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Why it's used

Terbinafine is a prescription medicine that is used to treat Terbinafine sensitive fungal infections of the toenails or fingernails (onychomycosis), scalp, legs or arms (Tinea corporis), groin area (Tinea cruris) and soles of feet (Tinea pedis). This medicine works by blocking the growth of fungi.
Allylamine Antifungal
Terbinafine belongs to the Allylamine Antifungal class of medicines. Allylamine antifungal medicines are used to treat fungal infections such as ringworm, athlete's foot, jock itch, and nail fungus. These medicines work by killing the growth of fungi.

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How to use

Read the medicine guide provided by your pharmacist, your doctor, or the medicine company. If you have any questions related to Terbinafine, ask your doctor or pharmacist. Use Terbinafine as per the instructions provided by your doctor.
Terbinafine is eaten with or without food.

Typical Dosage

The typical dose of Terbinafine for adults is 250 mg/day for 6-12 weeks. This medicine is generally used for a period of 6 weeks for fungal infections of fingernail, 12 weeks for fungal infections of toenail, 2–4 weeks for fungal infection of the arms or legs (tinea corporis) and groin area (tinea cruris), and 6 weeks for fungal infection of the soles of the feet (tinea pedis).

Talk to Your Doctor

Discuss with your doctor if you develop new or worsening symptoms. Discuss with your doctor if worsening lupus (autoimmune disorder), skin rash, loss of pigment, and unusual sensitivity to the sun.
Older patients may see an increase in the incidence of side-effects. As a result, a lower dose may be recommended for older patients.

Lab Tests

Your doctor may request that specific lab tests be performed before you start using Terbinafine. Your doctor may ask you to undergo Fungal Culture | Nail Biopsy | KOH Preparation test. Lab test such as fungal culture, KOH preparation, or nail biopsy should be performed for confirming the diagnosis of fungal infections of the toenails or fingernails (onychomycosis). Your doctor may request Aspartate Aminotransferase | Alanine Transaminase Blood | Liver Panel test. Measurement of the liver parameters such as aspartate aminotransferase and alanine transaminase should be performed before starting treatment with this medicine.
Medicines may be recommended for uses other than those listed in the medicine guide. You should not use Terbinafine for conditions or symptoms for which it was not prescribed. Do not give Terbinafine to other people, even if they have the same conditions or symptoms that you have. The use of this medicine without the advice of a doctor may cause harm.

Storage

Follow storage instructions on the product package if available. Store Terbinafine at 25°C (77°F), away from moisture, and away from light. Store this medicine away from children and pets.

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How to take Terbinafine

Your dose and how often you take Terbinafine will depend on the following factors:
  • age
  • medicines recommended by the doctor
  • any other medicines being used
  • herbal supplements in use

Terbinafine Dosage

Dosage for fungal infections of fingernail

Adult
  • Recommended: 250 mg/day for 6 weeks

Dosage for fungal infections of toenail

Adult
  • Recommended: 250 mg/day for 12 weeks

Forms

Tablet
Strength: 125 mg, 250 mg
Cream
Strength: 1 g/100 g, 1 g/100 g, 1 %
Granule
Strength: 125 mg, 187.5 mg
Spray
Strength: 1.25 ml/125 ml, 1 ml/100 ml, 1 %
Aerosol, spray
Strength: 0.84 g/125 ml
Gel
Strength: 10 mg, 10 mg/1 g
Solution
Strength: 1%

Special Instructions

Granules
For preparing dose of Terbinafine granules, a full packet of granules should be sprinkled on the spoonful of soft food such as mashed potatoes or pudding. Granules should not be sprinkled on the food made up of applesauce. If the doctor has asked you to take two packets of Terbinafine granules, You should sprinkle both packets on one spoonful or each packet on a separate spoonful of soft food. The spoonful of food and granules should be swallowed without chewing.

Missed Dose

A missed dose should be taken as early as you remember it. However, if the time for the next dose is almost there, then the missed dose should be skipped, and the regular dosing schedule should be continued.

Overdose

What to do if you overdose on Terbinafine?
The harmful effects of Terbinafine can be reduced by taking activated charcoal which prevents the absorption of Terbinafine. If required, supportive treatment according to symptoms should be given in the management of overdose.
Symptoms of an overdose of Terbinafine
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
If you think you have overdosed on Terbinafine, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Terbinafine

Before you use Terbinafine, tell your doctor of your medical and health history including the following:
Patient with liver disease may experience harmful effect and worsening of the functioning of the liver when using Terbinafine.
Before you use Terbinafine, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information.
The use of this medicine may change complete blood count. The complete blood count may alter in a patient with immunodeficiency taking Terbinafine for more than six week.
The use of Terbinafine may change liver function. The use of Terbinafine may increase level of the liver enzyme.
The use of this medicine may change creatinine phosphokinase. It may increase the blood creatine phosphokinase level.
The use of this medicine may change weight. Terbinafine may decrease the weight of patients.

