Terbinafine

Aka: Terbinafine, Lamisil, Allylamine Antifungal

advertisement

II. Mechanism

  1. Allylamine Antifungal

III. Indications

  1. Topical Management (Lamisil, Terbinafine HCl 1%)
    1. Resistant dermatophyte infection (e.g. Tinea Pedis)
  2. Systemic Management (Terbinafine)
    1. Onychomycosis

IV. 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

V. Monitoring: Oral Terbinafine

  1. Protocol
    1. Baseline labs
    2. Repeat CBC after 6 weeks of continuous use if Immunodeficiency
    3. New guidelines do not require repeat LFT testing routinely
      1. Obtain repeat testing if higher risk of liver abnormality, concurrent use of Hepatotoxic Medications, or symptoms
      2. In past, LFTs have been monitored every 4 to 6 weeks
      3. Stop agent if AST or ALT >2x normal
  2. Labs
    1. Complete Blood Count and Platelet Count (if Immunodeficiency)
    2. Aspartate Aminotransferase (AST)
    3. Alanine Aminotransferase (ALT)
    4. Serum Creatinine

VI. Dosing: Oral

  1. Dose
    1. Adult (and child >40 kg): 250 mg orally daily
    2. Child 20-40 kg: 125 mg (up to 187.5 mg) orally daily
    3. Child <20 kg: 67.5 mg (up to 125 mg) orally daily
  2. Duration
    1. Tinea Capitis: 6 weeks (longer course if culture grows Microsporum)
    2. Fingernail Onychomycosis: 6 weeks
    3. Toenail Onychomycosis: 12 weeks

VII. Drug Interactions

  1. Cimetidine increases Terbinafine levels
  2. Rifampin decreases Terbinafine levels
  3. Increased bleeding risk with Warfarin

VIII. References

  1. Ely (2014) Am Fam Physician 90(10): 702-10 [PubMed]
  2. Gupta (1999) J Am Acad Dermatol 41:237-49 [PubMed]
  3. Friedlander (1999) Pediatr Infect Dis J 18(2):205-10 [PubMed]
  4. McClellan (1999) Drugs 58(1):179-202 [PubMed]
  5. Perez (1999) Mycoses 43:79-83 [PubMed]

Images: Related links to external sites (from Bing)

These images are a random sampling from a Bing search on the term "Terbinafine." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images

Related Studies

Cost: Medications

terbinafine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
TERBINAFINE 1% CREAM Generic OTC $0.27 per gram
TERBINAFINE HCL 250 MG TABLET Generic $0.16 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

advertisement