Infectious Disease Book

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TerbinafineAka: Lamisil, Allylamine Antifungal

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  1. Mechanism
    1. Allylamine Antifungal
  2. Indications
    1. Topical Management (Lamisil, Terbinafine HCl 1%)
      1. Resistant dermatophyte infection (e.g. Tinea Pedis)
    2. Systemic Management (Terbinafine)
      1. Onychomycosis
  3. Adverse Effects: Oral Terbinafine
    1. Uncommon effects
      1. Headache
      2. Rash
      3. Gastrointestinal upset
    2. Rare effects
      1. Cholestatic hepatitis
      2. Blood dyscrasia
      3. Stevens-Johnson Syndrome
  4. Monitoring: Oral Terbinafine
    1. Protocol
      1. Baseline labs
      2. Repeat every 4 to 6 weeks
      3. Stop agent if AST or ALT >2x normal
    2. Labs
      1. Complete Blood Count and Platelet Count
      2. Aspartate Aminotransferase (AST)
      3. Alanine Aminotransferase (ALT)
  5. Dosing: Oral
    1. Dose
      1. Adult (and child >40 kg): 250 mg PO qd
      2. Child 20-40 kg: 125 mg PO qd
      3. Child <20 kg: 67.5 mg PO qd
    2. Course in Onychomycosis
      1. Fingernail: 6 weeks
      2. Toenail: 12 weeks
  6. Drug Interactions
    1. Cimetidine increases terbinafine levels
    2. Rifampin decreases terbinafine levels
    3. Increased bleeding risk with Warfarin
  7. References
    1. Gupta (1999) J Am Acad Dermatol 41:237
    2. Friedlander (1999) Pediatr Infect Dis J 18(2):205
    3. McClellan (1999) Drugs 58(1):179
    4. Perez (1999) Mycoses 43:79

terbinafine (C0076110)

Definition (NCI)A synthetic allylamine derivative with antifungal activity. Terbinafine exerts its effect through inhibition of squalene epoxidase, thereby blocking the biosynthesis of ergosterol, an important component of fungal cell membranes. As a result, this agent disrupts fungal cell membrane synthesis and inhibits fungal growth.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC041359
Englishterbinafine, TERBINAFINE PREPARATION
Spanishterbinafina
Parent ConceptsAntifungal Agents (C0003308), Naphthalenes (C0027378), [DE102] ANTIFUNGAL, TOPICAL (C0973520), Skin antifungal agent (C0304591), Naphthalenemethylamine derivative (C1689973), Dermatological Antifungals (C1579274), Allylamine Antifungals (C1579364)
SourcesLNC, MSH, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Lamisil (C0721298)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC041359
EnglishLamisil
SourcesMSH, NCI, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)


Allylamine Antifungals (C1579364)

ConceptsPharmacologic Substance (T121)
EnglishAllylamine Antifungals
Parent ConceptsAntifungal Agents (C0003308)
SourcesUSPMG
Derived from the NIH UMLS (Unified Medical Language System)



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