Terbinafine Uses

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What is Terbinafine?

Terbinafine is used to treat infections caused by a fungus. It works by killing the fungus or preventing its growth.

Terbinafine is applied to the skin to treat:

Terbinafine is available both over-the-counter (OTC) and with your doctor's prescription.

Terbinafine indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Terbinafine tablets, USP are indicated for the treatment of onychomycosis of the toenail or fingernail due to dermatophytes (tinea unguium).

Prior to initiating treatment, appropriate nail specimens for laboratory testing [potassium hydroxide (KOH) preparation, fungal culture, or nail biopsy] should be obtained to confirm the diagnosis of onychomycosis.

How should I use Terbinafine?

Use Terbinafine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Terbinafine.

Uses of Terbinafine in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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Use: Labeled Indications

Onychomycosis (tablets only): Treatment of onychomycosis of the toenail or fingernail caused by dermatophytes (tinea unguium).

Tinea capitis (granules only): Treatment of tinea capitis in patients 4 years and older.

Off Label Uses

Dermatophyte folliculitis (tinea barbae, Majocchi granuloma)

Data from a limited number of patients studied suggest that Terbinafine may be beneficial for the treatment of dermatophyte folliculitis.

Terbinafine description

Terbinafine (Lamisil) is a synthetic allylamine antifungal. It is highly lipophilic in nature and tends to accumulate in skin, nails, and fatty tissues. Like other allylamines, Terbinafine inhibits ergosterol synthesis by inhibiting the fungal squalene monooxygenase (squalene 2,3-epoxidase), an enzyme that is part of the fungal cell wall synthesis pathway.

Terbinafine dosage

Terbinafine Dosage

Applies to the following strength(s): 250 mg; 125 mg; 187.5 mg

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Onychomycosis - Fingernail

Tablets: 250 mg orally once a day for 6 weeks

Comments:

-Optimal clinical effect observed some months after mycological cure and end of therapy; related to time required for outgrowth of healthy nail.

Approved

Indication: Treatment of onychomycosis of the fingernail due to dermatophytes (tinea unguium)

Usual Adult Dose for Onychomycosis - Toenail

Tablets: 250 mg orally once a day for 12 weeks

Comments:

-Optimal clinical effect observed some months after mycological cure and end of therapy; related to time required for outgrowth of healthy nail.

Approved

Indication: Treatment of onychomycosis of the toenail due to dermatophytes (tinea unguium)

Usual Adult Dose for Tinea Capitis

Oral granules: 250 mg orally once a day for 6 weeks

Comments:

-Some evidence suggests that a longer duration of therapy (e.g., 6 to 8 weeks) or higher dosage may be necessary when tinea capitis is caused by Microsporum canis.

Usual Adult Dose for Cutaneous Candidiasis

(Not approved by FDA)

Tablets: 250 mg orally once a day for 2 to 4 weeks

Usual Adult Dose for Tinea Corporis

(Not approved by FDA)

Tablets: 250 mg orally once a day for 2 to 4 weeks

Usual Adult Dose for Tinea Cruris

(Not approved by FDA)

Tablets: 250 mg orally once a day for 2 to 4 weeks

Usual Adult Dose for Tinea Pedis

(Not approved by FDA)

Tablets: 250 mg orally once a day for 2 to 6 weeks

Usual Pediatric Dose for Tinea Capitis

Oral granules

:

4 years or older:

Less than 25 kg: 125 mg orally once a day

25 to 35 kg: 187.5 mg orally once a day

Greater than 35 kg: 250 mg orally once a day

Duration of therapy: 6 weeks

Comments:

-Some evidence suggests that a longer duration of therapy (e.g., 6 to 8 weeks) or higher dosage may be necessary when tinea capitis is caused by Microsporum canis.

Renal Dose Adjustments

CrCl 50 mL/min or less: Data not available

Liver Dose Adjustments

Chronic or active liver disease: Not recommended.

Precautions

Consult WARNINGS section for dosing related precautions.

Dialysis

Data not available

Other Comments

Administration advice:

-Oral granules: Take with food. Sprinkle the contents of each packet on a spoonful of pudding or other soft, nonacidic food (e.g., mashed potatoes) and swallow the entire spoonful without chewing; do not use applesauce or fruit-based foods.

General:

-Before starting therapy with Terbinafine tablets, appropriate nail specimens for laboratory testing (potassium hydroxide preparation, fungal culture, or nail biopsy) should be obtained to confirm the diagnosis of onychomycosis.

-Clinical resolution may not be observed until several weeks after mycological cure.