Use in Pregnancy

Terbinafine should be used in pregnancy only when required. Terbinafine should not be used in pregnancy but if necessary it should be used only after considering the possible benefit to the mother and potential risk to the fetus.

Use while Breastfeeding

Terbinafine is not safe for use in women who are breastfeeding. If you are breastfeeding, discuss with your doctor if you should either discontinue breastfeeding or stop using this medicine while breastfeeding. Terbinafine may pass into breast milk.

Impact on Fertility

Consult with your doctor on the use of Terbinafine, if you are trying to conceive.

Seizures

Terbinafine can make you feel sleepy. Be careful while driving, using machinery, or doing any other activity that needs you to be alert. The consumption of alcohol with Terbinafine can make you feel more sleepy. Terbinafine may cause seizures in some people. Discuss with your doctor if you perform activities where a loss of consciousness may cause you or others harm.

Increased Risk

This medicine may increase your sensitivity to sunlight. If this happens, limit your time outdoors and prevent sunburns. Cover your skin or use a sunscreen.

Terbinafine Side-effects

The following side-effects may commonly occur when using Terbinafine. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
Rarely, the use of Terbinafine may cause the following side-effects:
  • altered prothrombin time
  • burning or prickling sensation
  • decreased weight
  • dizziness
  • fatigue
  • feeling of discomfort
  • hair loss
  • hypoacusis/hearing loss
  • increased liver enzymes
  • inflammation of the connective tissues (cutaneous and systemic lupus erythematosus)
  • influenza like illness
  • red, dry, itchy, and scaly on the skin (psoriasiform eruptions/exacerbation of psoriasis)
  • reduced sense of touch or sensation
  • ringing in the ears (tinnitus)
  • sensation of spinning dizziness
  • visual disturbance including reduced visual acuity, visual field defect
The following severe side-effects may also occur when using Terbinafine:
  • Symptoms: low count of neutrophils in the blood, deficiency of granulocyts, abnormally low levels of thrombocytes, deficiency of red cells, white cells, and platelets lack of blood
    If this happens, stop taking Terbinafine and contact your doctor as soon as possible.
  • immune system disorders
    Symptoms: life-threatening allergic reaction (anaphylaxis), swelling of the lower layer of the skin allergic reaction to an injection of foreign protein
    If this happens, contact your doctor as soon as possible.
  • mental disorders such as anxiety and depression
    Symptoms: feel sad or worthless, change in sleep pattern, loss of energy or interest in daily activities, restlessness mood changes
    If these symptoms occur, contact your doctor as soon as possible.
  • nervous system disorders such as loss of taste and loss of smell
    Symptoms: decreased appetite, weight loss anxious or depressed feelings
    If this happens, stop taking Terbinafine and contact your doctor as soon as possible.
  • blood vessel disorder
    Symptoms: inflammation of a blood vessel (vasculitis)
  • stomach and intestinal disorder
    Symptoms: pancreas inflammation (pancreatitis)
    If this happens, contact your doctor as soon as possible.
  • liver disorders (possibly fatal)
    Symptoms: nausea, upper right stomach pain, poor appetite, yellowing of the skin or eyes, tiredness, dark (tea-colored) urine, vomiting, pale or light-colored stools, inflammation of the liver (hepatitis), liver failure blocked or reduced flow of bile from the liver (cholestasis)
    If this happens, stop taking Terbinafine and contact your doctor as soon as possible. In this case, the blood test should be performed for liver problems before using Terbinafine.
  • skin disorders
    Symptoms: skin allergic reaction caused by infection, life-threatening skin reaction (Stevens-Johnson Syndrome), life-threatening drug-induced skin reaction, red, scaly rash with bumps under the skin (acute generalized exanthematous pustulosis) sun allergic reaction
    If this happens, stop taking Terbinafine and contact your doctor as soon as possible.
  • musculoskeletal and connective tissue disorder
    Symptoms: muscle injury (rhabdomyolysis)
    If this happens, contact your doctor as soon as possible.
  • increased blood creatinine phosphokinase | fever |
    If this happens, contact your doctor as soon as possible.
Your doctor has prescribed this medicine because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious cases of side-effects. This page does not contain a complete list of all possible side-effects.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Functioning Of the Kidney

Patients with an abnormality in the functioning of the kidney are at an increased risk. Terbinafine should not be in such patients.

Medicinal Products Metabolized by CYP2D6

Patients taking Terbinafine with medicinal products metabolized by CYP2D6 are at an increased risk. Dose adjustment should be considered in such patients.

