Fungal infections of the skin can be caused by various organisms. Some common culprits include Trichophyton species, such as T. rubrum, T. mentagrophytes, T. verrucosum, and T. violaceum. Other notable fungi include Microsporum canis and Epidermophyton floccosum. Additionally, yeast infections, particularly those stemming from the genus Candida (like C. albicans), are also prevalent. Another condition associated with fungal infection is Pityriasis (tinea) versicolor, caused by Pityrosporum orbicular, which is also referred to as Malassezia furfur.
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Proper Packaging
Terbinafine Tablets:
Fingernail onychomycosis: 250 mg once daily for 6 weeks.
Toenail onychomycosis: 250 mg once daily for 12 weeks.
Clinical improvement may take several months after the end of treatment as the healthy nail grows out.
Terbinafine Granules:
< 25 kg: 125 mg/day up to 6 weeks.
25–35 kg: 187.5 mg/day up to 6 weeks.
35 kg: 250 mg/day up to 6 weeks.
Terbinafine is an allylamine antifungal agent that blocks the biosynthesis of ergosterol, an essential component of the fungal cell membrane, by inhibiting the enzyme squalene epoxidase. This inhibition leads to the accumulation of intracellular squalene, which causes increased membrane permeability and ultimately fungal cell death.
Terbinafine demonstrates fungicidal activity against dermatophytes such as Trichophyton mentagrophytes and Trichophyton rubrum.
Common:
Gastrointestinal upset (diarrhea, dyspepsia, abdominal pain), rash, urticaria, pruritus, and mild taste disturbances.
Less Common/Serious:
Hepatic dysfunction (including rare cases of liver failure), severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis), neutropenia, thrombocytopenia, angioedema, anaphylaxis, fatigue, malaise, arthralgia, myalgia, and transient hair loss.
Apply once or twice daily on cleansed and dried affected skin. Rub gently into the affected area and the surrounding skin. For intertriginous areas (groin, between fingers, under breasts), a gauze dressing may be used at night.
Terbinafine 1% Spray:
Apply once or twice daily to clean, dry skin, ensuring thorough coverage of the affected area.
Pediatric: Safety and efficacy have not been established in children.
Elderly: No dosage adjustment required; similar safety profile to younger adults.
Terbinafine inhibits the CYP450 2D6 enzyme system. Therefore, co-administration with drugs metabolized by CYP2D6 (such as tricyclic antidepressants, SSRIs, beta-blockers, class 1C antiarrhythmics, and MAO-B inhibitors) should be done with caution and may require dose adjustment.
Known hypersensitivity to terbinafine or any component of the formulation.
Animal studies show no fetal toxicity, but clinical data in humans are insufficient. Avoid unless benefits outweigh potential risks.
Store below 30°C in a cool, dry place protected from light and moisture. Keep out of reach of children.
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