I. Sporanox Fact File

Sporanox was introduced by Jassen Pharmaceuticals.

Janssen Pharmaceuticals is a member of the Johnson & Johnson family of companies, the world's most comprehensive and broadly based manufacturer of healthcare products, as well as a provider of related services, for the consumer, pharmaceutical, and medical devices and diagnostics markets.

Janssen produces and markets prescription medications in four therapeutic areas:

• central nervous system disorders,
• gastrointestinal health,
• pain management and
• the treatment of fungal infections

II. Sporanox Medication

Sporanox medication (Itraconazole) is a medicine used to treat fungal infections of the toenails and fingernails (Onychomycosis). It is also used to treat some types of fungal infections in other areas of the body.

Sporanox medication (Itraconazole) goes into your bloodstream and travels to the source of the infection underneath the nail so that it can fight the infection there. Improved nails may not be obvious for several months after the treatment period is finished because it usually takes about 6 months to grow a new fingernail and 12 months to grow a new toenail.

Unlike Sporanox medication, antifungal creams, ointments, and nail lacquers that you apply to the top of your nail do not penetrate completely through the nail. They do not reach deep into the nail bed, so the fungal infection may continue to live, grow, and attack the new nail that's growing in.

Once you have finished your treatment with Sporanox, your nails should continue to improve over time. You should start to see a new, normal nail replacing the damaged nail as it grows out. To grow out completely, normal fingernails take about 6 months and toenails take about 12 months.

Benefits of SPORANOX

• Using Sporanox, many patients begin to see results in as little as 3 months. It usually takes about 6 months to grow a new fingernail and 12 months to grow a new toenail.
• If you use the PulsePak for fingernail fungal infections, you will take Sporanox for 1 week and then take no Sporanox for the next 3 weeks before repeating the 1-week treatment. This is called "pulse dosing." The Sporanox PulsePak contains enough medicine for one "pulse" (1 week of treatment).
• Generic Sporanox treats nail infections caused by dermatophytes, a type of fungus that is the leading cause of nail infections.
• Sporanox medication works from inside the nail to fight infection, unlike antifungal creams, ointments, and nail lacquers, which are applied to the top of the nail and do not penetrate completely through the nail to where the infection resides.
• Sporanox capsules are easy to swallow.
• Generic Sporanox has been extensively studied in large clinical trials and is considered safe and effective when used as directed, with a low rate of side effects. (As with all prescription medications, patients-especially pregnant or nursing women-should consult a physician or other healthcare provider before starting treatment.)

Onychomycosis: Information

The clinical name for fungal nail infection is "onychomycosis". Onychomycosis is an infection that attacks underneath the surface of the nail and can penetrate the nail bed.

Diagram: Healthy Nail

Nails grow out from the cuticle and move forward at about 1/10th of an inch per month. New nails are created from cells in the growth center of the nail. This is the area of the nail that looks like a half moon. The cells in the growth center become hard and develop into a new nail. The nail bed, which is made up of softer tissue, supports the nail as it grows. The cells of the nail bed attach themselves to the underside of the nail to hold it in place.

Signs and Symptoms of Onychomycosis

One of the main signs of fungal nail infection is a change in the appearance of the nail itself. Hence it's a good idea to learn the signs of mild, moderate, and severe cases of fungal nail infection. While these are all signs and symptoms of fungal nail infection they may also be indicative of other conditions.

Fungal infection

Diagram: Mild fungal infection Mild fungal infection: White tip of nail turns yellow or brownish color.		Diagram: Moderate fungal infection Moderate fungal infection: Yellow or brown color spreads inward on nail. Nail becomes thick, brittle, and may start to separate from the underlying nail bed.		Diagram: Severe fungal infection Severe fungal infection: The entire nail is discolored, thick, and brittle. Parts of it have broken off. (In the most extreme cases, the entire nail has been destroyed.)

Also be alert to a few other telltale signs, which may indicate a fungal nail infection:

• Lifting of the nail away from skin
• The development of a foul-smelling odor
• Pain, especially while wearing shoes or hosiery, or when walking, working, or playing sports
• Reduced sensitivity in your fingertips, making it more difficult to pick up small objects or to use the computer

The Happening's Beneath the Surface of Nail

The most common type of fungal nail infection invades the nail from under the tip of the nail, the cuticle, or the top of the nail. It spreads to the lower layers of the nail, the nail bed, and growth center. The infection thrives on keratin, the nail's protein substance. The infected part of the nail may turn a slight yellow color, become thicker and brittle, and then break off.

Causes of Onychomycosis

In addition to age, other factors influence the development of fungal nail infection.

• Athlete's foot
• Nails continually covered with polish or artificial nails, giving your nails little chance to "breathe."
• The presence of an artificial nail or a polish impedes the passage of moisture through the nail.
• The water trapped below can become stagnant and unhealthy, ideal for fungi and similar organisms to thrive.
• Excessive heat and moisture, and/or sweating
• Frequent exposure of nails to water
• Tight-fitting shoes, hosiery, or gloves
• Diabetes and other conditions that may hinder circulation
• Conditions affecting the body's immune system (including chemotherapy and HIV)
• Trauma to the nail
• Fungus picked up in community showers (as in a gym) or by pools

Side Effects of Anti- Fungals

Oral antifungals can cause minor to serious side effects.

Minor side effects may include:

• Headaches.
• Stomach upset.
• Skin rashes.
• Changes in taste sensation (rare).
• Visual disturbances (rare).

Dangerous side effects of oral medications include:

• Liver damage.
• Liver failure, requiring liver transplant. A small number of deaths after liver failure have been linked to oral terbinafine.

Warning signs of liver failure include:

• Nausea, vomiting, abdominal pain.
• Fatigue.
• Loss of appetite.
• Dark urine.
• Changes in skin color.
• During oral antifungal treatment, your health professional may require blood tests to check your kidney and liver function.

Itraconazole may cause heart failure. Warning signs include:

• Shortness of breath at rest, with mild exertion, or when lying flat.
• Severe swelling of feet, ankles, legs, or abdomen.
• Weight gain.
• Fatigue.
• Coughing up white or pink mucus.
• aster-than-usual heart rate.

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III. Useful links

Government

http://www.cdc.gov/

http://www.fda.gov/

http://www.fda.gov/cder/ogd/

http://www.nih.gov/

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

http://www.health.gov.on.ca/

National Library of Medicine

World Health Organization

http://www.mayoclinic.com/index.cfm

MedicineNet.com

Drugdigest.org

Healthsquare.com

harmacy sites

http://www.janssen.com

http://www.hsforum.com/stories/storyReader$1509 ,

http://www.hsforum.com/stories/storyReader$1504,

http://www.people.vcu.edu/~urdesai/atc.htm#Process%20of%20clotting

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