Improving the risk-benefit equation for toenail fungus

Onychomycosis, or nail fungus, is one of the greatest examples of pharmaceutical companies promoting awareness of a new indication in order to sell products. Novartis's Lamisil is an oral drug for nail fungus. It doesn't work that well and can cause mild and severe side effects, including liver failure. It's hard to argue that the benefits outweigh the risks.Topical treatments are also often ineffective, but at least they don't tend to be dangerous. In addition to Dermik's prescription Penlac and OTC products, people have turned to home remedies including distilled vinegar, Vicks Vaporub, Oil of Oregano, and Tea Tree Oil and several others.Now Novartis is getting into the topical game, signing a licensing deal with NexMed to develop a topical version of Lamisil. Whether it works or not, it's likely to be a better choice for patients than Lamisil tablets. The press release presents a positive spin on Lamisil --there is no discussion at all of risks nor of the drug's limited efficacy.