Treatment of dermatophytoses of the skin, scalp, and nails, including tinea barbae (ringworm of bearded areas of face and neck), tinea capitis (scalp ringworm), tinea corporis (ringworm of the body), tinea cruris (jock itch; groin ringworm), tinea pedis (athlete’s foot, foot ringworm), and tinea unguium (onychomycosis; nail ringworm) caused by Trichophyton, Microsporum, or Epidermophyton floccosum.
A drug of choice for treatment of tinea capitis; prolonged therapy usually is necessary to cure the infection and poor compliance may affect response to the drug. Tinea barbae and tinea capitis generally require treatment with an oral antifungal.
Tinea corporis and tinea cruris generally can be effectively treated using a topical antifungal; an oral antifungal may be necessary if the disease is extensive, dermatophyte folliculitis is present, the infection does not respond to topical therapy, or the patient is immunocompromised or has coexisting disease (e.g., diabetes mellitus).
While topical antifungals usually are effective for treatment of acute, uncomplicated tinea manuum and tinea pedis, an oral antifungal usually is necessary for treatment of severe, chronic, or recalcitrant tinea pedis, chronic moccasin-type (dry-type) tinea pedis, and for treatment of tinea unguium (onychomycosis).
Dosage and Administration
Administration
Oral Administration
Administer orally.
When microsize griseofulvin (Grifulvin V®) tablets are used, absorption may be improved if given after a high-fat meal.
Dosage
Dosage varies depending on whether the drug is administered as griseofulvin microsize (Grifulvin V®) or griseofulvin ultramicrosize (Gris-PEG®).
Dosage and duration of treatment should be individualized according to the requirements and response of the patient. Griseofulvin generally should be continued for ≥4–12 weeks for treatment of tinea capitis; ≥2–4 weeks for treatment of tinea corporis; ≥4–8 weeks for tinea pedis; and from 4–6 months to a year or longer for tinea unguium.
Pediatric Patients
Dermatophytoses
Microsize (Grifulvin V®)
Oral
10–11 mg/kg daily, although dosages up to 20–25 mg/kg daily have been used.
Manufacturer suggests that those weighing approximately 14–23 kg may receive 125–250 mg daily and that those weighing >23 kg may receive 250–500 mg daily.
AAP recommends 10–20 mg/kg (maximum 1 g) daily in 1 or 2 doses. For tinea capitis, AAP recommends 15–20 mg/kg once daily.
Ultramicrosize (Gris-PEG®)
Oral
Children >2 years of age: Usually 7.3 mg/kg daily, although dosages up to 10–15 mg/kg daily have been used.
Manufacturer suggests that those weighing approximately 16–27 kg may receive 125–187.5 mg daily and those weighing >27 kg may receive 187.5–375 mg daily.
AAP recommends 5–10 mg/kg (maximum 750 mg) once daily.
Adults
Dermatophytoses
Microsize (Grifulvin V®)
Oral
500 mg daily for treatment of tinea capitis, tinea corporis, or tinea cruris. For more difficult infections (e.g., tinea pedis, tinea unguium), 1 g daily.
Ultramicrosize (Gris-PEG®)
Oral
375 mg once daily or in divided doses for treatment of tinea capitis, tinea corporis, or tinea cruris. For more difficult infections (e.g., tinea pedis, tinea unguium), 750 mg daily given in divided doses.
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