Monitoring:

-Hematologic: Complete blood counts in patients with immunodeficiency (known or suspected) using Terbinafine for more than 6 weeks or if clinical signs/symptoms suggestive of secondary infection develop

-Hepatic: Serum transaminases (ALT and AST) in all patients before starting therapy

-Psychiatric: Depressive symptoms

Patient advice:

-Minimize exposure to natural and artificial sunlight (tanning beds or UVA/B treatment) during therapy.

More about Terbinafine

Consumer resources

Professional resources

Related treatment guides

Terbinafine interactions

See also:
What other drugs will affect Terbinafine?

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Ajmaline: CYP2D6 Inhibitors (Moderate) may increase the serum concentration of Ajmaline. Monitor therapy

Amitriptyline: Terbinafine (Systemic) may increase the serum concentration of Amitriptyline. Management: Monitor for increased effects/toxicity of amitriptyline during concomitant administration with Terbinafine. Reduced dosages of amitriptyline may be needed. Consider therapy modification

Amphetamines: CYP2D6 Inhibitors (Moderate) may increase the serum concentration of Amphetamines. Monitor therapy

ARIPiprazole: CYP2D6 Inhibitors (Moderate) may increase the serum concentration of ARIPiprazole. Management: Monitor for increased aripiprazole pharmacologic effects. Aripiprazole dose adjustments may or may not be required based on concomitant therapy and/or indication. Consult full interaction monograph for specific recommendations. Monitor therapy

Brexpiprazole: CYP2D6 Inhibitors (Moderate) may increase the serum concentration of Brexpiprazole. Management: If brexpiprazole is to be used together with both a moderate CYP2D6 inhibitor and a strong or moderate CYP3A4 inhibitor, the brexpiprazole dose should be reduced to 25% of the usual dose when treating indications other than major depressive disorder. Monitor therapy

CloZAPine: CYP2D6 Inhibitors (Moderate) may increase the serum concentration of CloZAPine. Monitor therapy

Codeine: CYP2D6 Inhibitors (Moderate) may diminish the therapeutic effect of Codeine. These CYP2D6 inhibitors may prevent the metabolic conversion of codeine to its active metabolite morphine. Monitor therapy

CYP2D6 Substrates (High risk with Inhibitors): CYP2D6 Inhibitors (Moderate) may decrease the metabolism of CYP2D6 Substrates (High risk with Inhibitors). Exceptions: Tamoxifen. Monitor therapy

Desipramine: Terbinafine (Systemic) may increase the serum concentration of Desipramine. Management: Monitor for increased effects/toxicity of desipramine during concomitant administration with Terbinafine. Reduced dosages of desipramine may be needed. Consider therapy modification

DOXOrubicin (Conventional): CYP2D6 Inhibitors (Moderate) may increase the serum concentration of DOXOrubicin (Conventional). Management: Seek alternatives to moderate CYP2D6 inhibitors in patients treated with doxorubicin whenever possible. One U.S. manufacturer (Pfizer Inc.) recommends that these combinations be avoided. Consider therapy modification

Eliglustat: CYP2D6 Inhibitors (Moderate) may increase the serum concentration of Eliglustat. Management: Eliglustat dose is 84 mg daily with CYP2D6 inhibitors. Use is contraindicated (COI) when also combined with strong CYP3A4 inhibitors. When also combined with a moderate CYP3A4 inhibitor, use is COI in CYP2D6 EMs or IMs and should be avoided in CYP2D6 PMs. Consider therapy modification

Fesoterodine: CYP2D6 Inhibitors may increase serum concentrations of the active metabolite(s) of Fesoterodine. Monitor therapy

Imipramine: Terbinafine (Systemic) may increase the serum concentration of Imipramine. Management: Monitor for increased effects/toxicity of imipramine during concomitant administration with Terbinafine. Reduced dosages of imipramine may be needed. Consider therapy modification

Indoramin: CYP2D6 Inhibitors (Moderate) may increase the serum concentration of Indoramin. Monitor therapy

Metoprolol: CYP2D6 Inhibitors (Moderate) may increase the serum concentration of Metoprolol. Monitor therapy

Nebivolol: CYP2D6 Inhibitors (Moderate) may increase the serum concentration of Nebivolol. Monitor therapy

Nortriptyline: Terbinafine (Systemic) may increase the serum concentration of Nortriptyline. Management: Monitor for increased effects/toxicity of nortriptyline during concomitant administration with Terbinafine. Reduced dosages of nortriptyline may be needed. Consider therapy modification

Perhexiline: CYP2D6 Inhibitors may increase the serum concentration of Perhexiline. Management: Consider alternatives to this combination if possible. If combined, monitor for increased perhexiline serum concentrations and toxicities (eg, hypoglycemia, neuropathy, liver dysfunction). Perhexiline dose reductions will likely be required. Consider therapy modification

Pitolisant: CYP2D6 Inhibitors (Moderate) may increase the serum concentration of Pitolisant. Monitor therapy

Propafenone: CYP2D6 Inhibitors (Moderate) may increase the serum concentration of Propafenone. Management: Drugs listed as exceptions to this monograph are discussed in further detail in separate drug interaction monographs. Monitor therapy

RifAMPin: May decrease the serum concentration of Terbinafine (Systemic). Monitor therapy

Saccharomyces boulardii: Antifungal Agents (Systemic,

Oral) may diminish the therapeutic effect of Saccharomyces boulardii.

