Terbinafine Hydrochloride
Indications
Terbinafine Hydrochloride is used for:
Tinea pedis, Tinea cruris, Tinea corporis, Dermatophytosis, Nail infections
Adult Dose
Oral
Onychomycosis
Adult: 250 mg once daily for 6 weeks (fingernail) or 12 weeks (toenail)
Tinea Pedis, Tinea Corporis, Tinea Cruris
Adult: 250 mg/day PO in single dose or divided q12hr
2-4 wk in tinea cruris, tinea corporis
2-6 wk for tinea pedis
Hepatic impairment: Use not recommended in chronic or active liver disease
Child Dose
Tinea Capitis
>4 years (<25 kg): 125 mg/day PO for 6 weeks
>4 years (25-35 kg): 187.5 mg/day PO for 6 weeks
>4 years (>35 kg): 250 mg/day PO for 6 weeks
Renal Dose
Renal impairment: Use not recommended if CrCl <50 mL/min
Administration
May be taken with or without food.
Contra Indications
Hypersensitivity, active or chronic liver disease, lactation.
Precautions
Preexisting liver or renal impairment, pregnancy. Perform liver function tests prior to oral therapy.
Lactation: Drug excreted in breast milk; do not use
Pregnancy-Lactation
Interactions
Possible increase in levels in drugs metabolised by CYP450 2D6. Decreased terbinafine concentration with rifampicin; increased terbinafine concentration with cimetidine.
Adverse Effects
Side effects of Terbinafine Hydrochloride :
>10%
Headache (13%)
1-10%
Rash (6%),Pruritus (3%),Nausea (3%),Diarrhea (6%),Dyspepsia (4%),Abdominal pain (2%),Taste disturbance (3%),Elevated liver function test results (3%),Visual disturbance (1%)
Potentially Fatal: Liver failure, Stevens-Johnson syndrome, neutropaenia.
Mechanism of Action
Terbinafine causes fungal cell death by inhibiting squalene epoxidase, the main enzyme in sterol biosynthesis, resulting in ergosterol deficiency within fungal cell walls. It has fungicidal activity against dermatophytes and some yeast.