Jublia dosage, forms, and strengths

Jublia is a brand-name antifungal drug used to treat toenail fungus (onychomycosis of the toenail). Fungal infections of the toenails are difficult to eradicate, so Jublia is a long-term treatment. A topical dose is applied to the affected toenails every day for at least 48 weeks using an applicator. Side effects are minimal and uncommon.

Jublia forms and strengths

Jublia comes in only one dosage form:

• Topical solution: 10% efinaconazole topical (100 mg per gram of solution)

Jublia dosage for adults

Jublia treats toenail fungus, a type of fungal infection notoriously difficult to eradicate. Doses are applied once daily for 48 weeks—that’s how long it takes to get rid of the infection and regrow an entirely new healthy toenail. Side effects are minimal because only very tiny amounts of the medicine get into the bloodstream when used topically. As a result, there are no contraindications listed for this medicine. Anyone can safely use Jublia.

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Jublia dosage for toenail fungus

Unlike athlete’s foot or ringworm, toenail fungus is very difficult to cure. Treating fungal skin infections only takes a few weeks of antifungal treatment. The medicine is easily absorbed into the skin, and the skin tissues grow very rapidly and slough off the fungus. Toenail fungus can also infect the skin covered by the diseased and sometimes thickened nail. Toenails do not absorb medicine easily, and they grow very slowly. As a result, topical antifungal medications rarely succeed at eradicating a toenail fungal infection. Doctors typically see better outcomes with antifungal pills for toenail fungus, but those drugs can cause significant side effects, discomfort, and other problems.

Jublia is a topical antifungal specifically formulated to treat toenail fungus caused by Trichophyton rubrum and Trichophyton mentagrophytes fungi. It is the most effective topical treatment for toenail fungus, but not as effective as oral antifungals. In clinical trials, 48 weeks of Jublia treatment eradicated the fungal infection in over half the participants. 

Patients apply doses topically to the affected nails once daily. It will take almost a year or longer of daily doses to complete treatment. It’s vitally important that the entire toenail be covered with the medicine. That includes the nail plate, the white section, the toenail bed at the top of the toenail, the skin folds along the edge of the toenail, the underside of the toenail outer edge, and the skin beneath the toenail outer edge. The bottle works something like a marker. It has a moistened brush at the end. Squeezing the bottle gently will wet the brush.

If the toenail is the big toenail, two applications are necessary as a single dose.

• Standard dosage for toenail fungus: Apply once daily to the affected toenails for 48 weeks

Jublia dosage for children

Jublia is FDA approved for the pediatric use of Jublia in children 6 years of age and older. Dosages are the same as for adults: once daily applications to the affected nails. Jublia has not been studied in children younger than 6 years old.

• Standard Jublia dosage for children ages 6 and older: Apply once daily to the affected toenails for 48 weeks

Jublia dosage restrictions

Jublia has no dosage restrictions for kidney disease, liver disease, or other medical conditions.

How to take Jublia

Jublia requires at least a year of daily topical use to work, so the best advice is to never miss a dose. It also requires thorough application to the toenail. The Patient Information sheet includes Instructions for Use. They have useful pictures of the application process. The Jublia website for healthcare providers has a video showing how to apply doses on its dosing page. If that’s not enough, ask a healthcare provider how to properly apply the medicine.

• Follow all the prescriber’s instructions when using this medicine.

• Doses are applied once per day on all affected toenails using a brush.

• Doses can be applied at any time of day, but try to apply doses at that same time every day.

• Hold the bottle upside down, place the integrated flow-through brush applicator on the toenail, and gently squeeze it to moisten the brush.

• Gently brush the liquid over the top of the toenail, including the skin folds and membranes at the back and along the sides of the nail. 

• Do not press down on the brush or try to rub it against the toenail. No pressure is needed.

• You can squeeze the bottle as necessary to moisten the brush but don’t squeeze it when you’re using the brush to spread the medicine.

• Then place the brush below the undersurface of the toenail plate and squeeze to release the liquid. Use the brush to get the liquid on the skin below the free toenail edge, the bottom of the free toenail edge, and the edge.

