Terbinafine
DefinitionThis section has been translated automatically.
Allylamine antifungal.
Spectrum of actionThis section has been translated automatically.
Inhibition of squalene epoxidase, accumulation of fungicidally active squalene. Excretion: 71% renal, 22% faecal.
IndicationThis section has been translated automatically.
Infections with dermatophytes ( tinea capitis, tinea corporis, onychomycosis). Effective also for sporotrichosis ( off-label use). In 2 studies the efficiency in sporotrichosis could be shown. Also effective in mixed infections with Candida species (mycelial form) and scopularopsis.
Dosage and method of useThis section has been translated automatically.
250 mg/day p.o. for 4-6 weeks in the case of tinea corporis and for 3 months in the case of tinea unguium. Often the therapy duration of 3 months is not sufficient for Tinea unguium. Interval therapy with 4-weekly pauses between 4-weekly therapy cycles over 6-8 months is recommended)
Standard concentrationThis section has been translated automatically.
Apply 1% thinly as a cream 1-2 times/day for 2-4 weeks.
Undesirable effectsThis section has been translated automatically.
Allergic reactions, rarely Quincke's edema and drug-induced Lyell syndrome, AGEP, disorders of the sense of taste, BB changes (neutropenia, thrombocytopenia), gastrointestinal disorders, arthralgias, myalgias, rarely liver cell damage up to fatal liver cell necrosis.
Deterioration of psoriasis.
Notice! Due to the side effects, systemic use in Sweden has been limited to therapy-resistant onychomycoses!
InteractionsThis section has been translated automatically.
Cimetidine increases the Terbinafine level, Rifampicin increases the Terbinafine excretion.
ContraindicationThis section has been translated automatically.
Intolerance to the active substance, use on the eye, pregnancy, lactation, children < 5 years.
PreparationsThis section has been translated automatically.
Topical: e.g. Lamisil Pedisan cream, DermGel and spray.
Systemic: e.g. Lamisil, Terbinafine
Note(s)This section has been translated automatically.
In Switzerland and Austria Terbinafine is approved for oral application in children, in Germany however not yet ( off-label use). A careful documentation and education of parents about the off-label use and the effect of Terbinafine in studies should be carried out. The dosage recommendation is: Children with 10-20 kg bw: 62.5 mg/day; 21-40 kg bw: 125 mg/day; > 40 kg bw: 250 mg/day. 2 weeks of therapy are normally sufficient.
In a randomized double-blind study it could be shown that a therapy with Terbinafine cream 1% over 7 days (once/day) is sufficient to cure a Tinea pedis interdigitalis.
LiteratureThis section has been translated automatically.
- Seebacher C et al (2006) Tinea capitis. J Dtsch Dermatol Ges 4: 1085-1091
- Seebacher C et al (2007) Tinea of the free skin. J Dtsch Dermatol Ges 11: 921-926
- Wilmer A et al (1998) Systemic terbinafine treatment of dermatophytoses in children. Mycoses 41: 54-57