Clotrimazole is in a class of medications called Imidazole antifungals. It kills fungus by causing holes to appear in its cell membrane and the contents leak out. This kills the fungus and treats the infection.

Fluconazole is in a class of medications called Triazole antifungals. It kills fungus by causing holes to appear in its cell membrane and the contents leak out. This kills the fungus and treats the infection.

Terbinafine is in a class of medications called Allylamine antifungals. It kills fungus by causing holes to appear in its cell membrane and the contents leak out. This kills the fungus and treats the infection.

Urea is a humectant, which means it is able to absorb moisture from the environment and draw it to the nail. In addition, urea is also an exfoliant that softens the nail.

One size doesn’t fit all and every patient is unique. Drug compounding is the process of combining, mixing, or altering ingredients to create a medication tailored to the needs of a patient by a pharmacist as the result of a practitioner’s prescription drug order. While compounded medications are not FDA-approved, they serve an important patient need—especially when FDA-approved medication is not available for treatment. Our formulations are made to order in small batches to ensure freshness. The specific ingredients in your compounded formula will depend on your specific concerns and goals. It should be understood that your personal healthcare practitioner will make the final decision.

Yes! All of our compounded formulations, regardless of ingredients, are eligible for Flexible Spending Accounts (FSA) and Health Saving Accounts (HSA).

Nail fungus affects millions of people, but many go months or even years without getting treatment. Toenail fungus commonly affects seniors with chronic medical conditions or more serious underlying conditions. Diabetes, circulatory problems, or immune-deficiency conditions can contribute to toenail fungus which is caused by an infection under the surface of the nail. It can lead to discomfort, pain, and may impair your ability to walk if left untreated. Many people don’t recognize the symptoms of toenail fungus, including white marks on the nail bed, distorted shape, discoloration, or a thickening of the nail. It may affect one or several nails, and can affect ambulatory and non-ambulatory patients.

Based on research and patient testimonials, you may see improvements in 48 to 52 weeks; however, each patient is unique and time frames may differ.

• The Nail Fungus Formula is for topical use only. If this medicine gets in your eyes or mouth, rinse with water.

• Follow all directions on your prescription label and read all medication guides or instruction sheets.

• Wash your hands with soap and water before and after applying the medicine. Do not allow other people to get this medicine on their skin. If this happens, wash the area thoroughly with soap and water.

• Apply a thin layer to cover the affected nail(s) two to three times per day, using the brush applicator. When applying, ensure the toenail, the toenail folds, toenail bed, hyponychium, and the undersurface of the toenail plate, are completely covered.

• Avoid showering/bathing for at least 30 minutes after applying to the treated area(s).

• Avoid contact with eyes, mouth, or vagina. Do not apply to open wounds.

• Avoid wearing clothing over the treated area(s) until the treated area is dry.

• Avoid having a pedicure or using nail polish on your affected nail(s).

• The Nail Fungus Formula is flammable. Do not use high heat or open flame. Do not smoke until the solution has completely dried on your nail.

Do not start using the Nail Fungus Formula if you have a history of hypersensitivity to the prescribed ingredients. The prescribed ingredients may include, but are not limited to; antifungals (terbinafine, clotrimazole, fluconazole, itraconazole, efinaconazole, or others), thymol and/or urea. Please tell your doctor if you are pregnant or thinking about becoming pregnant or breastfeeding.

Apply the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose.

Store in an upright positoin at room temperature away from moisture and heat between 68°F to 77°F (20°C to 25°C).

Research has shown, topically applied medications are less likely to cause the same systemic side effects or drug-to-drug interactions as oral medications; however, there is never an absolute zero chance that side effects or drug interactions will not occur. Tell each of your healthcare providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

What are the common side effects of the Nail Fungus Formula?

Although the risk of serious side effects is low when the Nail Fungus Formula is applied to the nail, this medicine can be absorbed through the skin.

