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Terbinafine HCl
Terbinafine HCl is an antifungal medication used to treat a variety of fungal infections, including infections of the skin, hair, and nails. It works by inhibiting the growth of fungi, making it effective for conditions like onychomycosis (fungal nail infections) and tinea (ringworm) infections. Terbinafine is available in both oral and topical forms, and it is often used for the long-term treatment of stubborn or deep-seated fungal infections.
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Frequently Asked Questions
How long does it take for terbinafine to work?
For skin infections, terbinafine may start to show improvement within a few days to 1 week, but the full treatment duration is typically 1 to 4 weeks. For nail infections, it may take 6 to 12 weeks to complete the treatment, and it may take several months for the nail to grow back fully.
Can I drink alcohol while taking oral terbinafine?
It is recommended to avoid alcohol while taking oral terbinafine, as both the medication and alcohol can strain the liver, increasing the risk of liver damage.
What should I do if I miss a dose of oral terbinafine?
If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses to make up for the missed one.
Can I use terbinafine for athlete’s foot?
Yes, topical terbinafine is commonly used to treat athlete's foot (tinea pedis). It is typically applied once or twice daily for 1 to 4 weeks, depending on the severity of the infection.
Is terbinafine safe for long-term use?
Oral terbinafine is usually prescribed for short-term use (6 to 12 weeks) due to the potential for liver toxicity. Long-term use should only be considered under the close supervision of a healthcare provider.
Comprehensive Drug Guide
How Does Terbinafine HCl Work?
Terbinafine works by inhibiting an enzyme called squalene epoxidase, which is essential for the synthesis of ergosterol, a key component of fungal cell membranes. Without ergosterol, the fungal cells become weakened and cannot survive, leading to the elimination of the infection.
Common Dosages
- Oral tablet: 250 mg once daily for 6 weeks for fingernail infections and 12 weeks for toenail infections.
- Topical formulations: Applied once or twice daily to the affected area for 1 to 4 weeks, depending on the type and severity of the infection.
Typical Dosing
- For onychomycosis: One 250 mg tablet taken once daily for 6 weeks (fingernail infection) or 12 weeks (toenail infection).
- For topical use: Apply the cream, gel, or spray once or twice daily to the affected area for 1 to 4 weeks.
Typical Dosing
FDA Approved Indications
- Onychomycosis (fungal nail infections): Specifically in the fingernails and toenails caused by dermatophyte fungi.
- Tinea infections: Such as tinea corporis (ringworm), tinea pedis (athlete's foot), tinea cruris (jock itch), and tinea capitis (scalp infections).
Who Shouldn't Take Terbinafine HCl?
- Hypersensitivity to terbinafine or any component of the formulation
- Chronic or active liver disease, as terbinafine can affect liver function
- Renal impairment (use with caution and under close supervision)
Advice From The Pharmacist
- For oral terbinafine, take the medication exactly as prescribed, even if symptoms improve. Fungal infections may take time to fully resolve, and stopping the medication early can result in a return of the infection.
- Monitor liver function during long-term use of terbinafine, as it may cause liver toxicity. Regular blood tests are recommended.
- For topical terbinafine, apply a thin layer to the affected area and wash your hands afterward. Do not stop using the topical medication too soon, even if the symptoms appear to improve.
- Keep affected areas clean and dry, as moisture can worsen fungal infections.
- Avoid alcohol consumption during oral treatment, as it can increase the risk of liver damage.
Side Effects of Terbinafine HCl
Common Side Effects
- Diarrhea
- Headache
- Rash or itching
- Changes in taste or loss of taste
- Redness or irritation at the site of application
- Itching
- Burning or stinging sensation
Uncommon/Severe Side Effects
- Liver damage: Symptoms such as yellowing of the skin or eyes, dark urine, fatigue, or abdominal pain should be reported immediately.
- Severe skin reactions: Rare but serious allergic reactions like Stevens-Johnson syndrome.
- Changes in blood counts: Unexplained bruising, sore throat, or infections may indicate a drop in white blood cells.
Risks and Warnings of Terbinafine HCl
- Liver Toxicity: Terbinafine can cause liver damage, particularly in individuals with pre-existing liver conditions or those taking the medication for a long period. Liver function should be monitored regularly through blood tests.
- Taste Disturbances: Some patients report loss of taste or changes in taste perception during treatment with oral terbinafine. This effect is usually temporary but can last for several weeks after discontinuing the medication.
- Allergic Reactions: Severe skin reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis, are rare but possible. Stop using the medication and seek medical attention if you experience severe rash, blistering, or peeling skin.
Interactions with Terbinafine HCl
Common Drug Interactions
- Cimetidine: This drug may increase the levels of terbinafine in the blood, leading to a higher risk of side effects.
- Rifampin: May reduce the effectiveness of terbinafine by lowering its blood levels.
- Antidepressants: Terbinafine can affect the metabolism of certain antidepressants (such as tricyclic antidepressants), altering their effectiveness or increasing side effects.
- Warfarin: Terbinafine may increase the blood-thinning effects of warfarin, leading to an increased risk of bleeding.
Alternatives to Terbinafine HCl
- Itraconazole (Sporanox): Another antifungal used for the treatment of onychomycosis and systemic fungal infections.
- Fluconazole (Diflucan): An antifungal used for a variety of fungal infections, including systemic infections and superficial infections like thrush.
- Griseofulvin: Another oral antifungal used for the treatment of ringworm and fungal infections of the skin and nails.
- Topical antifungal creams: Such as clotrimazole, miconazole, or ketoconazole, for milder fungal infections of the skin.
