Terbinafine is a commonly used drug used to treat fungal diseases. Like the antifungal drug naftifine, it has an inhibitory effect on an enzyme that is important for fungal reproduction. This suppresses the growth of the fungi. Terbinafine can be taken as an ointment on the skin or orally as a tablet. Side effects may include itching and rash. In some cases, there is also an increase in liver values in the blood when tablets are taken. Caution is advised if additional medications are taken at the same time and if liver and kidney diseases are present.
What is terbinafine?
Terbinafine is an antifungal drug whose active ingredient in medicines is in the form of the compound terbinafine hydrochloride. Terbinafine is mainly used for the treatment of fungal diseases of the skin (cutaneous mycoses) and nails (onychomycoses). Therefore, terbinafine belongs to the group of antifungal drugs. It is a drug that is usually taken in tablet form for nail fungus or applied to the skin as an ointment for milder forms of cutaneous fungus. The advantage of terbinafine over other antifungal drugs is that it has relatively few side effects for many people with fungal infections. Terbinafine is marketed by different manufacturers and is accordingly available under different trade names. For example, terbinafine and its generics can be found under the following names:
- Lamisil
- Terbinafine beta
- Terbinafine aurobindo
- Terbinafine actavis
- Terbinafine Heumann
- Terbinafine Hexal
How does terbinafine work?
The drug mainly attacks the outer shell of fungi: their cell membrane made of the substance ergosterol. Terbinafine acts via inhibition of the enzyme squalene epoxidase harmful to this envelope and thus aggravates the growth, reproduction and survival of skin and nail fungi.
Side effects and dangers of terbinafine
How dangerous is terbinafine? In most cases, terbinafine is well tolerated. The following side effects may occur with treatment with terbinafine:
- Skin rashes
- Itching
- Headache
- Abdominal pain and loss of appetite
- Pain in the limbs and joints
- Increase in liver enzymes in the blood
- Damage to the liver
Terbinafine interactions
Terbinafine can cause damage to human liver cells. Therefore, it should only be taken with caution together with other medications that can also have a damaging effect on the liver. Alcohol should also be avoided during treatment with Terbinafine. St. John’s wort and the antiepileptic drug carbamazepine can accelerate the breakdown of terbinafine, so care must be taken here to avoid interactions.
Contraindications: When should terbinafine not be used?
Terbinafine should be used with caution in cases of hypersensitivity to terbinafine hydrochloride or any of the other ingredients of the drug. Also, affected individuals with severe impairment of liver function and or kidney function should be treated with terbinafine only in close consultation with the treating physician and at lower doses. In addition, use is not recommended in children younger than two years of age, and terbinafine should also be used cautiously in older children.
Use of Terbinafine
What is terbinafine used for? Terbinafine is available as tablets, creams, and ointments and is often prescribed for the treatment of skin and nail fungus. When and how often to take? The medicine should be taken once a day, always at the same time of day, if prescribed by the attending physician. There are no other special features to be observed with terbinafine tablets regarding an intake schedule in normal cases – the drug can also be taken independently of meals.
Dosage of terbinafine
With regard to the dosage of terbinafine, the following should be noted:
- The usual dosage in adults weighing more than 40 kilograms is one tablet of 250 mg terbinafine per day as a single dose.
- Children aged two years and older are usually given 62.5 mg of terbinafine a day if they weigh less than 20 kilograms. For 20 to 40 kilograms of body weight, 125 mg of terbinafine a day is recommended, taking once a day is also sufficient.
- When treated with terbinafine as an ointment, the drug should be applied to the affected area of the body once or twice a day.
How long do you take terbinafine?
How long terbinafine must be taken or applied depends on the disease. Athlete’s foot and fungus on other skin areas of the body are usually treated for a period of two weeks. A special case is the skin on the head and lower leg: This should be treated for four weeks. Treatment of nail fungus lasts even longer, and here the use of terbinafine is recommended for several months.
When and how quickly does terbinafine take effect?
In fungal diseases of the skin, Terbinafine can cause a significant improvement in symptoms and skin appearance after only a few days. Nail fungus is usually much more protracted to treat, and it can take weeks to months to see a positive effect on fungal growth.
How long is terbinafine in the blood?
Terbinafine accumulates mainly in the skin, hair, and nails. In the body, terbinafine is detectable in tissues or blood for about 200 to 400 hours after ingestion. Ointments usually do not accumulate as much in the body and act mainly locally. However, again, in children, pregnant women, and those affected with liver and kidney disease, terbinafine should only be used in consultation with the treating physician.
When to discontinue.
When side effects occur and in case of pregnancy, terbinafine should be discontinued. Discontinuation should be done in consultation with the treating physician to consider possible alternative therapies.
How much do terbinafine tablets cost?
Terbinafine tablets and cream for skin and foot fungus are available at pharmacies. The price depends on the manufacturer and the package size and should be asked at the pharmacy. For people with statutory health insurance, the co-payment for terbinafine tablets is usually five euros per pack.
Alternatives to terbinafine
A frequently used alternative to terbinafine is represented by active substances from the group of imidazoles and triazoles. Well-known representatives of the antifungal agents mentioned are itroconazole, clotrimazole, and miconazole. Another active ingredient also used in the treatment of fungal diseases is ciclopirox, known by the trade name Batrafen.
