Trade names Lamisil, Terboderm, Triabin

Administration oral and topical.

Low-strength topical preparations available without prescription

Readily absorbed orally at 70–90%

Protein binding about 99%.

Metabolism is hepatic.

Biological half-life is highly variable.

It is highly hydrophobic and tends to accumulate in hair, skin, nails, and fatty tissue.

Mainly effective on the dermatophyte group of fungi.

As a 1% cream or powder, it is used topically for superficial skin infections such as tinea cruris, tinea pedis, and other types of tinea corporis.

Terbinafine cream works in about half the time required by other antifungals.

Oral 250-mg tablets are often prescribed for the treatment of onychomycosis, a fungal nail infection, typically by a dermatophyte or Candida species.

Fungal nail infections are located deep under the nail in the cuticle to which topically applied treatments are unable to penetrate in sufficient amounts.

May, rarely, cause hepatotoxicity.

May induce or exacerbate subacute cutaneous lupus erythematosus.

Terbinafine hydrochloride, antifungal granules can be sprinkled on a child’s food to treat ringworm of the scalp, tinea capitis.

Adverse events include:

Diarrhea, constipation, nausea, sickness, fullness, abdominal pain, indigestion, dyspepsia, gastritis, cholestasis, flatulence, altered stool color, abdominal muscular pain, elevated liver enzyme levels, hepatitis, liver damage, and liver failure.

Headaches, dizziness, vertigo, light-headedness, decreased concentration levels, and paresthesias.

Decreased white blood cell counts including pancytopenia, leukopenia, lymphopenia, thrombocytopenia, agranulocytosis, and neutropenia, autoimmune reactions such as lupus erythematosus.

Psychological problems include: Depression, anxiety, insomnia, increased or unusual dream activity, malaise.

Sensory problems include ageusia, decreased taste and distorted taste, often involving a metallic taste sensation, dry mouth, visual disturbances including blurred vision, green vision and double vision.

Skin problems include: Rashes, urticaria, skin irritation, pruritis, jaundice, Stevens–Johnson syndrome.

Other side effects: Fatigue, tachycardia, hair loss, anemia, muscle pain and joint pain.

Inhibits ergosterol synthesis by inhibiting squalene epoxidase, an enzyme that is part of the fungal cell membrane synthesis pathway, causing fungal cell lysis.

Prevents conversion of squalene to lanosterol

Ergosterol cannot be synthesized.

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