Tavaborole Monotherapy for Onychomycosis

Renal Impairment Considerations

• The American College of Physicians recommends considering tavaborole as a first-line treatment for patients with renal impairment, as terbinafine is contraindicated in renal impairment (CrCl ≤50 mL/min) and fluconazole requires dose reduction when GFR <45 mL/min 1
• Tavaborole bypasses renal clearance concerns due to its topical application with minimal systemic absorption, making it a suitable option for patients with renal impairment 1

Hepatic Impairment Considerations

• The British Association of Dermatologists suggests that tavaborole has no hepatic contraindications, whereas terbinafine is contraindicated in active or chronic liver disease and itraconazole carries hepatotoxicity risk 2
• Tavaborole is a suitable option for patients with hepatic impairment, as it does not require hepatic function monitoring or dose adjustment 2

Treatment Guidelines

• The British Association of Dermatologists recommends topical monotherapy, such as tavaborole, for superficial and distal disease where systemic therapy is contraindicated, with a treatment duration of 48 weeks 2
• Mycological confirmation should be obtained before initiating any antifungal therapy, including tavaborole, to ensure accurate diagnosis and effective treatment 2