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Terbinafine
(tr-bi-nuh-fn)
Terbinafine is an FDA-approved medication for treating fungal infections of the toe and the scalp.
Disclaimer
The content on this page is not medical advice and should be used for informational purposes only. Always consult your health care provider or pharmacist to determine what medication and dosage are right for you.
Last updatedMay 19, 2023
Terbinafine
Terbinafine is a medicine that fights fungal infections by blocking a specific enzyme. It can treat many types of fungal infections, including onychomycosis (a nail infection). Most side effects are not serious and go away on their own, like headaches and stomach issues. However, some people may experience changes in their sense of taste, which can be mild or severe. In rare cases, these taste changes can lead to weight loss and may last a long time.
Generic name
Rx or OTC
Topical Terbinafine can be purchased over-the-counter. The tablet form is available only by prescription.
When & How
You can take terbinafine with or without food, and it will still work the same way. The body eliminates terbinafine through the liver and kidneys. It's important to know that terbinafine can interact with other medications, so it's necessary to keep an eye out for any potential drug interactions.
Discuss with your doctor
The most common side effects of terbinafine are usually not serious and go away on their own. These can include headaches, stomach problems, and a rash. Some less common side effects are changes in vision, strange taste sensations, and mild liver problems. In very rare cases, severe liver damage may occur. Although skin problems are usually not specific, there have been a few reports of serious conditions like Stevens-Johnson syndrome, toxic epidermal necrolysis, and lupus.
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What is Terbinafine?
Terbinafine, also known as Lamisil, fights against fungal infections like ringworm, jock itch, athlete's foot, and fungal nail infections. You can take it by mouth or apply it directly to your skin as a cream or ointment. Some common side effects when taken orally include feeling nauseous, having diarrhea, getting a headache, coughing, developing a rash, or having slightly elevated liver enzymes. Severe side effects are rare but can include liver problems and allergic reactions. It's generally not recommended to use terbinafine during pregnancy. If you use the cream or ointment, you might experience some itchiness, but it's usually well tolerated. Terbinafine works by stopping the fungi from making certain substances they need to survive, ultimately leading to their death.
Tablets
Terbinafine comes in a tablet form that you take by mouth, and each tablet has 250 mg of the medicine. For most fungal infections, the usual dose is one tablet a day. The length of treatment depends on the type of infection you have. If it's a fingernail infection, you may take the tablets for six weeks, and if it's a toenail infection, it could be up to 12 weeks.
Another dosing schedule, called pulse-dose treatment, hasn't been approved by the FDA, but some doctors may prescribe it. This schedule involves taking one tablet a day for four weeks, then having four weeks without any therapy, and finally, taking one tablet a day again for another four weeks. This treatment schedule has been shown to be just as effective as taking the medicine continuously.
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Side effects
Disclaimer
Medications may affect individuals differently. Usage of any medication may include side effects and other interactions. Here is a list of known common side effects and interactions. This list is not exhaustive -- there may be other side effects or interactions for this medication that are not listed here. In some cases, the likelihood of side effects or interactions may increase depending on dosage. It’s important to keep in mind that in extreme cases, other serious side effects, even death, may occur. Always consult your health care provider or pharmacist to determine what medication and dosage is right for you.
Safety notes
Some patients taking terbinafine may experience changes in taste, nausea, vomiting, abdominal cramping, and headaches. The decision to continue taking the medication depends on how severe the symptoms are and how much discomfort the patient is experiencing. If the symptoms are bothersome, stopping the medication can help resolve them. However, the most serious side effects of terbinafine affect the liver. Liver problems may not show any symptoms, but they can be detected through lab tests that measure liver enzymes. If the liver enzymes are more than twice the normal value, the medication should be stopped immediately. In severe cases, supportive care and even liver transplantation may be necessary.
Terbinafine interactions
Disclaimer
Medications may affect individuals differently. Usage of any medication may include side effects and other interactions. Here is a list of known common side effects and interactions. This list is not exhaustive -- there may be other side effects or interactions for this medication that are not listed here. In some cases, the likelihood of side effects or interactions may increase depending on dosage. It’s important to keep in mind that in extreme cases, other serious side effects, even death, may occur. Always consult your health care provider or pharmacist to determine what medication and dosage is right for you.
Tell your doctor if you are taking any of these medications or supplements
Terbinafine can interact with other medications due to its effects on the liver enzyme CYP2D6.
Some examples of drugs that may interact with terbinafine include:
- fluconazole
- rifampin
- caffeine
- paroxetine
- codeine
- metoprolol
- simvastatin
- nifedipine
- digoxin
- phenytoin
Tell your doctor if you have any of these pre-existing conditions
Terbinafine should not be used in people with chronic or active liver disease or those who have had an allergic reaction to oral terbinafine in the past.
Terbinafine is not recommended during pregnancy or while breastfeeding because it can be passed to the baby through breast milk. However, topical terbinafine, available over the counter, may be used for treating skin infections during pregnancy.
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References
Maxfield L, Preuss CV, Bermudez R. Terbinafine. [Updated 2022 Oct 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545218/