Author Topic: Toenail fungus  (Read 19973 times)

Re: Toenail fungus
« Reply #75 on: June 20, 2019, 01:05:42 pm »
Off to the phlebotomist later today[1] to get the liver enzymes checked and, if all ok, will fill the repeat prescription I've been given.

Blood test at hospital midday on a Wednesday. Text from doctor at 6pm the next day (Thursday) to say that test results are good and I can continue to take terbinafine. Prescription for another 84 days filled. Just need to make a note in the diary for ~3 months time to book another doc appt.

I have just picked up my 3rd batch of 28 making it 84 in total I have had so far (just coming to the end of the second batch).
The 3rd batch contains another repeat prescription, which doesn't say anything about having to back and have a liver function test.

Did they tell you you're only allowed 3 batches before getting the liver function test, or did you opt for that yourself?

I'm sure it has had an effect, as last week, on the most affected one with the deepest infection, the nail basically fell off completely. It started with a crack fairly near the base, then the crack propogated to down the middle like an upside-down T shape, then each half (left and right) basically came away. Skin beneath looks a bit brown and scabby but hopefully it is free of fungus, and hopefully a new healthy nail will grow in its place.
It is what it is. It's not what it's not, so it must be what it is.

Re: Toenail fungus
« Reply #76 on: June 21, 2019, 09:29:21 am »
Did they tell you you're only allowed 3 batches before getting the liver function test, or did you opt for that yourself?

Each prescription I get is for 84 tablets (12 weeks worth).

Liver enzyme test before taking first one. (I was given the prescription but told not to fill it until I got the ok with the results of the liver test.)

Told to book another doctors appointment a week or so before those first 84 tables were due to run out.

2nd Doctors appointment was just to check everything was going ok (a quick look at the nails, and check that I'm not turning yellow and no unexplained abdominal pain, etc). Given another prescription and a referral for another blood test. Again told not to fill prescription until given the all clear from the latest blood test.

I'll book another doctors appointment a week or so before this next batch of tablets is due to run out (i.e. day 160 or so). I expect it'll be another quick check that everything is ok, a look at the nails to see if I need another 12 weeks, prescription, blood test referral and told not to fill prescription until results.

I never asked for the liver tests, they've been a condition of me getting the prescriptions. The pharmacist also asked whether I'd had a recent liver test before filling the prescriptions (both times).

So, 3 months in and I've got about 9mm of it left on my big toe, the nail on my middle toe is taking longer than expected as that nail is raised/arched and I guess the fungus was deep in the nail bed. Wouldn't be surprised if I have to go the full 12 months on it to get rid of it completely. Joy.

"Yes please" said Squirrel "biscuits are our favourite things."

Re: Toenail fungus
« Reply #77 on: September 03, 2019, 09:42:51 am »
I'll book another doctors appointment a week or so before this next batch of tablets is due to run out (i.e. day 160 or so). I expect it'll be another quick check that everything is ok, a look at the nails to see if I need another 12 weeks, prescription, blood test referral and told not to fill prescription until results.

Almost exactly that. Quick check of nails, blood test referral (good as I have to go to the hospital to chase up the physio referral) and the doc sent the prescription to my designated pharmacy (no need to get a hardcopy prescription any more).

The only change was that he said that since I've been on it for 6 months with no problems (and two good liver test results) I can collect the prescription and continue with the next batch of tablets without waiting for the ok - he'll just ring me if there's a reason to stop taking them (before that they would ring to tell me it was ok to start taking them).

Still about 4mm-5mm of nail on the big toe that's cloudy and there's still a bit of crumbliness on my middle toenail (the other one that was infected). Might be done in the next 3 months but may possibly require a further 3 months (i.e. 12 months in total) to be sure, will know more next time. Will set up a reminder to book appointments in 12 weeks time.
"Yes please" said Squirrel "biscuits are our favourite things."

simonp

  • Omnomnomnipotent.
Re: Toenail fungus
« Reply #78 on: November 21, 2019, 11:37:44 pm »
I’m nearly 5 weeks in. They only gave me 6 weeks supply and I have to have follow up bloods at 4-6 weeks so that is booked for next week. I have one 4th nail fully discoloured and both big toe nails down one side. I lost both big nails after a 600k and I think they were susceptible during regrowth.

