Adult: For cases when topical treatment has failed or is considered inappropriate: As microsize preparation: 500-1,000 mg daily as a single dose or in 2-4 divided doses depending on the severity of infection. Duration of treatment: 2-4 weeks (tinea corporis); 4-8 weeks (tinea capitis or pedis); at least 4 weeks (tinea infection of fingernails); 6-12 months (tinea infection of toenails). Dosage and treatment duration recommendations may vary among individual products and between countries (refer to specific product guidelines). Child: >2 years As microsize preparation: 10 mg/kg once daily or in 2 divided doses. Alternative dosing recommendation: Children weighing 14-23 kg: 125-250 mg daily; >23 kg: 250-500 mg daily. Doses may be given as a single or in 2 divided doses. Dosage recommendations and starting age of use may vary among individual products and between countries (refer to specific product guidelines).
Oral Tinea capitis, Tinea corporis, Tinea cruris
Adult: As 165 mg ultramicrosize tab: 330 mg daily as a single dose or in 2 divided doses. Duration of treatment: 2-4 weeks (tinea corporis or cruris); 4-6 weeks (tinea capitis). Dosage and treatment duration recommendations may vary among individual products and between countries (refer to specific product guidelines).
Oral Onychomycosis caused by dermatophyte, Tinea pedis
Adult: As 165 mg ultramicrosize tab: 660 mg daily in 2-4 divided doses. Duration of treatment: 4-8 weeks (tinea pedis); at least 4 months (fingernail infections); at least months (toenail infections). Dosage and treatment duration recommendations may vary among individual products and between countries (refer to specific product guidelines).
Topical/Cutaneous Tinea pedis
Adult: As 1% spray (each spray of approx 0.05 mL delivers 0.4 mg dose): 1 spray (0.05 mL) once daily, may be increased to 3 sprays (0.15 mL) once daily for more severe or extensive cases that affect the sides or soles of the feet. Allow each spray to dry between applications. Continue treatment for 10 days after all lesions have disappeared. Max treatment duration: 4 weeks.
What are the brands available for Griseofulvin in Malaysia?
Grivin
Krisovin
Pharmaniaga Griseofulvin
Hepatic Impairment
Oral:
Severe, including hepatocellular failure: Contraindicated.
Administration
Griseofulvin Should be taken with food.
Contraindications
Hypersensitivity. Systemic lupus erythematosus (SLE), porphyria. Severe hepatic impairment, including hepatocellular failure. Pregnancy.
Special Precautions
Not effective for the treatment of pityriasis versicolor. Safety and efficacy for the prophylaxis of fungal infections have not been established. Mild to moderate hepatic impairment. Children. Lactation.
Adverse Reactions
Significant: Lupus erythematosus or lupus-like syndromes, exacerbation of existing lupus; photosensitivity reaction. Rarely, leucopenia. Blood and lymphatic system disorders: Neutropenia. Gastrointestinal disorders: Nausea, vomiting, diarrhoea, epigastric discomfort. General disorders and administration site conditions: Fatigue. Nervous system disorders: Headache, dizziness, drowsiness, impaired coordination, peripheral neuropathy. Psychiatric disorders: Insomnia, confusion. Skin and subcutaneous tissue disorders: Skin irritation and stinging or burning sensation (topical). Potentially Fatal: Severe skin reactions (e.g. Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme), hepatotoxicity (e.g. jaundice, elevated LFTs or bilirubin).
Oral: This drug may cause drowsiness, confusion and dizziness, if affected, do not drive or operate machinery. Avoid exposure to natural or artificial sunlight; use sunscreen and wear protective clothing when going outdoors. Women of childbearing potential must use proven birth control methods during therapy and for 1 month after stopping the treatment. Consider using other reliable contraceptive methods recommended by the doctor as hormonal contraceptives may be ineffective. Men should not father a child during treatment and for 6 months after the last dose. Topical: Avoid contact with eyes or mucous membranes.
Monitoring Parameters
Monitor LFTs and kidney or haematopoietic function tests periodically, especially during long-term use. Assess for signs of hepatotoxicity and severe skin reaction.
Drug Interactions
May reduce the serum levels and efficacy of coumarin anticoagulants, oral contraceptives (e.g. estrogen), and ciclosporin. Concomitant use with barbiturates (e.g. phenobarbital), phenylbutazone, and other sedative/hypnotic drugs may decrease the serum level and efficacy of griseofulvin.
Food Interaction
Increased absorption with food, particularly high-fat meals. May enhance the adverse effects (e.g. nausea, flushing, tachycardia) of alcohol.
Action
Description: Mechanism of Action: Griseofulvin is fungistatic antifungal antibiotic. It disrupts the mitotic spindle structure of fungal cells, thereby arresting the metaphase of cell division. Griseofulvin may also interfere with DNA production. Pharmacokinetics: Absorption: Variably and incompletely absorbed from the gastrointestinal tract. Food, particularly high-fat meals, and reduced griseofulvin particle size enhance absorption. Time to peak plasma concentration: 4 hours. Distribution: Distributed in the keratin layer of the skin, hair and nails; concentrates in the liver, fat and skeletal muscles. Crosses the placenta. Plasma protein binding: Approx 84%. Metabolism: Extensively metabolised in the liver into 6-desmethylgriseofulvin and glucuronide conjugate. Excretion: Via urine (<1% as unchanged drug); faeces (approx 33%); perspiration. Elimination half-life: 9-24 hours.
Chemical Structure
Griseofulvin Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 441140, Griseofulvin. https://pubchem.ncbi.nlm.nih.gov/compound/Griseofulvin. Accessed Aug. 26, 2025.
Storage
Tab/Oral susp: Store between 20-25°C. Protect from light. Topical spray: Store below 25°C. Protect from direct light and heat. Keep away from naked flames.
D01AA08 - griseofulvin ; Belongs to the class of antibiotics. Used in the topical treatment of fungal infection. D01BA01 - griseofulvin ; Belongs to the class of antifungals for systemic use.
References
Brayfield A, Cadart C (eds). Griseofulvin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 25/07/2025.Griseofulvin 125 mg Tablets (Chemidex Pharma Ltd). MHRA. https://products.mhra.gov.uk. Accessed 25/07/2025.Griseofulvin 500 mg Tablets (Chemidex Pharma Ltd). MHRA. https://products.mhra.gov.uk. Accessed 25/07/2025.Griseofulvin Microsize Tablet (Chartwell RX, LLC.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 25/07/2025.Griseofulvin Suspension (Cosette Pharmaceuticals, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 25/07/2025.Griseofulvin. UpToDate Lexidrug, AHFS DI (Adult and Pediatric) Online. American Society of Health-System Pharmacists, Inc. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 25/07/2025.Griseofulvin. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 25/07/2025.Grisol 1% Spray Solution (Crescent Pharma Limited). MHRA. https://products.mhra.gov.uk. Accessed 25/07/2025.Joint Formulary Committee. Griseofulvin. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 25/07/2025.Krisovin Tablet 500 mg (Duopharma Manufacturing [Bangi] Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 20/08/2025.Medofulvin 125 mg and 500 mg Tablets (Komedic Sdn Bhd). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 25/07/2025.Ultramicrosize Griseofulvin Tablet (Ayurax, LLC.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 25/07/2025.
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