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Terbinafine

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Molecule Description

Terbinafine is an antifungal medication used to treat fungal infections. It is used for common fungal conditions like athlete's foot (tinea pedis), jock itch (tinea cruris), ringworm (tinea corporis), and most notably fungal nail infections (onychomycosis). It works by actively attacking the structure of the fungus, leading to its death and allowing your body to grow healthy, infection-free skin and nails. It works by killing the fungus rather than just stopping it from growing. When taken orally as a tablet, it travels through your bloodstream and concentrates in the skin, nails, and hair, reaching the source of the infection. Because nail infections are locked deep within the nail bed, oral Terbinafine is often the preferred treatment, although it's also available as topical creams and sprays for milder skin infections. Due to the slow growth rate of nails, a course of treatment may last several weeks or months to ensure the infection is completely eliminated and a new, healthy nail can grow in.

Uses

  • Terbinafine is an antifungal medicine used for fungal infections
  • It is used to treat ringworm infections of the scalp, foot and nails

Contraindications

When should one not use Terbinafine

  • Allergic reaction to Terbinafine
  • Liver disease
  • Breastfeeding

Side effects

Common side effects of this drug are:

  • Nausea
  • Itching
  • Dark-colored urine
  • Clay-colored stools
  • Loss of appetite
  • Stomach pain
  • Weakness
  • Headache
  • Diarrhea

Precautions and Warnings

Pregnancy

Pregnancy

Limited data were available about its safety in pregnancy. Doctor's discretion required.

Breast Feeding

Breast Feeding

Avoid application around the nipple area and ensure that the infant's skin does not come into direct contact with the areas of skin that have been treated. Only water-miscible cream, gel or liquid products should be applied on the breast; otherwise, the ointments might expose the infant to the high levels of mineral paraffin via licking. Oral consumption of the tablet is unsafe during breastfeeding.

Driving

Driving

While taking the oral tablet, some people feel dizzy or giddy; in such a case, caution is advised while driving.

Other General Warnings

Other General Warnings

Talk to your doctor if
  • Have Psoriasis
  • Terbinafine can make you more sensitive to sunlight, so avoid excessive exposure to sunlight when on treatment

Mode of Action

How Does It Work?

Terbinafine interferes with fungal cell membrane synthesis. This leads to the death of the fungus.

Interactions

Interactions with other medicines

  • Blood pressure-lowering medicines such as Atenolol, Metoprolol and Propranolol
  • A blood thinner such as Warfarin
  • Rifampicin for infections
  • Antidepressants including Tricyclic antidepressants, SSRIs (Selective Serotonin Reuptake Inhibitors), or MAOIs (Monoamine Oxidase Inhibitors)
  • Oral contraceptives (as irregular periods and breakthrough bleeding may occur in some female patients)
  • Beta-blockers or anti-arrhythmic for heart problems
  • Medicines to treat heart problems (e.g. Propafenone, Amiodarone)
  • Ciclosporin
  • Medicines used to treat fungal infections (e.g. Fluconazole, Ketoconazole)
  • Medicines used to treat cough (e.g. Dextromethorphan)
  • Caffeine

Interactions with food items

Terbinafine may also interact with coffee, cola, tea or other drinks that contain caffeine.

Dosage

Overdose

Overdose is rare with Terbinafine. Doses as high as 5-20 times of actual recommended dosage do not show severe adverse effects. Symptoms like nausea, vomiting, abdominal pain, rash, frequent urination, dizziness and headache may be seen.

Missed a Dose

Take the missed dose as early as you remember. Skip the missed dose & do not take extra medicine to compensate for the missed dose. Avoid missing the dosages as it causes resistance in the microorganism.

Frequently Asked Questions (FAQs)

Terbinafine is not to be used in patients with liver diseases. It is known to exacerbate (or at times cause) psoriasis. Hence, you must share the history of all existing and past skin diseases. It is advisable to share information on your ongoing medications with your doctor so that the risk of medicine interactions is minimal and optimum results can be achieved with this therapy.

The length of treatment depends heavily on the location and severity of the infection, as advised by your physician:Skin infections (like athlete's foot, jock itch): Typically 2 to 6 weeks.Fingernail infections: Usually about 6 weeks.Toenail infections: Can take 12 weeks (3 months) or sometimes longer, as toenails grow very slowly.You must complete the full course of treatment as prescribed by your doctor, even if your symptoms seem to clear up early. Stopping too soon can cause the infection to come back.

Caffeine: Terbinafine can sometimes cause caffeine to stay in your body longer, potentially increasing its effects (like jitters or a fast heartbeat). You may be advised to limit your intake of caffeine (coffee, soda, chocolate).Alcohol: It's best to avoid or limit alcohol, especially if you have pre-existing liver conditions, as both alcohol and Terbinafine are processed by the liver.

Oral Tablets (Prescription): Used for more serious, widespread, or deep infections, especially fungal nail infections. These require a prescription and liver monitoring.Creams/Sprays (OTC): These are topical and contain a lower concentration of the medication. They are used for mild, localized skin infections like athlete's foot and jock itch, and do not usually require a prescription.

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