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efinaconazole

General

Pronunciation:
eff-in-a-kon-a-zole


Trade Name(s)

  • Jublia

Ther. Class.
antifungals

Pharm. Class.
triazoles

Indications

Topical treatment of onychomycosis of the toenail.

Action

Inhibits synthesis of ergosterol, a component of fungal cell membranes.

Therapeutic Effect(s):

Resolution of toenail fungus.

Spectrum:

Active against Tricyhophyton rubrum and Trychophyton mentagrophytes.

Pharmacokinetics

Absorption: Minimal systemic absorption follows application to toenails.

Distribution: Unknown.

Metabolism and Excretion: Unknown.

Half-life: 29.9 hr.

TIME/ACTION PROFILE

ROUTEONSETPEAKDURATION
Topical†unknownunknownunknown
† Prolonged treament is necessary due to need for treatment throughout growth of new toenails.

Contraindication/Precautions

Contraindicated in:

  • None noted.

Use Cautiously in:

  • Geri: Elderly patients may be more sensitive to drug effects;
  • OB: Use during pregnancy only if potential maternal benefit justifies potential risk to fetus;
  • Lactation:Use cautiously if breastfeeding;
  • Pedi: Safe and effective use in children has not been established.

Adverse Reactions/Side Effects

Local: application site dermatitis, application site pain, application site vesicles, ingrown toenail

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Drug-Drug

None noted.

Route/Dosage

Topical: (Adults) Apply to affected toenails once daily for 48 wk.

Availability

Solution: 10% in 4– and 8–mL bottles (with integrated flow-through applicator brush)

Assessment

  • Inspect involved areas of skin before and frequently during therapy. Increased skin irritation may indicate need to discontinue medication.

Potential Diagnoses

Implementation

  • Topical: Apply to affected clean, dry toenails once daily for 48 wks with integrated flow-through brush applicator. Ensure toenail, toenail folds, toenail bed, hyponychium, and undersurface of toenail plate are completely covered. Solution is clear, colorless to pale yellow.

Patient/Family Teaching

  • Instruct patient to apply efinaconazole as directed for full course of therapy, even if feeling better. Emphasize the importance of topical use only, not for oral, ophthalmic or intravaginal use. Advise patient to wait at least 10 min after showering, bathing, or washing before applying. Efinaconazole is flammable; avoid use near heat or open flame.
  • Advise patient to report increased skin irritation (redness, itching, swelling) to health care professional.
  • Caution patient to avoid pedicures, nail polish, and cosmetic nail procedures during therapy.
  • Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
  • Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

Resolution of toenail fungus.

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Citation

Quiring, Courtney, et al. "Efinaconazole." Davis's Drug Guide, 16th ed., F.A. Davis Company, 2019. Nursing Central, nursing.unboundmedicine.com/nursingcentral/view/Davis-Drug-Guide/110168/all/efinaconazole.
Quiring C, Sanoski CA, Vallerand AH. Efinaconazole. Davis's Drug Guide. 16th ed. F.A. Davis Company; 2019. https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Drug-Guide/110168/all/efinaconazole. Accessed April 20, 2019.
Quiring, C., Sanoski, C. A., & Vallerand, A. H. (2019). Efinaconazole. In Davis's Drug Guide. Available from https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Drug-Guide/110168/all/efinaconazole
Quiring C, Sanoski CA, Vallerand AH. Efinaconazole [Internet]. In: Davis's Drug Guide. F.A. Davis Company; 2019. [cited 2019 April 20]. Available from: https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Drug-Guide/110168/all/efinaconazole.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - efinaconazole ID - 110168 A1 - Quiring,Courtney, AU - Sanoski,Cynthia A, AU - Vallerand,April Hazard, BT - Davis's Drug Guide UR - https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Drug-Guide/110168/all/efinaconazole PB - F.A. Davis Company ET - 16 DB - Nursing Central DP - Unbound Medicine ER -