Home Drug Guide Efinaconazole

Drug Guide

Generic Name

Efinaconazole

Brand Names Jublia

Classification

Therapeutic: Antifungal

Pharmacological: Azole antifungal

FDA Approved Indications

  • Onychomycosis (nail fungus) caused by dermatophytes

Mechanism of Action

Efinaconazole inhibits fungal lanosterol 14α-demethylase, an enzyme involved in converting lanosterol to ergosterol, an essential component of the fungal cell membrane. This inhibition impairs cell membrane synthesis, leading to fungal cell death.

Dosage and Administration

Adult: Apply a thin layer of the solution to affected nails once daily for 48 weeks.

Pediatric: Safety and efficacy in pediatric patients have not been established.

Geriatric: No specific dose adjustment necessary; however, monitor for efficacy and tolerance.

Renal Impairment: No specific adjustment; use with caution in severe impairment.

Hepatic Impairment: No specific data; use with caution.

Pharmacokinetics

Absorption: Minimal systemic absorption when applied topically.

Distribution: Primarily localized in the nail and surrounding tissues.

Metabolism: Metabolized minimally; any absorbed drug is cleared hepatically.

Excretion: Primarily via feces; negligible urinary excretion.

Half Life: Not well-defined, as systemic absorption is minimal.

Contraindications

  • Known hypersensitivity to efinaconazole or other azole antifungals.

Precautions

  • Prior to use, confirm diagnosis of onychomycosis; monitor for local reactions such as irritation or redness.

Adverse Reactions - Common

  • Ingrowing toenail, (Rare)
  • Nail disorder, abnormal nail, (Rare)
  • Application site reactions (redness, pain, irritation) (Uncommon)

Adverse Reactions - Serious

  • Hypersensitivity reactions, such as rash, swelling (Very rare)
  • Liver enzyme abnormalities (Unreported in topical use)

Drug-Drug Interactions

N/A

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess affected nails prior to and periodically during therapy for signs of infection and adverse reactions.

Diagnoses:

  • Impaired skin integrity related to topical application.
  • Risk for allergic reaction.

Implementation: Instruct patient on topical application technique, hygiene measures, and adherence to therapy.

Evaluation: Monitor for clinical improvement and adverse reactions.

Patient/Family Teaching

  • Apply the medication as directed, ensuring the nail surface is clean and dry before application.
  • Avoid getting the medication in eyes, mouth, or other mucous membranes.
  • Report any signs of adverse reactions or worsening infection.

Special Considerations

Black Box Warnings:

  • None

Genetic Factors: None identified for this medication.

Lab Test Interference: No known interference with laboratory tests.

Overdose Management

Signs/Symptoms: Local skin irritation or allergic reaction; systemic absorption is unlikely.

Treatment: Discontinue use and provide supportive care; consult poison control or emergency services if ingested.

Storage and Handling

Storage: Store at controlled room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable until expiration if stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.