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terbinafine

Pronunciation

Generic Name: terbinafine (ter BIN na feen)
Brand Name: LamISIL

What is terbinafine?

Terbinafine is an antifungal medication that fights infections caused by fungus.

Terbinafine tablets are used to treat infections caused by fungus that affect the fingernails or toenails.

Terbinafine oral granules are used to treat a fungal infection of scalp hair follicles in children who are at least 4 years old.

Terbinafine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about terbinafine?

Some people taking terbinafine have developed severe liver damage leading to liver transplant or death.

Call your doctor at once if you have symptoms of liver damage, such as nausea, upper stomach pain, vomiting, loss of appetite, tiredness, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes). These events can occur whether or not you have ever had liver problems before.

What should I discuss with my healthcare provider before taking terbinafine?

You should not use terbinafine if you are allergic to it, or if you have:

  • liver disease.

To make sure terbinafine is safe for you, tell your doctor if you have ever had:

  • liver problems;

  • weak immune system (caused by disease or by using certain medicine); or

  • lupus.

It is not known whether this medicine will harm an unborn baby. You should wait until after your pregnancy to start treating your nail or scalp infection with terbinafine. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Terbinafine can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

How should I take terbinafine?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

You may take the terbinafine tablet with or without food.

Terbinafine granules should be sprinkled into a spoonful of pudding or mashed potatoes (do not mix with applesauce, fruit juice, or other fruit-based or acidic foods). Swallow this mixture right away without chewing. Do not save the mixture for later use.

Terbinafine is usually taken for 6 weeks to treat scalp or fingernail infections, and for 12 weeks to treat a toenail infection.

Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antifungal medicine. Terbinafine will not treat a viral infection such as the flu or a common cold.

While using terbinafine, you may need frequent blood tests.

It may take several months for your nails to return to their normal appearance after your treatment with terbinafine.

Store at room temperature away from moisture, heat, and light. Keep the terbinafine oral granules in their sealed packet until you are ready to use.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include headache, dizziness, vomiting, stomach pain, rash, and increased urination.

What should I avoid while taking terbinafine?

Avoid coffee, tea, cola, energy drinks or other sources of caffeine while taking this medicine.

Avoid exposure to sunlight or tanning beds. Terbinafine can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Terbinafine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

In rare cases, terbinafine may cause a severe drug reaction that can affect many parts of the body. This type of reaction can start several weeks after you begin using this medicine. Seek medical treatment if you have new or worsening symptoms of fever, facial swelling, swollen glands, mouth sores, trouble swallowing, cough, chest pain, trouble breathing, fast heartbeats, blood in your urine, peeling skin, or a blistering rash.

Some people taking terbinafine have developed severe liver damage leading to liver transplant or death. It is not clear whether terbinafine actually caused the liver damage in these patients. In most cases, the patient had a serious medical condition before taking terbinafine.

Call your doctor at once if you have symptoms of liver damage, such as nausea, upper stomach pain, vomiting, loss of appetite, tiredness, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes). These events can occur whether or not you have ever had liver problems before.

Also call your doctor if you have:

  • changes in your sense of taste or smell;

  • depressed mood, sleep problems, lack of interest in daily activity, feeling anxious or restless;

  • pale skin, easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  • swelling, rapid weight gain, little or no urinating;

  • blood in your urine or stools;

  • skin sores, butterfly-shaped skin rash on your cheeks and nose (worsens in sunlight);

  • weight loss due to taste changes or loss of appetite; or

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • diarrhea, nausea, gas, stomach pain or upset;

  • rash;

  • headache;

  • abnormal liver function tests.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Terbinafine dosing information

Usual Adult Dose for Onychomycosis -- Fingernail:

Tablets: 250 mg orally once a day

Duration of therapy:
-Fingernail onychomycosis: 6 weeks
-Toenail onychomycosis: 12 weeks

Comments:
-Before using this drug, patients should be evaluated for evidence of chronic or active liver disease.
-Before starting therapy, appropriate nail specimens for laboratory testing (potassium hydroxide preparation, fungal culture, or nail biopsy) should be obtained to confirm the diagnosis of onychomycosis.
-Optimal clinical effect observed some months after mycological cure and completion of therapy; related to time required for outgrowth of healthy nail.

Use: For the treatment of onychomycosis of the fingernail or toenail due to dermatophytes (tinea unguium)

Usual Adult Dose for Onychomycosis -- Toenail:

Tablets: 250 mg orally once a day

Duration of therapy:
-Fingernail onychomycosis: 6 weeks
-Toenail onychomycosis: 12 weeks

Comments:
-Before using this drug, patients should be evaluated for evidence of chronic or active liver disease.
-Before starting therapy, appropriate nail specimens for laboratory testing (potassium hydroxide preparation, fungal culture, or nail biopsy) should be obtained to confirm the diagnosis of onychomycosis.
-Optimal clinical effect observed some months after mycological cure and completion of therapy; related to time required for outgrowth of healthy nail.

Use: For the treatment of onychomycosis of the fingernail or toenail due to dermatophytes (tinea unguium)

Usual Adult Dose for Tinea Capitis:

Oral granules: 250 mg orally once a day for 6 weeks

Comments:
-Before using this drug, patients should be evaluated for evidence of chronic or active liver disease.

Usual Adult Dose for Tinea Corporis:

Some experts recommend:
-Tablets: 250 mg orally once a day for 2 to 4 weeks

Usual Adult Dose for Tinea Cruris:

Some experts recommend:
-Tablets: 250 mg orally once a day for 2 to 4 weeks

Usual Adult Dose for Tinea Pedis:

Some experts recommend:
-Tablets: 250 mg orally once a day for 2 to 6 weeks

Usual Pediatric Dose for Tinea Capitis:

4 years or older:
Oral granules:
Less than 25 kg: 125 mg orally once a day
25 to 35 kg: 187.5 mg orally once a day
Greater than 35 kg: 250 mg orally once a day

Duration of therapy: 6 weeks

Comments:
-Before using this drug, patients should be evaluated for evidence of chronic or active liver disease.

For Children, Some Experts Recommend:
Tablets: 5 mg/kg/day orally

Based on weight:
10 to 20 kg: 62.5 mg orally once a day
21 to 40 kg: 125 mg orally once a day
41 kg or more: 250 mg orally once a day

Duration of therapy:
-Trichophyton tonsurans infection: 2 to 4 weeks
-Microsporum canis infection: Longer duration needed.

What other drugs will affect terbinafine?

Other drugs may interact with terbinafine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

See also: Side effects (in more detail)

Where can I get more information?

  • Your pharmacist can provide more information about terbinafine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 13.01.

Date modified: October 13, 2017
Last reviewed: July 12, 2017

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