The FDA recently approved two new prescription medications to treat nail fungus. These topical liquids are shockingly expensive.
One little bottle of Jublia (efinaconazole) contains 4 milliliters (ml). That’s less than a teaspoon, which contains 5 ml. The cost at a giant chain drugstore is $539. A competitor, Kerydin (tavaborole), costs about the same–$531 for 4 ml.
That would be scary enough if one bottle could cure your fungus-ridden nails. But toenail fungus is hard to treat and takes a very long time to eradicate.
The instructions on Jublia call for one drop per nail each day. If the big toe is affected, it gets two drops. That means that if you have two big toes with fungus-ridden nails, you’ll need four drops every day. With approximately 20 drops in a milliliter (depending on how thick the liquid is), that comes to about 80 drops in a 4 ml bottle. So, using four drops a day will get you through almost three weeks of treatment.
At that point, you’ll be just getting started. Jublia should be used on those bad nails every day for 48 weeks. That means you’ll need 16 of those little bottles for a complete treatment, bringing the total to $8,624.
What about Kerydin? It too needs to be used for 48 weeks, but rather than one drop, Kerydin should be applied to the entire toenail surface and under the tip of each nail being treated. We haven’t done the test to see how many drops that takes, but we’d guess that the total cost of treatment is pretty close to that of Jublia.
If you decide to put your money down on one of these new nail fungus drugs, what are your chances of a cure? Clinical trials on Kerydin show that a complete cure was achieved by 6.5 to 9.1 percent of the patients who used it for the full course. Comparable data from tests on Jublia found a complete cure in 15.2 to 17.8 percent. By the way, these complete cure rates are included in the official prescribing information, so the effectiveness information is readily available to prescribers and dispensers.
We don’t know about you, but more than $8,000 strikes us as a pretty high price to pay for a one-in-ten to one-in-six chance of curing your nail fungus. That could be well worth it if nail fungus were a life-threatening condition like cancer. But we are talking about a problem that is embarrassing or uncomfortable in most cases rather than serious.
That’s why we continue to endorse the home remedies that readers have found helpful against nail fungus. Over-the-counter products such as Listerine, Vicks VapoRub, hydrogen peroxide, vinegar and white iodine have all yielded successful results for some people. The cost for any of these is a tiny fraction of what the prescription drugs cost.
So far as we know, Vicks VapoRub is the only home remedy to have been tested in a trial published in the medical literature (Journal of the American Board of Family Medicine, Jan-Feb, 2011). Although the study was small, with only 18 people, and not placebo-controlled, the cure rate of 27.8 percent compares favorably to that of the pricey prescriptions. The authors noted:
“RESULTS: fifteen of the 18 participants (83%) showed a positive treatment effect; 5 (27.8%) had a mycological and clinical cure at 48 weeks; 10 (55.6%) had partial clearance, and 3 (16.7%) showed no change. All 18 participants rated their satisfaction with the nail appearance at the end of the study as “satisfied” (n = 9) or “very satisfied” (n = 9).”
A small jar (1.76 oz) of Vicks VapoRub costs $5-$7 and a large jar (6 oz) is about $15 online.
Sharon from the UK shared this experience:
“A couple of years ago I had a fungal infection so bad in my toenail that it was about to fall off. My GP [general practitioner] recommended Vicks VapoRub and it worked a treat.
“It took several months for the new nail to grow out, but once it did it was perfect. Because of my occupation as a nurse I was prone to these infections, and now I use the rub a couple of times a week to prevent the problem from returning. It may not work for everyone, but it’s worth a try.”
In case you are not familiar with the British phrase “worked a treat,” it means very effective or worked like a charm.
We discuss many home remedies for nail fungus in our book, The People’s Pharmacy Quick & Handy Home Remedies (from National Geographic). You will learn about cornmeal mush foot soaks, brushing toenails with Pert Plus or Head & Shoulders dandruff shampoo, hydrogen peroxide or tea tree oil applications, iodine’s magical powers against fungus, and the perennial favorite: amber Listerine and vinegar foot soaks. Of course you will also find hundreds of other conditions and home remedies in the book, from constipation and coughs to nosebleeds and skin tags. Act now and you can still get 50% off the book, Recipes & Remedies at this link.