Tinea Unguium, Onychomycosis
Conditions
Keywords
Toenail fungus
Brief summary
Study evaluates these take of diclofenac sodium when used in conjunction with miconazole and urea as a topical antifungal nail gel treatment for onychomycosis. All of the patient's will be treated with the active formula and blood levels of diclofenac sodium tested for as well as monitoring of hepatic and renal functions
Detailed description
Tinea Unguium/onychomycosis is a ubiquitous health problem affecting \ 3% of the adult population. It is associated with higher risk for other disease processes. Effective treatment for this disease has been lacking. Oral antifungal agents are associated with high incidence of recurrence of disease, hepatotoxicity, cytochrome P450 Pathway interference, non-compliance, side effects and cost. No effective long-term topical applications have been verified. Debridement of the damaged nail in combination with a broad-spectrum topical antifungal agent and an anti-inflammatory agent is a safe, inexpensive and easily formulated alternative to previous ineffective treatments. The rationale for debridement is simple in that the effectiveness of the topical antifungal is present only when it is in contact with the fungal agent, nail bed and involved diseased tissue. The associated inflammatory response associated with fungal infections is well-established. The only topical NSAID available in the United States is diclofenac sodium. The combination of miconazole, diclofenac sodium and urea has proven effective in this researcher's self-treatment of tinea unguium. Miconazole and diclofenac sodium are well studied and well-established pharmaceutical
Interventions
DRUGAntifungal Nail Gel Study
Daily Application antifungal gel of miconazole 3% and diclofenac sodium 1% and urea 40% to infected nails.
Sponsors
William N Handelman
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
21 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
1. Male or female ≥ 21 years of age at Visit 1. 2. Not pregnant. 3. Stage 3 or lower Chronic Renal Failure. 4. PT/INR \< 1.3 and not on anti-thrombotic; AST, ALT, Total Bilirubin WNL. 5. Documentation of a diagnosis of tinea unguium as evidenced by one or more clinical features consistent with the onychomycosis and one or more of the following criteria: KOH prep of the nail scrapings or positive culture of the nail scrapings; culture of nail with growth of any of the following Dermatophytes, non-dermatophytes or yeast. 6. TABLE 1 Epidermophyton floccosum Trichophyton mentagrophytes Trichophyton rubrum Acremonium Alternaria species Aspergillus species Botryodiplodia theobromae Fusarium species Onycochola canadensis Pyrenochaeta unguis-hominis Scytalidium dimidiatum scopulariopsis species Scytalidium hyalimum Candida albicans
Exclusion criteria
1. Chronic renal failure, chronic liver disease, alcoholism, pregnant, breastfeeding, or unwilling to practice birth control during participation in the study if of childbearing age.. 2. Presence of a condition or abnormality that in the opinion of the Investigator would compromise the safety of the patient or the quality of the data. 3. Concomitant use of any prescribed medication that may be adversely affected by diclofenac sodium.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Diclofenac sodium serum levels | 12 hours | Peak Plasma Concentration (Cmax) diclofenac sodium 12 hours after 1st dose |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Peak Plasma Concentration (Cmax) of diclofenac sodium 3 months after starting application | 3 months | Peak Plasma Concentration (Cmax) of diclofenac sodium |
Countries
United States
Contacts
Primary ContactWilliam N Handelman, MD
Backup ContactMyung-Joo Handelman, ARNP
Outcome results
None listed