Rapamycin and toenail fungus

The one disappointment I’ve had with rapamycin is that, after 6 months of 6 to 10mg per week, my toenail fungus has barely improved. Interested to hear others experiences of this? Do I need to apply topically?

Give it another 6 months. I don’t know how long it took… Just noticed one day (after having it for many years) that it was gone. It could have been a year, or 18 months.

But trying topical is not a bad idea too

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I have had it most of my life. Been taking rapa for 5 years. From 6 mg weekly to 20 mg twice a month. Seems to help keep in check without curing. At current dosing of 20 mg twice a month it is almost gone, but not entirely. Good Luck

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At 3mg per week for 4+ years, no symptoms, or need of treatment for more than 3 years.

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At 6 months of 6 mg to 8 mg per week I notice no improvement. It may be helping my long-term tinea versicolor, but it’s still too soon to tell about that too. Being an avid swimmer I’m in the pool for extended times several times a week. Then, there’s the shower beforehand, the rinse off after, the sauna, and a final shower after the sauna. I’m doing everything fungus likes: moisture, heat, darkness.

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Thanks for that.
What is your protocol and the specific brand you have used? Is it Rapacan (biocon)? Have you noticed differences among brands?

My toenail fungus still bothersome, but jock itch is gone after a month.

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What dosage are you taking? Up dosage, it worked for me. Toenail fungus is inside of your body not just on the surface. Nail bed is hard to get to, but not impossible.

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12mg/week (0.15mg/kg/wk)

pollux, How long have you been taking Rapamycin? Give it up to a year to see significant results. The Rapamycin works systemically throughout the body. A bit of it goes to the nail bed and a very small amount gets inside the toenail where the toenail first begins to grow (the lunula I think). As the toenail grows out, fungus will be inhibited only where rapamycin is embedded in the nail. Of course, the amount of Rapamycin you’re taking can make a difference, too. And, it may just not work for you, but it’s probably safer than Lamisil pills.

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Thanks Jay, i have taken 6mg Rapa weekly for 10 months. My toenail fungus infection has not abated.
It is just one big toe infection. i have tried Loceryl nail lacquer and laser heating, all not working. I know Lamisil pill will work, but i have to take at least 6 month long and my doctor is against using it.

Fluconazole is believed to be the safest oral antifungal agent. And it collects in nails. So pulse therapy can be utilized to minimize potential toxicity. You can take it just once per week at 200 or 300 mg. And to increase the likelihood of mycological cure, you could use it in combination with a topical lacquer like Penlac (ciclopirox olamine).

As an alternative, you could also pulse itraconazole, which may be more effective. It would be taken twice a day for a week. And then this would be repeated every month.

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Try iodine. See link below.

I am a retired physician whose left big toenail became heavily colonized by an unidentified fungus with resultant thickening, opacity and deformation. A respected dermatologist confirmed my diagnosis, but we decided not to initiate any treatment. The cost of oral treatments ranges from about $250 to $500, and there are many serious side effects.[1–3]

(An economical cure - PMC)

Shortly after the consultation, I decided to undertake a trial of topical iodine. I obtained a bottle of 2.5% iodine tincture at a cost of $3.27, and applied one drop of the solution daily, with occasional lapses, to the tip of the affected toenail. The iodine travelled rapidly into the depths of the affected subungual tissues.

After 2 weeks, a sliver of normal-looking nail appeared at the proximal end of the affected nail. Encouraged, I continued the treatment. The nail grew at the normal slow rate, and the diseased area gradually moved distally. The nail is now apparently normal.

The total cost of the treatment was $3.27, and half of the original bottle of iodine solution remains for further treatment, if required. In view of the efficacy of the treatment in this isolated case, it would seem reasonable to institute a trial with a larger number of patients to obtain scientifically acceptable results. However, blinded trials would be difficult, given the telltale colour and odour of iodine. No side effects were observed in the case described.

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pollux, You have a number of suggestions that have worked for some people. I’ll add one more. You could talk to a podiatrist about either sanding the top of the nail down to allow better penetration of Loceryl or removal of the nail followed by some type of topical anti-fungal treatment during the year that it will take for the nail to regrow. No matter what, it’s a slow process to rid yourself of this problem. I continue to use an antifungal cream daily (Terpenicol) to prevent recurrence. And, as others have said, upping the Rapamycin dose may help. A multi-pronged approach may be better than using a slngle line of attack.

If you read about home remedies you may be tempted to try them, but from my experience none of them worked and they caused me to have to restart the process from the beginning with real mediines several times.

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Your experience is slightly ironic: as I remember, some of the rapa-lore is that the Rapanui natives were noticed to have fewer foot infections (tetanus, I think), presumably from the Rapa-bacteria. Wasn’t it also first used as an anti-fungal? Maybe you should apply it topically as the Islanders (inadvertantly) did.