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Side effects may include irritation of the skin and discoloration of clothing. [2] If it is taken by mouth, toxicity and death may occur. [4] Potassium permanganate is an oxidizing agent. [5] The British National Formulary recommends that each 100 mg be dissolved in a liter of water before use. [3]
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Potassium permanganate is toxic if taken by mouth. [29] Side effects may include nausea, vomiting, and shortness of breath may occur. [30] If a sufficiently large amount (about 10 grams) is eaten death may occur. [30] Concentrated solutions when drunk have resulted in acute respiratory distress syndrome or swelling of the airway. [31]
Before oral antifungal therapies are used to treat nail disease, a confirmation of the fungal infection should be made. [36] Approximately half of suspected cases of fungal infection in nails have a non-fungal cause. [36] The side effects of oral treatment are significant and people without an infection should not take these drugs. [36]
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Ketoconazole by mouth is not recommended due to side effects. [27] Oral terbinafine is better tolerated than itraconazole. [28] For superficial white onychomycosis, systemic rather than topical antifungal therapy is advised. [29] Topical agents include ciclopirox nail paint, amorolfine, and efinaconazole.