What is Tavaborole: Uses, Dosage, Side Effects and More

Tavaborole is a topical antifungal medication that treats nail fungus infections, specifically onychomycosis. It works differently from other antifungal treatments by blocking a specific enzyme that fungus needs to survive and grow. This prescription medication comes as a clear solution that you apply directly to infected toenails once daily for up to 48 weeks.

What is Tavaborole?

Tavaborole is a prescription antifungal solution designed specifically for toenail fungus infections. It belongs to a unique class of antifungal medications called boron-based inhibitors, which makes it different from traditional antifungal treatments.

The medication targets fungal infections at the cellular level by interfering with protein production in fungal cells. This approach helps clear the infection while allowing healthy nail tissue to grow back over time.

Tavaborole is relatively new compared to other antifungal treatments, having been approved by the FDA in 2014. It offers an alternative for people who haven't responded well to other topical antifungal medications or prefer not to take oral antifungal drugs.

What is Tavaborole Used For?

Tavaborole treats onychomycosis, commonly known as toenail fungus or nail fungus infection. This condition causes nails to become thick, discolored, brittle, and sometimes painful.

The medication works best on mild to moderate nail fungus infections that haven't spread to the nail matrix (the area where nail growth begins). It's particularly effective when the infection affects less than 50% of the nail surface.

Your doctor might recommend tavaborole if you have recurring nail fungus infections or if other topical treatments haven't worked effectively. It's also considered when oral antifungal medications aren't suitable due to potential drug interactions or liver concerns.

How Does Tavaborole Work?

Tavaborole works by blocking an enzyme called leucyl-tRNA synthetase, which fungal cells need to make proteins essential for survival. This is a moderate-strength antifungal approach that specifically targets fungal cells without significantly affecting human cells.

The medication penetrates through the nail plate to reach the infection site beneath the nail. Once there, it disrupts the fungus's ability to reproduce and maintain itself, gradually clearing the infection over several months.

Unlike some stronger systemic antifungals, tavaborole works locally at the application site. This targeted approach means fewer side effects throughout your body while still providing effective treatment for the infected area.

How Should I Take Tavaborole?

Apply tavaborole once daily to clean, dry toenails, preferably at the same time each day. You don't need to take it with food or milk since it's applied topically rather than swallowed.

Before applying, wash your hands and feet thoroughly with soap and water, then dry completely. Apply a thin layer of the solution to the entire nail surface, including the nail bed and under the tip of the nail if possible.

Let the medication dry completely before putting on socks or shoes, which usually takes about 2-3 minutes. Avoid washing the treated area for at least 6 hours after application to allow proper absorption.

You can eat normally since this is a topical medication, but avoid getting the solution on healthy skin around the nail as much as possible. If you do get some on surrounding skin, it's generally not harmful but may cause mild irritation.

How Long Should I Take Tavaborole For?

Most people need to use tavaborole for 48 weeks (nearly one year) to see complete results. This extended treatment time is necessary because toenails grow very slowly, and it takes time for healthy nail to replace the infected portions.

You might start seeing improvements in nail appearance after 24 weeks, but it's important to continue treatment for the full prescribed duration. Stopping too early often leads to the infection returning because fungus can still be present in nail tissue that looks healthy.

Your doctor will monitor your progress during treatment and may adjust the duration based on how your nails respond. Some people with severe infections might need treatment beyond 48 weeks, while others with milder cases might see complete clearing sooner.

What Are the Side Effects of Tavaborole?

Most people tolerate tavaborole well, with side effects being generally mild and limited to the application area. The most common side effects affect the skin and nails where you apply the medication.

Here are the side effects you might experience, understanding that most are temporary and manageable:

• Skin irritation or redness around the treated nail
• Mild burning or stinging sensation when first applied
• Dry or peeling skin near the application site
• Temporary nail discoloration or changes in nail texture
• Mild swelling of the toe or surrounding tissue

These reactions typically improve as your skin adjusts to the medication over the first few weeks of treatment.

Rare but more serious side effects can occur in some people, though these affect fewer than 1% of users:

• Severe allergic reactions with widespread rash or difficulty breathing
• Persistent burning or pain that worsens over time
• Signs of secondary bacterial infection (increased redness, warmth, pus)
• Nail separation from the nail bed (onycholysis)
• Severe skin blistering or ulceration

If you experience any severe reactions, contact your healthcare provider immediately as these may require stopping the medication or additional treatment.

Who Should Not Take Tavaborole?

Tavaborole isn't suitable for everyone, and certain conditions make it inadvisable or require special precautions. People with known allergies to tavaborole or any of its inactive ingredients should avoid this medication.

You should discuss alternatives with your doctor if you have severe nail damage or infections involving more than 50% of the nail surface. The medication works best on mild to moderate infections and may not be effective for advanced cases.

People with compromised immune systems, such as those with diabetes, HIV, or taking immunosuppressive medications, may need closer monitoring during treatment. While not prohibited from use, these conditions can affect healing and increase infection risks.

Pregnant and breastfeeding women should use tavaborole only if the benefits clearly outweigh potential risks. Limited data exists on its safety during pregnancy, so your doctor will carefully weigh your specific situation.

Tavaborole Brand Name

Tavaborole is sold under the brand name Kerydin in the United States. This is currently the only FDA-approved brand containing tavaborole as the active ingredient.

Kerydin is manufactured by Anacor Pharmaceuticals (now part of Pfizer) and comes as a 5% topical solution in a bottle with an applicator brush. The brand name formulation is what's been studied in clinical trials and approved for treating toenail fungus.

Generic versions of tavaborole are not yet widely available, so most prescriptions will be filled with the brand name Kerydin. Your insurance coverage may vary for brand name medications, so check with your provider about coverage options.

Tavaborole Alternatives

Several alternative treatments exist for toenail fungus if tavaborole isn't suitable or effective for you. These options include other topical antifungals, oral medications, and procedural treatments.

Other topical antifungal alternatives include ciclopirox (Penlac), efinaconazole (Jublia), and amorolfine (not available in the US). These work through different mechanisms and may be effective when tavaborole isn't.

Oral antifungal medications like terbinafine (Lamisil) or itraconazole (Sporanox) are more potent options for severe infections. However, they carry higher risks of side effects and drug interactions compared to topical treatments.

Newer treatments include laser therapy, photodynamic therapy, and surgical nail removal in severe cases. Your doctor can help determine which alternative might work best based on your specific infection and health situation.

Is Tavaborole Better Than Ciclopirox?

Both tavaborole and ciclopirox are effective topical antifungals, but they work through different mechanisms and have distinct advantages. Tavaborole may be more effective for some people because of its unique enzyme-blocking action.

Clinical studies suggest tavaborole achieves complete cure rates of about 6-9% compared to ciclopirox's 5-8% rate. While this difference seems small, tavaborole's newer mechanism of action may work better for infections resistant to traditional antifungals.

Ciclopirox requires daily application with weekly removal using rubbing alcohol, while tavaborole has a simpler once-daily application routine. Some people prefer tavaborole's easier application schedule and don't mind the longer treatment duration.

The choice between these medications often depends on your specific fungal strain, previous treatment responses, and personal preferences. Your doctor can help determine which option offers the best chance of success for your particular case.