Terbinex with Eco Formula (hydroxypropyl chitosan / terbinafine topical) Disease Interactions

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.

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.

Postmarketing studies have reported depressive symptoms with the use of terbinafine tablets. Terbinafine should be used with caution in patients with depression, and prescribers should be alert to the development of depressive symptoms. Patients and caregivers should be instructed to report any depressive symptoms.

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.

Precipitation and exacerbation of cutaneous and systemic lupus erythematosus has been reported postmarketing in patients taking terbinafine tablets. Terbinafine should be discontinued in patients with any clinical signs and symptoms suggestive of lupus erythematosus.

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.