Medicine & USMLE


  1. Amphotericin B
  2. Nystatin
  3. Flucytosine
  4. Azoles
  5. Terbinafine
  6. Echinocandins
  7. Griseofulvin


Griseofulvin is an antifungal medication that disrupts microtubules, preventing fungal replication. Griseofulvin is used to treat tinea, especially tinea infections of the nails, also known as onychomycosis. Remember that griseofulvin is a CYP450 inducer, so watch out for drug-drug interactions. Griseofulvin is teratogenic and also can cause photosensitive rashes and disulfiram-like reactions with alcohol use.

Key Points

  • Griseofulvin
    • Mechanism
      • Binds to and disrupts microtubule functions
        • Inhibits mitosis in fungi
        • Fungistatic (inhibits replication of fungi)
      • Deposits in nails and other keratin-containing tissues (e.g. skin)
    • Clinical Use
      • Oral treatment of superficial fungal infections
      • Inhibits growth of dermatophytes (tinea)
        • Esp. in onychomycosis (nail infections)
    • Adverse Effects
      • Induces CYP450 enzymes
        • Drug interactions (e.g. warfarin, theophylline)
      • Teratogenic
        • Pregnancy category X; contraindicated in all pregnant women
      • Photosensitive rash
      • Disulfiram-like reaction to alcohol
      • Hepatotoxicity
      • GI upset
      • Confusion, headaches, dizziness may be seen