Fungal infections affect roughly one in four adults at some point — most often skin (tinea pedis, tinea cruris, tinea corporis), nails (onychomycosis), scalp (tinea capitis), oral or vaginal candidiasis, and seborrheic dermatitis. Severe systemic fungal infections (invasive candidiasis, aspergillosis, mucormycosis) require hospital-grade IV agents and are not part of this catalogue. The MedsBase Fungal Infection Treatment catalogue carries 31 products covering the full topical and oral antifungal range, supplied by WHO-GMP gecertificeerde fabrikanten.
Topical azoles. Topical azoles inhibit fungal CYP51-mediated ergosterol synthesis. Ketoconazole 2% cream and shampoo (the workhorse for seborrheic dermatitis, tinea versicolor, and superficial candidiasis) is available as Keto Cream, KZ Cream, Ketoforce, en Keto Lotion. Miconazole 2% cream and gel (broad-spectrum, particularly good for candidiasis) is stocked as Daktarin Gel en Micogel. Luliconazole 1% (single-daily-application advantage) is available as Lulibet XL Cream. Clotrimazole (vaginal pessary + cream) for vulvovaginal candidiasis is stocked as Candid V Gel.
Allylamines (topical and oral). Terbinafine inhibits squalene epoxidase and is fungicidal against dermatophytes — first-line for tinea pedis, tinea corporis, tinea cruris, and onychomycosis. Topical 1% cream is available as Terbicip Cream en Terbiface. Oral 250 mg tablets (the gold standard for onychomycosis: 6 weeks for fingernails, 12 weeks for toenails) are stocked as Terbicip, Terbijohn, Zimig, and the topical Fintop Cream. Oral terbinafine requires baseline LFTs and a 4–6-week recheck — hepatotoxicity is rare but real. Avoid in active liver disease.
Oral azoles. Fluconazole (water-soluble, excellent CSF and urinary penetration, weekly-dosing option for chronic candidiasis prophylaxis) is available as Fluconaz, Forcan, Zocon, Zocon DT, Fluka, en Fluka Capsule. Single 150 mg dose for uncomplicated vulvovaginal candidiasis; weekly 150 mg for recurrent VVC; 6–12 weeks for tinea pedis/cruris. Itraconazole (broader spectrum including dermatophytes, dimorphic fungi, and many moulds) is available as Sporanox, Itratuf, Itrotab, en Itaspor. Pulse-dose itraconazole (200 mg BID × 1 week per month, 2 pulses for fingernails, 3 for toenails) is the alternative onychomycosis regimen when terbinafine is contraindicated. Voriconazole (specialist agent for invasive aspergillosis) is stocked as Voritrol and Vorier.
Griseofulvin. The classic oral antifungal still used for tinea capitis in children (where azoles are second-line), and for severe extensive tinea infections. Available as Grisovin FP, Griso, Grisoheal, en Griseofulvin. Take with fatty meal to enhance absorption; treatment courses are long (4–8 weeks for tinea capitis, up to 12 months for onychomycosis). Less commonly used now because of slower fungal kill compared to terbinafine.
Topical nail lacquers. Amorolfine 5% lacquer (weekly application) is available as Loceryl Nail Liq en Nailrox Nail Lacquer. Best used for early-stage onychomycosis affecting <50% of the nail with the matrix spared, or as adjunct to oral terbinafine.
Combination kits. The Zocon-T Kit (fluconazole + tinidazole + adapalene-clindamycin / azithromycin variant; used for combined vaginal/cervical infection) is available as Zocon-T Kit. Co-Trimoxazole is stocked as Co-Trimoxazole for selected pneumocystis prophylaxis.
Hoe te kiezen. Localised superficial tinea or candidiasis → topical azole or terbinafine for 2–4 weeks. Extensive, recurrent, or scalp / nail involvement → oral terbinafine first-line for dermatophytes, oral fluconazole for candida and pityriasis versicolor, oral itraconazole as alternative or for dimorphic / broader-spectrum coverage. Vulvovaginal candidiasis (uncomplicated) → fluconazole 150 mg single dose or topical clotrimazole. Recurrent VVC → fluconazole 150 mg weekly × 6 months. Severe invasive disease is hospital-managed.
Belangrijk. Confirm fungal aetiology before starting prolonged systemic therapy — many “stubborn rashes” are eczema or psoriasis, not fungus, and respond worse to antifungals than to topical steroids. Oral terbinafine and azoles need hepatic monitoring on extended courses. Itraconazole and ketoconazole have major CYP3A4 interactions (avoid with statins, oral midazolam, ergot alkaloids, many tyrosine-kinase inhibitors). Do not use any oral antifungal in pregnancy without specialist advice.
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