Avoid combination

Tamoxifen: CYP2D6 Inhibitors (Moderate) may decrease serum concentrations of the active metabolite(s) of Tamoxifen. Specifically, CYP2D6 inhibitors may decrease the metabolic formation of highly potent active metabolites. Management: Consider alternatives with less of an inhibitory effect on CYP2D6 activity when possible. Consider therapy modification

Tamsulosin: CYP2D6 Inhibitors (Moderate) may increase the serum concentration of Tamsulosin. Monitor therapy

Thioridazine: CYP2D6 Inhibitors may increase the serum concentration of Thioridazine. Avoid combination

TraMADol: CYP2D6 Inhibitors (Moderate) may diminish the therapeutic effect of TraMADol. These CYP2D6 inhibitors may prevent the metabolic conversion of tramadol to its active metabolite that accounts for much of its opioid-like effects. Monitor therapy

Terbinafine side effects

See also:
What are the possible side effects of Terbinafine?

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Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

The most frequently reported adverse events observed in the 3 U.S./Canadian placebo-controlled trials are listed in the table below. The adverse events reported encompass gastrointestinal symptoms (including diarrhea, dyspepsia, and abdominal pain), liver test abnormalities, rashes, urticaria, pruritus, and taste disturbances. Changes in the ocular lens and retina have been reported following the use of Terbinafine tablets in controlled trials. The clinical significance of these changes is unknown. In general, the adverse events were mild, transient, and did not lead to discontinuation from study participation.

Adverse Event Discontinuation
Terbinafine

Tablets (%)

n=465

Placebo

(%)

n=137

Terbinafine

Tablets (%)

n=465

Placebo

(%)

n=137

* Liver enzyme abnormalities ≥2 times the upper limit of normal range.

Headache

12.9

9.5

0.2

0

Gastrointestinal Symptoms:

Diarrhea

Dyspepsia

Abdominal Pain

Nausea

Flatulence

5.6

4.3

2.4

2.6

2.2

2.9

2.9

1.5

2.9

2.2

0.6

0.4

0.4

0.2

0

0

0

0

0

0

Dermatological Symptoms:

Rash

Pruritus

Urticaria

5.6

2.8

1.1

2.2

1.5

0

0.9

0.2

0

0.7

0

0

Liver Enzyme Abnormalities*

3.3

1.4

0.2

0

Taste Disturbance

2.8

0.7

0.2

0

Visual Disturbance

1.1

1.5

0.9

0

Postmarketing Experience

The following adverse events have been identified during postapproval use of Terbinafine tablets. Because these events are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Blood and lymphatic system disorders: Pancytopenia, agranulocytosis, severe neutropenia, thrombocytopenia, anemia

Immune system disorders: Serious hypersensitivity reactions e.g., angioedema and allergic reactions (including anaphylaxis), precipitation and exacerbation of cutaneous and systemic lupus erythematosus, serum sickness-like reaction

Psychiatric disorders: Anxiety and depressive symptoms independent of taste disturbance have been reported with use of Terbinafine tablets. In some cases, depressive symptoms have been reported to subside with discontinuance of therapy and to recur with reinstitution of therapy

Nervous system disorders: Cases of taste disturbance, including taste loss, have been reported with the use of Terbinafine tablets. It can be severe enough to result in decreased food intake, weight loss, anxiety, and depressive symptoms. Cases of smell disturbance, including smell loss, have been reported with the use of Terbinafine tablets. Cases of paresthesia and hypoesthesia have been reported with the use of Terbinafine tablets.

Eye disorders: Visual field defects, reduced visual acuity

Ear and labyrinth disorders: Hearing impairment, vertigo, tinnitus

Vascular disorders: Vasculitis

Gastrointestinal disorders: Pancreatitis, vomiting

Hepatobiliary disorders: Cases of liver failure some leading to liver transplant or death, idiosyncratic and symptomatic hepatic injury. Cases of hepatitis, cholestasis, and increased hepatic enzymes have been seen with the use of Terbinafine tablets.