Terbinafine is actually pretty safe compared to older drugs but although I don’t drink much these days I’m staying off the booze entirely during treatment. I’ve seen advice to avoid caffeine. Nope.  :hand:

Re: Toenail fungus
« Reply #79 on: November 22, 2019, 08:31:49 am »
Good reminder. My doc appt earlier this week was cancelled on the day as the doctor was ill, rebooked for 2 weeks' time (the day before my latest 12 week batch runs out).

I expect to get another 12 weeks worth (and another blood test) as it is still not all done. That'll be 48 weeks if that happens.

Terbinafine is actually pretty safe compared to older drugs but although I don’t drink much these days I’m staying off the booze entirely during treatment. I’ve seen advice to avoid caffeine. Nope.  :hand:

Haven't noticed any other changes though, but I'll be glad not to be taking the tablet every day (I'm lucky in that I don't have to take any other tablets at all). Horrible chalky things that taste disgusting if they don't go down with the first gulp of water.

I've cut down a bit on booze (mostly because I haven't been playing 5-a-side for the last 4 months due to ankle injury) and I gave up caffeinated coffee 10 years ago for LEL, so that's not a problem for me.
"Yes please" said Squirrel "biscuits are our favourite things."

simonp

  • Omnomnomnipotent.
Re: Toenail fungus
« Reply #80 on: November 30, 2019, 12:31:43 pm »
I had blood test on Wednesday which came back fine. They only seem to want to give me 6 weeks supply at a time at my surgery, with instructions for another test in 4-6 weeks. I didn't see the doctor, just had blood taken and then repeat prescription issued direct to the local pharmacy.

Re: Toenail fungus
« Reply #81 on: November 30, 2019, 01:00:11 pm »
It'll cost you twice as much then.
"Yes please" said Squirrel "biscuits are our favourite things."

simonp

  • Omnomnomnipotent.
Re: Toenail fungus
« Reply #82 on: November 30, 2019, 08:57:47 pm »
It'll cost you twice as much then.

Indeed it will - could cost almost £80 if it takes a year. Is it worth it?!


Re: Toenail fungus
« Reply #83 on: November 30, 2019, 10:43:34 pm »
It'll cost you twice as much then.

Indeed it will - could cost almost £80 if it takes a year. Is it worth it?!

I'd ask them specifically about getting a 12 week prescription, even if they still want you to have blood tests every 6 weeks. (There may be a specific reason why they want this for you.)

I'll be looking at £36 for my 48 weeks (assuming I get another 12 weeks when I see the doc on Tuesday).

My local chiropodist had "Fungal nail complete treatment" at £310 on their price list but I'm guessing this includes a lot of in person treatment (even if they still just give you terbinafine) and might be assuming it's multiple nails infected.
"Yes please" said Squirrel "biscuits are our favourite things."

Re: Toenail fungus
« Reply #84 on: December 03, 2019, 09:09:37 am »
I expect to get another 12 weeks worth (and another blood test) as it is still not all done. That'll be 48 weeks if that happens.

Another 12 weeks for me (I think, haven't seen the prescription as it gets sent to the pharmacy directly) but it's almost gone so the doc said to take it until the last of it has disappeared from the nail and then I can stop, so hopefully only another month or two. Another blood test (handily have a physio appt for my ankle next week at the local hospital so I can combine the two).

If I remember later I'll post before/current pics (behind spoiler tags...)
"Yes please" said Squirrel "biscuits are our favourite things."

simonp

  • Omnomnomnipotent.
Re: Toenail fungus
« Reply #85 on: December 03, 2019, 12:54:03 pm »
4-6 weeks monitoring is what is suggested by emc: https://www.medicines.org.uk/emc/product/1031/smpc

However, the FDA actually removed the monitoring requirement from the drug label in 2001

I'm not bothered about the cost TBF, it's just a minor inconvenience to get retested and refill the prescription.