What is Terbinafine
Terbinafine is an oral and topical antifungal agent that is pharmacologically similar to naftifine.
Oral terbinafine is highly effective for treating onychomycosis due to its fungicidal activity and ability to concentrate within the nail.
In clinical studies, the efficacy of oral terbinafine in the treatment of onychomycosis was found to be superior to both griseofulvin and itraconazole.
Further, the rate of relapse with terbinafine were lower than those observed with griseofulvin.
Onychomycosis clinical cure rates for terbinafine are approximately 50% to 70%.
Oral terbinafine has also been utilized in small open-label studies as an alternative treatment for bronchopulmonary aspergillosis refractory to other treatments; in some cases terbinafine has suppressed or eradicated the disease.
Topical terbinafine was approved by the FDA in 1993.
Terbinafine oral tablets were approved May 1996.
Terbinafine cream received approval as an over-the-counter treatment of tinea pedis in March 1999.
Terbinafine oral granules were approved for use in pediatric patients, ages 4 years and older, for the treatment of tinea capitis in September 2007.
Indications & Dosage
- aspergillosis
- Aspergillus fumigatus
- Aspergillus sp.
- Candida albicans
- Candida parapsilosis
- Epidermophyton floccosum
- Histoplasma sp.
- Malassezia furfur
- Microsporum canis
- Microsporum gypseum
- Microsporum nanum
- onychomycosis
- Scopulariopsis brevicaulis
- sporotrichosis
- tinea capitis
- tinea corporis
- tinea cruris
- tinea pedis
- tinea versicolor
- Trichophyton mentagrophytes
- Trichophyton rubrum
- Trichophyton verrucosum
- Trichophyton violaceum
Side Effects
- abdominal pain
- acute generalized exanthematous pustulosis (AGEP)
- agranulocytosis
- alopecia
- anaphylactoid reactions
- anemia
- angioedema
- anorexia
- anosmia
- anxiety
- arthralgia
- cholestasis
- cough
- dental pain
- depression
- diarrhea
- dizziness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dysgeusia
- dyspepsia
- elevated hepatic enzymes
- erythema multiforme
- exfoliative dermatitis
- fatigue
- fever
- flatulence
- headache
- hearing loss
- hemolytic-uremic syndrome
- hepatic failure
- hepatitis
- hyperbilirubinemia
- hypoesthesia
- infection
- jaundice
- lupus-like symptoms
- lymphopenia
- malaise
- myalgia
- nasal congestion
- nausea
- neutropenia
- pancreatitis
- pancytopenia
- paresthesias
- pharyngitis
- photosensitivity
- pruritus
- psoriaform rash
- rash
- rhabdomyolysis
- rhinorrhea
- serum sickness
- skin irritation
- Stevens-Johnson syndrome
- thrombocytopenia
- thrombotic microangiopathy
- thrombotic thrombocytopenic purpura (TTP)
- tinnitus
- toxic epidermal necrolysis
- urticaria
- vasculitis
- vertigo
- visual impairment
- vomiting
- weight loss
- xerosis
Monitoring Parameters
- CBC with differential
- LFTs
Contraindications
- anxiety
- breast-feeding
- children
- depression
- hemolytic-uremic syndrome
- hepatic disease
- hepatitis
- human immunodeficiency virus (HIV) infection
- immunosuppression
- insomnia
- jaundice
- neutropenia
- onychomycosis
- pregnancy
- renal failure
- renal impairment
- serious rash
- suicidal ideation
- thrombotic thrombocytopenic purpura (TTP)
Interactions
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Propoxyphene
- Acetaminophen; Tramadol
- Aldesleukin, IL-2
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amlodipine; Telmisartan
- Amobarbital
- Amoxapine
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amprenavir
- Apalutamide
- Aprepitant, Fosaprepitant
- Aripiprazole
- Armodafinil
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atazanavir
- Atazanavir; Cobicistat
- Atomoxetine
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Boceprevir
- Bosentan
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- Brompheniramine; Hydrocodone; Pseudoephedrine
- Butabarbital
- Caffeine
- Caffeine; Ergotamine
- Carbamazepine
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carvedilol
- Ceritinib
- Cevimeline
- Chloramphenicol
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
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- Citalopram
- Clarithromycin
- Class IC Antiarrhythmics
- Clomipramine
- Clozapine
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- Cyclosporine
- Danazol
- Darifenacin
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- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Delavirdine
- Desipramine
- Dexamethasone
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dextromethorphan
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Dichlorphenamide
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diltiazem
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- Donepezil
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- Ethinyl Estradiol; Norethindrone
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- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
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- Etravirine
- Fedratinib
- Felbamate
- Fluconazole
- Fluorouracil, 5-FU
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Flutamide
- Fluvastatin
- Fluvoxamine
- Fosamprenavir
- Fosphenytoin
- Gefitinib
- Gemfibrozil
- grapefruit juice
- Green Tea
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Haloperidol
- Homatropine; Hydrocodone
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrochlorothiazide, HCTZ; Telmisartan
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydroxyprogesterone
- Ibuprofen; Oxycodone
- Idelalisib
- Iloperidone
- Imatinib
- Imipramine
- Indinavir
- Isavuconazonium
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Itraconazole
- Ivacaftor
- Ketoconazole
- Lansoprazole
- Lansoprazole; Naproxen
- Leflunomide
- Lofexidine
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Luliconazole
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- Lumacaftor; Ivacaftor
- Maprotiline
- Meperidine
- Meperidine; Promethazine
- Mephobarbital
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- Methohexital
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- Mexiletine
- Mitotane
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- Nebivolol; Valsartan
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- Nevirapine
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- Nortriptyline
- Octreotide
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Oritavancin
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- Paroxetine
- Peginterferon Alfa-2b
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- Primidone
- Propoxyphene
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- Quinine
- Rabeprazole
- Ranolazine
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- Saccharomyces boulardii
- Saquinavir
- Secobarbital
- Segesterone Acetate; Ethinyl Estradiol
- Selective serotonin reuptake inhibitors
- Sertraline
- St. John’s Wort, Hypericum perforatum
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
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- Telaprevir
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- tobacco
- Topiramate
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- Valproic Acid, Divalproex Sodium
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