• If the affected toenail is the big toenail, repeat this process a second time.

• Put the cap back on the applicator.

• Let the toenail completely dry before covering it with socks, shoes, or other clothing.

• Wash your hands with soap and water.

• Store Jublia in its original bottle in an upright position at room temperature. Keep it away from heat or flame because it’s flammable. 

• Keep Jublia out of the reach of children.

Jublia dosage FAQs

How long does it take Jublia to work?

Jublia eradicates a toenail fungal infection in 48 weeks at minimum, but treatment may last longer than a year. 

How long does Jublia stay in your system?

Jublia is a topical medication, so only a very small amount enters the system. When it does, the maximum half-life of efinaconazole is about 30 hours. 

What happens if I miss a dose of Jublia?

Apply a missed dose when remembered. Since doses are performed once daily, skip the missed dose if it’s the next day and apply that day’s dose instead. Do not apply extra medicine or do more than one application in a day to make up for a missed dose.

How long can you take Jublia?

Jublia is a long-term treatment. At the minimum, treatment lasts for 48 weeks, but it could go on for longer than a year depending on the severity of the fungal infection. Later clinical studies of the drug involved 72 weeks of treatment.

How do I stop taking Jublia?

Jublia can be stopped at any time without causing withdrawal problems. 

The prescriber has other choices including topical tavaborole or ciclopirox. The most effective treatment of onychomycosis involves systemic antifungals, drugs that are taken orally, such as terbinafine (76% cure rate), itraconazole (63% cure rate), and fluconazole (48% cure rate). Because these drugs are taken orally, they will have side effects. Some may be serious enough to stop therapy. These drugs also have significant drug interactions that may require that they be stopped. 

What is the maximum dosage for Jublia?

Jublia is a topical medication. The manufacturer has not specified a maximum dosage, but the recommended dosage is one application on each affected toenail once daily. Two applications if it involves the big toenail once daily.

Can you overdose on Jublia?

When Jublia is used as directed, it’s not possible to overdose on the drug. Do not swallow the drug or put it anywhere else except on the toenails. Swallowing the drug or using it in the mouth, vagina, or eyes is hazardous. Get immediate emergency medical help if this drug is swallowed or misapplied.

What interacts with Jublia?

As a topical drug, Jublia has no drug interactions. Even so, make sure the prescriber knows about all prescription drugs, supplements, and other medications that are being taken.

What happens when you mix Jublia and alcohol?

There are no restrictions on drinking alcohol when using Jublia.

Is it safe to take Jublia during pregnancy?

Healthcare professionals aren’t sure if Jublia is safe to take during pregnancy because it hasn’t been studied in pregnant women. Make sure the prescriber knows if you’re pregnant or planning to become pregnant.

Is it safe to take Jublia while breastfeeding?

Healthcare professionals are uncertain if Jublia is safe to take while breastfeeding or if it affects lactation. There is no evidence that women using Jublia will excrete the drug into breast milk, but this hasn’t been studied. Get medical advice from the prescriber if you are breastfeeding or plan to breastfeed.

What are the side effects of Jublia?

Side effects are minimal and rare. The most common side effects are ingrown toenails and contact dermatitis, but these were reported by 2% of the participants in clinical trials. Other possible side effects include skin redness, application site pain, burning, stinging, blisters, vesicles, separation of the toenail from the toenail bed, and nail discoloration.

What are the serious side effects of Jublia?

Jublia has no reported serious side effects.

Can I use nail polish?

Do not use nail polish or other cosmetic nail products on the affected toenails during the entire time that you use Jublia.

When should I apply a Jublia dose?

Jublia can be applied any time of day. Once you pick a preferred time of day, try to apply doses every day at that time. 

Sources

• Jublia, Ortho Dermatologics

• Jublia drug summary, Prescriber’s Digital Reference (PDR)

• Jublia efinaconazole solution prescribing information, DailyMed (NIH National Library of Medicine)

• Jublia HCP, Ortho Dermatologics

• Onychomycosis, StatPearls