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Terbinafine is authorised in the world under the following brand names: Bramazil, Lamasil, Lamisil, Lamisil AT, Lamisil Oral, Terbifoam, Terbina.

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The allylamine derivative terbinafine can be used orally or topically. It is active against a broad range of fungi, including filamentous fungi and, to a lesser extent, yeastlike fungi. However, probably because of irreversible protein binding, its clinical usefulness is limited to the treatment of dermatophyte infections and perhaps lymphocutaneous sporotrichosis. Terbinafine acts by inhibiting the synthesis of fungal ergosterol at the level of squalene oxidase, leading to depletion of ergosterol and accumulation of toxic squalenes in the fungal cell membrane.

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Theophylline is largely metabolized by CYP1A2 and terbinafine increases its half-life. In a randomized, crossover study in 12 healthy volunteers, terbinafine increased theophylline exposure by 16%, with a 14% reduction in clearance and a 24% increase in half-life. These pharmacokinetic changes may predispose individuals to accumulation of theophylline and unwanted toxicity. Caution should be taken in prescribing terbinafine for patients taking long-term theophylline.

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The pharmacokinetics of terbinafine and five known metabolites have been investigated in 12 children, (mean age 8 years; range 5-11 years), who took terbinafine 125 mg/day for 6-8 weeks for tinea capitis. The metabolism of terbinafine was similar to that observed in adults, and there were comparable steady-state plasma concentrations after administration of the same oral dose. Steady state was reached by day 21 with no further accumulation up to day 56.

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Taste disturbance is a rare adverse effect of terbinafine. It is usually reversible, with a median time to recovery of 42 days. However, a 46-year-old woman had complete loss of taste after taking oral terbinafine, with persistent taste disturbances for 3 years after stopping the drug. The projected rate of all blood dyscrasias associated with terbinafine has been estimated to be 32 per million patient-years.

Antimicrobial therapy: general principles

A wide variety of antimicrobial agents is available to treat established infections caused by bacteria, fungi, viruses, or parasites. This section will cover the general principles of antimicrobial therapy and will also include illustrative clinical problems to emphasize proper decision-making in using antimicrobials.

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Terbinafine is used orally in the treatment of dermatophytic infections of the toenail or fingernail (onychomycosis, tinea unguium) caused by susceptible fungi. Prior to administration of oral terbinafine, appropriate nail specimens for microbiologic studies (e.g., potassium hydroxide [KOH] preparation, fungal culture, or nail biopsy) should be obtained to confirm the diagnosis of onychomycosis. The optimal clinical effect of terbinafine in the treatment of onychomycoses is seen several months after mycologic cure and completion of treatment, and is related to the period required for outgrowth of healthy nail.

Econazole Nitrate

Econazole nitrate is a topical / antifungal agent. It increases cell membrane permeability in susceptible fungi. It is indicated in the treatment of tinea pedis (athlete’s foot), tinea cruris (jock itch), tinea corporis (ringworm), cutaneous candidiasis, and tinea versicolor.

Dosage forms of Terbinafine:
Lamisil 1% cream Apo-Terbinafine 250 mg Tablet Co Terbinafine 250 mg Tablet Mylan-Terbinafine 250 mg Tablet
Novo-Terbinafine 250 mg Tablet Pms-Terbinafine 250 mg Tablet Sandoz Terbinafine 250 mg Tablet Lamisil 250 mg Tablet
Terbinafine hcl 250 mg tablet Lamisil 250 mg tablet Terbinafine HCl 1% Cream 24 gm Tube Terbinafine hcl powder
LamISIL 1% Solution 30ml Bottle LamISIL 14 187.5 mg Packets Packet Lamisil af defense 1% powder Lamisil antifungal 1% spray
Lamisil af defense crm to powd Athlete’s 1% foot cream CVS Pharmacy athlete’s foot 1% cream CVS Pharmacy jock itch 1% cream
Lamisil at 1% cream Sm athlete’s 1% foot cream Lamisil 1 % Cream Lamisil 1 % Solution

Synonyms of Terbinafine:

Terbinafine, Terbinafine HCl, Terbinafine Hydrochloride, Ternbinafine HCl

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Therapeutic classes of Terbinafine:

Allylamines, Antifungal Agents, Antifungals, Enzyme Inhibitors, Trypanocidal Agents

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