An example of a condition they are sometimes used for is candida vulvovaginitis which is treated with intravaginal Clotrimazole[4] This is sometimes indicated when there's a fungal infection on the skin.

The polyene antimycotics bind with sterols in the fungal cell membrane, principally ergosterol.

However, at therapeutic doses, some amphotericin B may bind to animal membrane cholesterol, increasing the risk of human toxicity.

[16][17] Incidents of liver injury or failure among modern antifungal medicines are very low to non-existent.

For example, the azole antifungals such as ketoconazole or itraconazole can be both substrates and inhibitors of the P-glycoprotein, which (among other functions) excretes toxins and drugs into the intestines.

[34] Azole antifungals are also both substrates and inhibitors of the cytochrome P450 family CYP3A4,[34] causing increased concentration when administering, for example, calcium channel blockers, immunosuppressants, chemotherapeutic drugs, benzodiazepines, tricyclic antidepressants, macrolides and SSRIs.

[35] 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.

They inhibit the enzyme 14-alpha-sterol demethylase, a microsomal CYP, which is required for the biosynthesis of ergosterol for the cytoplasmic membrane.

This leads to the accumulation of 14-alpha-methylsterols resulting in impairment of function of certain membrane-bound enzymes and disruption of close packing of acyl chains of phospholipids, thus inhibiting growth of the fungi.

[1][38][39] The emergence of Candida auris as a potential human pathogen that sometimes exhibits multi-class antifungal drug resistance is concerning and has been associated with several outbreaks globally.