terbinafine

Generic Name: terbinafine (ter BIN na feen)Brand Names: Lamisil

What is terbinafine?

Terbinafine is an antifungal antibiotic.

Terbinafine is 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 other purposes not listed in this medication guide.

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

Before using terbinafine, tell your doctor if you have liver or kidney disease, or an autoimmune disorder such as lupus or psoriasis.

Take this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Terbinafine will not treat a viral infection such as the common cold or flu. 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, stomach pain, loss of appetite, itching, 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.

To be sure this medication is not causing harmful effects, your blood may need to be tested on a regular basis. Your liver function may also need to be tested. Do not miss any scheduled appointments.

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

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

You should not use this medication if you are allergic to terbinafine.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use this medication:

• liver disease;
• kidney disease; or

• an autoimmune disorder such as lupus or psoriasis.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. 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. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take terbinafine?

Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Take the terbinafine tablet with a full glass (8 ounces) of water.

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

The terbinafine granule mixture should be taken with a meal. Terbinafine is usually taken for 6 to 12 weeks. Take this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Terbinafine will not treat a viral infection such as the common cold or flu.

To be sure this medication is not causing harmful effects, your blood may need to be tested on a regular basis. Your liver function may also need to be tested. Do not miss any scheduled appointments.

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

Store terbinafine at room temperature away from moisture, heat, and light.

Keep the terbinafine oral granules in their sealed packet until you are ready to use.

See also: Terbinafine dosage in more detail

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medication.

Overdose symptoms may include dizziness, stomach pain, nausea, vomiting, skin rash, or urinating more than usual.

What should I avoid while taking terbinafine?

Follow your doctor's instructions about any restrictions on food, beverages, or activity while you are using terbinafine.

Terbinafine side effects

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

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, stomach pain, loss of appetite, itching, 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.

Stop taking terbinafine and call your doctor at once if you have a serious side effect such as:

• joint pain or swelling, swollen glands, patchy skin color, or a butterfly-shaped skin rash over your cheeks and nose;

• fever, chills, body aches, flu symptoms;

• changes in your vision;

• weight loss due to taste changes;

• scaly, itchy, and flaky skin rash; or

• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash.

Less serious side effects may include:

• stomach pain, heartburn, diarrhea;

• headache;

• tired feeling;

• runny or stuffy nose, sore throat, cold symptoms;

• mild skin rash or itching;

• unusual or unpleasant taste in your mouth; or

• decreased taste sensation.

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 Cutaneous Candidiasis:

Tablets: 250 mg orally once a day for 2 to 4 weeks.

Usual Adult Dose for Tinea Corporis:

Tablets: 250 mg orally once a day for 2 to 4 weeks.

Usual Adult Dose for Tinea Cruris:

Tablets: 250 mg orally once a day for 2 to 4 weeks.

Usual Adult Dose for Onychomycosis -- Fingernail:

Tablets: 250 mg orally once a day for 6 weeks.

Usual Adult Dose for Tinea Pedis:

Tablets: 250 mg orally once a day for 2 to 6 weeks.

Usual Adult Dose for Onychomycosis -- Toenail:

Tablets: 250 mg orally once a day for 12 weeks.

Usual Adult Dose for Tinea Capitis:

Tablets: 250 mg orally once a day. Therapy should be continued for 4 weeks, although, longer therapy maybe necessary to effectively treat tinea capitis caused by Microsporum species. The optimal clinical effect will generally not be observed for several weeks to months after mycological cure and completion of treatment.

Usual Pediatric Dose for Tinea Capitis:

Granules: Greater than or equal to 4 years: Give orally once a day with food for 6 weeks based upon body weight:Less than 25 kg: 125 mg25 to 35 kg: 187.5 mg Greater than 35 kg: 250 mg

What other drugs will affect terbinafine?

Before taking terbinafine, tell your doctor if you are taking any of the following medicines:

• cimetidine (Tagamet, Tagamet HB);

• rifampin (Rifadin, Rimactane);

• another antifungal antibiotic, such as fluconazole (Diflucan);

• a blood thinner such as warfarin (Coumadin);

• a heart rhythm medication such as propafenone (Rythmol) or flecainide (Tambocor);

• an "SSRI" antidepressant such as fluoxetine (Prozac), fluvoxamine (Luvox), or paroxetine (Paxil);

• a tricyclic antidepressant such as amitriptyline (Elavil, Etrafon), desipramine (Norpramin), imipramine (Janimine, Tofranil), and others;

• an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate); or

• a beta-blocker such as atenolol (Tenormin, Tenoretic), bisoprolol (Zebeta, Ziac), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), timolol (Blocadren), and others.

This list is not complete and there may be other drugs that can interact with terbinafine. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

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.
• 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 1996-2006 Cerner Multum, Inc. Version: 5.01. Revision Date: 06/01/2009 1:18:59 PM.