Common side effects may include application site reactions of:

• Skin reactions (dermatitis)

• Burning, stinging or warmth

• Itching or tingling

• Redness, dryness or peeling

• Ingrown toenails

Get emergency medical help if you have signs of an allergic reaction: hives, severe itching; difficult breathing; swelling of your face, lips, tongue, or throat. These are not all of the possible side effects of the Nail Fungus Formula. For more information, ask your healthcare provider or pharmacist. Tell your healthcare provider if you have any side effects that bother you or do not go away.

What happens if I overdose?

An overdose is not expected to be dangerous. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medication.

• FDA Approved Drug Products: Lamisil AT (terbinafine)

• FDA Approved Drug Products: Lotrimin AF (clotrimazole)

• FDA Approved Drug Products: Diflucan (fluconazole)

• Marchese A, Orhan IE, Daglia M, Barbieri R, Di Lorenzo A, Nabavi SF, Gortzi O, Izadi M, Nabavi SM. Antibacterial and antifungal activities of thymol:

A brief review of the literature. Food Chem. 2016 Nov 1;210:402-14. doi: 10.1016/j.foodchem.2016.04.111. Epub 2016 Apr 26. PMID: 27211664.

• Shanbhag P, Jani U. Drug Delivery through nails: Present and Future. Eur Soc for Trans Med 2016 Dec;2307-5023. doi.org/10.1016/j.nhtm.2017.01.002

Received 7 December 2016

• Dars S, Banwell HA, Matricciani L. The use of urea for the treatment of onychomycosis: a systematic review. J Foot Ankle Res. 2019 Apr 11;12:22.

doi: 10.1186/s13047-019-0332-3. PMID: 31007722; PMCID: PMC6458736.

• Onychomycosis. Merck Manual Professional Version. https://www.merckmanuals.com/professional/dermatologic-disorders/nail-disorders/onychomycosis. Accessed May 15, 2017.

• Goldstein AO, et al. Onychomycosis: Management. https://www.uptodate.com/contents/search. Accessed May 15, 2017.

• Toenail fungus. American Podiatric Medical Association. http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=1523. Accessed May 15, 2017.

• Varade RS, et al. Cutaneous fungal infections in the elderly. Clinics in Geriatric Medicine. 2013;29:461.

• Gupta AK, et al. Improved efficacy in onychomycosis therapy. Clinics in Dermatology. 2013;31:555.

• Westerberg DP, et al. Onychomycosis: Current trends in diagnosis and treatment. American Family Physician. 2013;88:762.

• AskMayoExpert. Fungal nail infection (onychomycosis). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.

• Nail care. Natural Medicines. https://naturalmedicines.therapeuticresearch.com/databases/medical-conditions/n/nail-care.aspx. Accessed May 17, 2017.

• Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. June 6, 2017.

All prescription medications require a valid and complete online consultation prior to approval and final pricing is determined. All compounded medications in the U.S. are considered off-label use. Licensed healthcare practitioners have the ability to prescribe compounds for off-label treatment, if they believe that it is an appropriate course of treatment.

The drug and medical information provided on this website is not meant to cover all adverse effects, drug interactions, warnings, medical uses, directions and precautions. The information provided is a medical resource and the judgment of your physician and/or healthcare practitioner should not be substituted. Premier Pharmacy has made every effort to ensure the information on the website is accurate and current based on present medical literature.

Premier Pharmacy does not make any guarantees regarding the drug and medical information, and does not assume responsibility regarding the content. The drug safety and drug information contained on the website may be time sensitive and should not be utilized as a medical reference beyond the date hereof. The deficiency of a warning for prescription medications and vitamins provided on this website in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient.

If you have questions or concerns about your medications, please do not hesitate to contact us and/or your medical practitioner, including your pharmacist. Compound prescription products have not been tested or approved by the FDA for their intended use. No claims are made as to the safety, efficacy or use of this compound.