Inflammation of the Connective Tissues (Lupus Erythematous)

Patients taking Terbinafine are at an increased risk. These patients may experience lupus erythematosus. Terbinafine should be discontinued on the occurrence of signs and symptoms of lupus erythematosus. Precaution should be taken in patients with psoriasis or lupus erythematosus.

Skin Reactions

Patients taking Terbinafine are at an increased risk. These patients may experience serious skin reaction such as life-threatening allergic reactions and drug-induced life-threatening allergic reactions. Terbinafine should be discontinued on the occurrence of progressive skin rash.

Blood-Related Effects

Patients taking Terbinafine are at an increased risk. These patients may experience low levels of blood cells such as neutrophils, granulocytes, thrombocytes, white blood cells, platelets or red blood cells, fever, and sore throat. Complete blood count test and blood-related effects should be examined on the occurrence of symptoms of secondary infection and in patients with immunodeficiency using Terbinafine for more than six weeks. Terbinafine should be discontinued on the occurrence of severe low levels of blood cells. Also, dose adjustment and supportive therapy should be considered in such cases.

Depressive Symptoms

Patients taking Terbinafine are at an increased risk. These patients may experience depressive symptoms. Patients should be informed to report the doctor immediately on the occurrence of depressive symptoms.

Smell Disturbance

Patients taking Terbinafine are at an increased risk. These patients may experience smell disturbance such as loss of smell. Terbinafine should be discontinued on the occurrence of smell disturbance. These symptoms may resolve after discontinuation of Terbinafine therapy but may be prolonged or permanent.

Taste Disturbance

Patients taking Terbinafine are at an increased risk. These patients may experience taste disturbance such as taste loss, which may lead to weight loss, decreased food intake, and depressive symptoms. Terbinafine should be discontinued on the occurrence of taste disturbance. These symptoms may resolve after discontinuation of Terbinafine therapy, but these symptoms may be prolonged or permanent.

Harmful Effects on Liver

Patients using Terbinafine, with and without liver disease are at an increased risk. These patients may experience nausea, fatigue, stomach pain, jaundice, dark urine, eating disorder (anorexia), pale stools, harmful effects of the liver, or liver failure which may lead to liver transplant or fatality. If this happens, stop taking Terbinafine and contact your doctor as soon as possible. In this case, the blood test should be performed for liver problems before using Terbinafine.

Interactions with Terbinafine

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Terbinafine. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Rifampin

Your doctor's guidelines may need to be followed while taking this medicine along with rifampin, which is used to treat lung infection (tuberculosis). When Terbinafine is used with rifampin, it may increase the clearance of the Terbinafine. Dose adjustments of Terbinafine should be considered when using both medicines together.

Ciclosporin

Terbinafine interacts with ciclosporin, which is used to prevent organ rejection. When Terbinafine is used with ciclosporin, it may increase the clearance of ciclosporin.

Caffeine

There may be an interaction of Terbinafine with caffeine, which is used to treat headache. When Terbinafine is used with caffeine, it may decrease the clearance of caffeine.

Drugs Metabolised by CYP2D6

Terbinafine may interact with drugs metabolised by CYP2D6 (beta-blockers, antiarrhythmics, desipramine). When Terbinafine is used with drugs metabolized by CYP2D6 such as beta-blockers, antiarrhythmics, tricyclic antidepressants, selective serotonin inhibitors, or monoamine oxidase inhibitors, it may interfere in the metabolism of these drugs. Terbinafine may decrease the clearance of desipramine. Dose reduction along with monitoring should be considered in patients using these medicines together.

Warfarin

Special instructions need to be followed while taking this medicine along with warfarin, which is used to reduce the risk of heart attack. When Terbinafine is used with warfarin, it may either increase or decrease the blood clotting time.

Amiodarone

Terbinafine interacts with amiodarone, which is used to treat irregular heartbeat. When Terbinafine is used with amiodarone, it may increase the levels of Terbinafine.

Oral contraceptives

Special instructions need to be followed while taking this medicine along with oral contraceptives, which is used to prevent pregnancy. When Terbinafine is used with oral contraceptives, it may cause irregular menstruation.

Antifungals

There may be an interaction of Terbinafine with antifungals (fluconazole and ketoconazole), which is used to treat fungal infection. When Terbinafine is used with fluconazole or ketoconazole, it may increase the levels of Terbinafine.

Cimetidine

Terbinafine may interact with cimetidine, which is used to treat ulcer. When Terbinafine is used with cimetidine, it may decrease the clearance of the Terbinafine. Dose adjustments of Terbinafine should be considered when using both medicines together.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Terbinafine is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.

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