A retrospective study evaluating hepatic laboratory alterations and potential drug interactions in patients treated for onychomycosis. We evaluated 202 patients, 82% female. In 273 liver enzyme tests, there were changes in only 6%. Potential drug interactions were identified in 28% of patients for imidazole and 14% for terbinafine. The risk of potential interactions increased with the patient's age and use of multiple drugs.
Drug interactions; Fluconazole; Liver diseases; Onychomycosis
| Patient | Abnormalities ** | Antifungal used | Other systemic medications being used |
| 1 | GGT | Terbinafine | Captopril, Methyldopa, Hydrochlorothiazide, Glibenclamide, Metformin, Simvastatin |
| 2 | GGT | Fluconazole | No |
| 3 | AP, GGT | Fluconazole | Omeprazole, Ketoprofen, Hydrochlorothiazide, Amiloride, Amitriptyline |
| 4 | AP | Fluconazole | No |
| 5 | GGT, AST | Fluconazole | No |
| 6 | GGT, AST, ALT | Terbinafine | Hydrochlorothiazide, Nifedipine |
| 7 | AST, ALT | Fluconazole | No |
| 8 | ALT | Fluconazole | Atenolol |
| Drug | Number of patients | Interaction with imidazole | Interaction with terbinafine |
| Captopril | 33 | ||
| Hydrochlorothiazide | 26 | ||
| Acetylsalicylic acid | 19 | ||
| Metformin | 14 | ||
| Simvastatin | 13 | X | |
| Propranolol | 11 | X | X |
| Amitriptyline | 10 | X | X |
| Enalapril | 9 | ||
| Glibenclamide | 9 | X | |
| Atenolol | 6 | ||
| Furosemide | 6 | ||
| Levothyroxine | 6 | ||
| Nifedipine | 4 | X | |
| Omeprazole | 4 | ||
| Prednisone | 4 | ||
| Amlodipine | 3 | X | |
| Digoxin | 3 | ||
| Fluoxetine | 3 | X | X |
| Amiodarone | 2 | ||
| Carvedilol | 2 | X | |
| Imipramine | 2 | X | |
| Losartan | 2 | X | |
| Methyldopa | 2 | ||
| Sertraline | 2 |
