Terbinafine

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

  1. abdominal pain
  2. acute generalized exanthematous pustulosis (AGEP)
  3. agranulocytosis
  4. alopecia
  5. anaphylactoid reactions
  6. anemia
  7. angioedema
  8. anorexia
  9. anosmia
  10. anxiety
  11. arthralgia
  12. cholestasis
  13. cough
  14. dental pain
  15. depression
  16. diarrhea
  17. dizziness
  18. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
  19. dysgeusia
  20. dyspepsia
  21. elevated hepatic enzymes
  22. erythema multiforme
  23. exfoliative dermatitis
  24. fatigue
  25. fever
  26. flatulence
  27. headache
  28. hearing loss
  29. hemolytic-uremic syndrome
  30. hepatic failure
  31. hepatitis
  32. hyperbilirubinemia
  33. hypoesthesia
  34. infection
  35. jaundice
  36. lupus-like symptoms
  37. lymphopenia
  38. malaise
  39. myalgia
  40. nasal congestion
  41. nausea
  42. neutropenia
  43. pancreatitis
  44. pancytopenia
  45. paresthesias
  46. pharyngitis
  47. photosensitivity
  48. pruritus
  49. psoriaform rash
  50. rash
  51. rhabdomyolysis
  52. rhinorrhea
  53. serum sickness
  54. skin irritation
  55. Stevens-Johnson syndrome
  56. thrombocytopenia
  57. thrombotic microangiopathy
  58. thrombotic thrombocytopenic purpura (TTP)
  59. tinnitus
  60. toxic epidermal necrolysis
  61. urticaria
  62. vasculitis
  63. vertigo
  64. visual impairment
  65. vomiting
  66. weight loss
  67. 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
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  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Brompheniramine; Guaifenesin; Hydrocodone
  • 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
  • Cimetidine
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Class IC Antiarrhythmics
  • Clomipramine
  • Clozapine
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  • 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
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Disulfiram
  • Donepezil
  • Donepezil; Memantine
  • Doxepin
  • Doxercalciferol
  • Dronedarone
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Duloxetine
  • Dutasteride; Tamsulosin
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elbasvir; Grazoprevir
  • Elexacaftor; tezacaftor; ivacaftor
  • Eliglustat
  • Elvitegravir
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
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  • Enzalutamide
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Escitalopram
  • Eslicarbazepine
  • Ethinyl Estradiol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • Ethinyl Estradiol; Etonogestrel
  • Ethinyl Estradiol; Levonorgestrel
  • Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestrel
  • 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
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • Maprotiline
  • Meperidine
  • Meperidine; Promethazine
  • Mephobarbital
  • Methadone
  • Methamphetamine
  • Methohexital
  • Metoclopramide
  • Metoprolol
  • Mexiletine
  • Mitotane
  • Modafinil
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  • Nebivolol; Valsartan
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  • Norfloxacin
  • Nortriptyline
  • Octreotide
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  • Omeprazole; Amoxicillin; Rifabutin
  • Oritavancin
  • Oxycodone
  • Paroxetine
  • Peginterferon Alfa-2b
  • Pentobarbital
  • Perampanel
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenobarbital
  • Phentermine; Topiramate
  • Phenytoin
  • Pimozide
  • Pitolisant
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  • Primidone
  • Propoxyphene
  • Propranolol
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  • Quinine
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  • Ranolazine
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  • Saccharomyces boulardii
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  • Selective serotonin reuptake inhibitors
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  • Tamoxifen
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  • Telithromycin
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  • tobacco
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  • Voriconazole
  • Warfarin
  • Zafirlukast
  • Zileuton
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