to replace the infected toenails. There is a risk of fungus growing back in case the treatment is discontinued before the healthy toenails grow back.

The cost of Efinaconazole

In the USA, the average retail price is $732.22 for a bottle of a topical solution containing 4ml of 10%. In the ingredient form, the White Efinaconazole ingredient powder cost USD 2000 a 100 kilos.

How does Efinaconazole Work?

Antifungal drugs target ergosterol biosynthesis to achieve fungicide. Ergosterol, an important structural component of fungal cell membranes is involved in maintaining membrane fluidity. It acts as a permeability barrier and is essential for fungal cell viability (1–3). Among these antifungals, triazole antifungals block sterol 14α-demethylase in the ergosterol biosynthesis pathway. This results in depletion of ergosterol, which affects cell membrane integrity and function. This action is believed to inhibit fungal cell growth and affect morphology. The overall result is the death of the fungus.

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