Lamisil (terbinafine) Disease Interactions

There are 4 disease interactions with Lamisil (terbinafine):

Terbinafine (Includes Lamisil) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

Oral terbinafine is not recommended for use in patients with chronic or active liver disease. Terbinafine may be hepatotoxic. Rare cases of cholestatic hepatitis and liver failure, some resulting in liver transplant or death, have been reported during treatment of various dermatologic conditions in patients with and without preexisting liver disease. Although a causal relationship has not been established, the severity of hepatic events and/or their outcome may be worse in patients with active or chronic liver disease.

References

  1. Lowe G, Green C, Jennings P "Hepatitis associated with terbinafine treatment." BMJ 306 (1993): 248
  2. "Product Information. Lamisil (terbinafine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  3. Balfour JA, Faulds D "Terbinafine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in superficial mycoses [published erratum appears in Drugs 1992 May;43(5):699]." Drugs 43 (1992): 259-84
View all 4 references

Terbinafine (Includes Lamisil) ↔ Neutropenia

Severe Potential Hazard, Low plausibility

Applies to: Neutropenia

Isolated cases of severe neutropenia have been reported in patients administered oral terbinafine. A causal relationship has not been established, although the neutropenia resolved following discontinuation of terbinafine with or without supportive care. Therapy with terbinafine should be administered cautiously in patients with preexisting neutropenia. It may be appropriate to monitor blood counts more frequently during terbinafine therapy. If secondary infection occurs and the neutrophil count is <= 1000 cells/mm3, terbinafine should be discontinued and supportive management initiated.

References

  1. Kovacs MJ, Alshammari S, Guenther L, Bourcier M "Neutropenia and pancytopenia associated with oral terbinafine." J Am Acad Dermatol 31 (1994): 806
  2. "Product Information. Lamisil (terbinafine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.

Terbinafine (Includes Lamisil) ↔ Immunosuppression

Moderate Potential Hazard, Moderate plausibility

Applies to: Immunodeficiency

Transient decreases in absolute lymphocyte counts have been reported with oral terbinafine during clinical trials. The clinical significance of these decreases is unknown. Monitoring of complete blood counts may be appropriate in patients with known or suspected immunodeficiency receiving terbinafine for greater than six weeks.

References

  1. "Product Information. Lamisil (terbinafine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  2. Kovacs MJ, Alshammari S, Guenther L, Bourcier M "Neutropenia and pancytopenia associated with oral terbinafine." J Am Acad Dermatol 31 (1994): 806

Terbinafine (Includes Lamisil) ↔ Renal Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

The use of oral terbinafine in patients with renal impairment (CrCl <= 50 mL/min) has not been adequately studied and is, therefore, not recommended. Terbinafine metabolites are primarily eliminated by the kidney. The clinical significance of possible metabolite accumulation due to decreased clearance is unknown.

References

  1. Jensen JC "Clinical pharmacokinetics of terbinafine (Lamisil)." Clin Exp Dermatol 14 (1989): 110-3
  2. "Product Information. Lamisil (terbinafine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.

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Lamisil (terbinafine) drug Interactions

There are 290 drug interactions with Lamisil (terbinafine)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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