HEAD - Tinea Capitis, Fungal (Trichophyton tonsurans, Microsporum canis)
Griseofulvin microsize (Grifulvin-V^®, Fulvicin-U/F^®) Pregnancy: C; Lactation: Unk Generics available Tabs: 125 mg, 250 mg, 500 mg Oral Susp: 125 mg/5 mL 1st Line Microsporum	Children: 10-20 mg/kg/day in one or two divided doses (max 500 mg/day). Using 125 mg/5 mL @ 10 mg/kg/day 5 kg (11 lb) = 2 mL Q24H 7.5 kg (16 lb) = 3 mL Q24H 10 kg (22 lb) = 4 mL Q24H 12.5 kg (28 lb) = 5 mL (1tsp) Q24H 15 kg (33 lb) = 6 mL Q24H 20 kg (44 lb) = 8 mL Q24H 25 kg (55 lb) = 10 mL (2 tsp) Q24H or 250-mg tab/cap Q24H Treat until hair regrows (usually 4-8 weeks). Adult: 500 mg once daily or 250 mg twice daily for 4-6 weeks.	Food: With food, especially fatty meal, to increase absorption. Important side effects: Rash, urticaria, headache, dizziness, hepatotoxicity (rare). Avoid prolonged exposure to sunlight and avoid alcohol.
Itraconazole (Sporanox^®) Pregnancy: C; Lactation: Unsafe Caps: 65 mg 100 mg     Tablet: 200 mg Oral Solution: 100 mg/10 mL Less effective than Griseofluvin/Terbinafine	Children: 5 mg/kg/day (max 100 mg/day) once daily for 4-6 weeks. Limited information on use in children. Using 100 mg/10 mL @ 5 mg/kg/day 5 kg (11 lb) = 2.5 mL Q24H 10 kg (22 lb) = 5 mL (1 tsp) Q24H 15 kg (33 lb) = 7.5 mL Q24H 25 kg (55 lb) = 10 mL (2 tsp) Q24H or 100-mg cap Adult: 100 mg daily for 4-6 weeks.	Food: Avoid grapefruit products. Take capsules with food. Take oral solution on an empty stomach. Not well absorbed with acid-suppressing drugs. Important side effects: Advise patient to report any sign of liver failure: anorexia, nausea, vomiting, RUQ discomfort, jaundice, ascites. Caution: May cause hepatitis. Use with caution in persons with history of liver disease. Consider periodic liver function tests. May cause or contribute to congestive heart failure or cardiac dysrhythmias. Use with caution in persons with history of cardiac disease. Use is contraindicated in any patient taking cisapride, dofetilide, quinidine, midazolam, triazolam, pimozide, lovastatin, or simvastatin. Not well absorbed with acid-suppressing drug. Has caused bone defects and changes in tooth appearance in rats; implications for humans are not established.
Terbinafine (Lamisil^®) Pregnancy: B; Lactation: Unsafe Tabs: 250 mg	Children: Difficult to give to children <20 kg. <20 kg: 62.5 mg once daily for 4-8 weeks. 20-40 kg: 125 mg once daily for 4-8 weeks. ≥40 kg and Adult: 250 mg PO daily for 4-8 weeks. Baseline LFT should be obtained.	Food: With or without meals. Important side effects: Advise patient to report any signs of liver failure: anorexia, nausea, vomiting, RUQ discomfort, jaundice, and ascites.
Fluconazole (Diflucan^®) Pregnancy: C; Lactation: Likley Safe Tabs: 50 mg, 100 mg, 150 mg, 200 mg Oral Susp: 10 mg/mL, 40 mg/mL 2nd Line Alternative	Children: 8 mg/kg (NTE 200 mg/day) once per week for 8-12 weeks. 40 mg/mL @ 8 mg/kg 10 kg (22 lb) = 2 mL (80 mg) 15 kg (33 lb) = 3 mL (120 mg) 20 kg (44 lb) = 4 mL (160 mg) 40 kg (88 lb) = Use adult dose. Adult: 200-300 mg once per week for 8-12 weeks.	Food: With or without meals. Important side effects: Advise patient to report any signs of liver failure: anorexia, nausea, vomiting, RUQ discomfort, jaundice, and ascites.
Selenium sulfide (Selsun^®, Exsel^®) Generics available Pregnancy: C; Lactation: Unk Shampoo 1% (OTC) Selsun Blue^® Shampoo and Lotion 2.5%: Rx and OTC - 240-mL bottle	Children and Adult: Shampoo twice weekly until resolved (average 2 weeks). Leave in hair for 2-3 minutes, then rinse and repeat. Wash hands after use. Avoid contact with eye(s) and inflamed skin. May be useful adjunct to griseofulvin; unlikely to be effective alone.	Important side effects: May irritate skin and discolor hair or jewelry. Rinse thoroughly after use.