Terbinafine – effective against fungal diseases

Terbinafine – effective against fungal diseases

Terbinafine is a commonly used drug used to treat fungal diseases. Like the antimycotic naftifine, it has an inhibitory effect on an  enzyme that is important for the proliferation of  fungi  . This suppresses the growth of the fungi.

Terbinafine can be taken as an ointment on the skin or orally as a tablet. Side effects can include  itching  and rashes. In some cases, taking tablets also leads to an increase in liver values ​​in the blood. Caution should be exercised if additional  medications  are taken at the same time and if liver and kidney diseases are present.

What is terbinafine?

Terbinafine is an antifungal drug whose  active ingredient  in medicines is in the form of the compound terbinafine hydrochloride. Terbinafine is mainly used to treat fungal diseases of the skin (cutaneous mycoses) and nails ( onychomycoses ). Therefore, terbinafine belongs to the group of  antifungal drugs.

It is a drug that is usually taken in tablet form for nail fungus or   applied to the skin as an ointment for milder forms of skin fungus . The advantage of terbinafine over other antifungals is that terbinafine has  relatively few side effects  in many people affected by fungal diseases .

Terbinafine is sold by different manufacturers and is therefore available under different trade names. For example, terbinafine and its generics can be found under the following names:

  • Lamisil®
  • Terbinafine beta®
  • Terbinafine Aurobindo®
  • Terbinafin-Actavis®
  • Terbinafine Heumann®
  • Terbinafine-Hexal®

How does terbinafine work?

The drug primarily attacks the outer shell of the mushrooms: their cell membrane made of the substance ergosterol. By inhibiting the enzyme squalene epoxidase, terbinafine has a detrimental effect on this envelope and thus aggravates the growth, reproduction and survival of skin and nail fungi.

Side Effects and Dangers of Terbinafine

How dangerous is terbinafine? In most cases, terbinafine is well tolerated. The following side effects may occur during treatment with terbinafine:

  • skin rashes
  • itching
  • headache
  • abdominal pain and loss of appetite
  • limb and  joint pain
  • Increase in liver values ​​in the blood
  • damage to the liver

Interactions of Terbinafine

Terbinafine can damage human liver cells. It should therefore only be taken with caution with other medications that can also have a damaging effect on the liver. Alcohol should also be avoided during treatment with terbinafine.

St. John’s wort and the antiepileptic carbamazepine can accelerate the breakdown of terbinafine, which is why interactions must be observed here.

Contraindications: when should terbinafine not be used?

Terbinafine should be used with caution in case of hypersensitivity to terbinafine hydrochloride or any of the other ingredients of the drug.

Those affected with severely impaired liver function and/or kidney function should only be treated with terbinafine in close consultation with the doctor treating them and at a lower dose.

In addition, use in children under the age of two years is not recommended, and terbinafine should also be used with caution in older children.

Use of terbinafine

What is terbinafine used for? Terbinafine is available in the form of  tablets, creams and ointments  and is often prescribed to treat skin and nail fungus.

When and how often to take? The medicine should be taken once a day, always at the same time, if prescribed by the treating doctor. Other special features are not to be observed with terbinafine tablets with regard to an intake schedule in normal cases – the drug can also be taken independently of meals.

Dosing of terbinafine

The following should be considered with regard to the dosage of terbinafine:

  • The usual dosage  for adults  weighing more than 40 kg is one tablet of 250 mg terbinafine per day as a single dose. 
  • Children  from the age of two are usually given 62.5 mg of terbinafine per day if they weigh less than 20 kilograms. With a body weight of 20 to 40 kilograms, 125 mg of terbinafine per day is recommended, and taking it once a day is also sufficient here. 
  • In the case of treatment with terbinafine  as an ointment  , the drug should be applied to the affected part of the body once or twice a day.

How long do you take terbinafine?

How long terbinafine has to be taken or applied depends on the disease. Athlete’s foot  and fungus on other skin areas of the body is usually treated for a  period of two weeks  .

The skin on the head and lower legs is special case  : it should be treated for four weeks. The treatment of nail fungus takes even longer, here the use of terbinafine over several months is recommended.

When and how quickly does terbinafine work?

In the case of fungal diseases of the skin, terbinafine can bring about a significant improvement in symptoms and the appearance of the skin after just a few days. Nail fungus is usually much more time-consuming to treat and it can take weeks to months before a positive effect on fungal growth can be seen.

How long is terbinafine in the blood?

Terbinafine accumulates primarily in the skin, hair and nails. In the body, terbinafine can still be detected in the tissue or blood about 200 to 400 hours after ingestion.

Ointments usually do not accumulate so much in the body and mainly have a local effect. But here, too, terbinafine should only be used in children, pregnant women and those affected with liver and kidney diseases in consultation with the doctor treating you.

when to drop off

If side effects occur and  if you become pregnant  , terbinafine should be discontinued. Discontinuation should take place in consultation with the attending physician in order to consider possible alternative therapies.

How much do terbinafine tablets cost?

Terbinafine tablets and cream for skin and athlete’s foot are available in pharmacies. The price depends on the manufacturer and the pack size and should be asked at the pharmacy. For those with statutory health insurance, the co-payment for terbinafine tablets is usually five euros per pack.

Alternatives to terbinafine

A frequently used alternative to terbinafine are active ingredients from the group of imidazoles and triazoles. Well-known representatives of the antimycotics mentioned are itroconazole,  clotrimazole  and miconazole. Another drug also used in the treatment of fungal diseases is  ciclopirox , which is known by the trade name Batrafen®.


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