Skin and subcutaneous tissue disorders: Serious skin reactions [e.g., Stevens - Johnson syndrome, toxic epidermal necrolysis, erythema multiforme, exfoliative dermatitis, and bullous dermatitis, and drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome], acute generalized exanthematous pustulosis, psoriasiform eruptions or exacerbation of psoriasis, photosensitivity reactions, hair loss

Musculoskeletal and connective tissue disorders: Rhabdomyolysis, arthralgia, myalgia

General disorders and administration site conditions: Malaise, fatigue, influenza-like illness, pyrexia

Investigations: Altered prothrombin time (prolongation and reduction) in patients concomitantly treated with warfarin and increased blood creatine phosphokinase have been reported.

Terbinafine contraindications

See also:
What is the most important information I should know about Terbinafine?

Terbinafine tablets are contraindicated in individuals with a history of allergic reaction to oral Terbinafine because of the risk of anaphylaxis.

Active ingredient matches for Terbinafine:

Terbinafine Hydrochloride in Argentina, Australia, Austria, Bahrain, Bangladesh, Belgium, Bosnia & Herzegowina, Brazil, Bulgaria, Canada, China, Colombia, Congo, Croatia (Hrvatska), Czech Republic, Denmark, Ecuador, Estonia, Finland, France, Georgia, Germany, Greece, Hong Kong, Hungary, Iceland, Indonesia, Ireland, Israel, Italy, Japan, Latvia, Lithuania, Malaysia, Malta, Mexico, Netherlands, New Zealand, Norway, Oman, Peru, Philippines, Poland, Portugal, Romania, Russian Federation, Serbia, Singapore, Slovakia, Slovenia, South Africa, South Korea, Sweden, Switzerland, Taiwan, Thailand, Tunisia, Turkey, United Kingdom, United States, Venezuela, Vietnam.

Terbinafine in Romania.


Unit description / dosage (Manufacturer)Price, USD
Tablet; Oral; Terbinafine Hydrochloride 250 mg
Injectable; Injection; Terbinafine Hydrochloride 1 mg / ml
Cream; Topical; Terbinafine Hydrochloride 1%
Tablet; Oral; Terbinafine Hydrochloride 125 mg
LamISIL 14 187.5 mg Packets Packet$ 202.16
LamISIL 1% Solution 30ml Bottle$ 88.18
Terbinafine hcl powder$ 42.84
Terbinafine HCl 1% Cream 24 gm Tube$ 17.99
Lamisil 250 mg tablet$ 4.79
Terbinafine hcl 250 mg tablet$ 13.19
Apo-Terbinafine 250 mg Tablet$ 2.64
Co Terbinafine 250 mg Tablet$ 2.64
Mylan-Terbinafine 250 mg Tablet$ 2.64
Novo-Terbinafine 250 mg Tablet$ 2.64
Pms-Terbinafine 250 mg Tablet$ 2.64
Sandoz Terbinafine 250 mg Tablet$ 2.64
Lamisil 1% cream$ 2.13
Lamisil 1 % Solution$ 0.58
Lamisil 1 % Cream$ 0.57
Sm athlete's 1% foot cream$ 0.53
Lamisil at 1% cream$ 0.51
CVS Pharmacy jock itch 1% cream$ 0.49
CVS Pharmacy athlete's foot 1% cream$ 0.40
Athlete's 1% foot cream$ 0.27
Lamisil af defense crm to powd$ 0.20
Lamisil antifungal 1% spray$ 0.07
Lamisil af defense 1% powder$ 0.05
Tablets; Oral; Terbinafine Hydrochloride 250 mg
Tablets; Oral; Terbinafine Hydrochloride 125 mg
Terbinafine tablet 250 mg (Sanis Health Inc (Canada))
Terbinafine tablet 250 mg/1 (Pd Rx Pharmaceuticals, Inc. (US))
Terbinafine tablet 250 1/1 (Cipla USA Inc. (US))
Sm athlete's 1% foot cream$ 0.53
CVS Pharmacy athlete's foot 1% cream$ 0.40
Athlete's 1% foot cream$ 0.27

List of Terbinafine substitutes (brand and generic names):

Terbinafine Actavis tab 250 mg 28's (Actavis)
Terbinafine Cadila 250 mg x 14's (Cadila)
Terbinafine Cadila tab 250 mg 14's (Cadila)

References

  1. DailyMed. "TERBINAFINE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "terbinafine". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "terbinafine". http://www.drugbank.ca/drugs/DB00857 (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Terbinafine are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Terbinafine. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

User reports

Consumer reported useful

No survey data has been collected yet


Consumer reported price estimates

No survey data has been collected yet


Consumer reported time for results

No survey data has been collected yet


3 consumers reported age

Users%
6-152
66.7%
30-451
33.3%


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Information checked by Dr. Sachin Kumar, MD Pharmacology

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