Lomitin

Indications

Terbinafine is an antifungal medicine. It is used for:

• Fungal nail infections (tablets)
• Ringworm of the body, groin (jock itch), feet (athlete's foot) and scalp, when creams are not enough (tablets)
• Fungal skin infections, as a cream, gel or spray
• Pityriasis versicolor and some yeast skin infections (cream)

How It Works

It blocks an enzyme the fungus needs to make its cell membrane. Harmful substances build up inside the fungus and it dies.

Dosage and Administration

Tablets, adults: 250 mg once a day. Usual length: skin infections 2 to 6 weeks; fingernails about 6 weeks; toenails about 12 weeks or longer. Nails may take months to look normal after treatment ends, as healthy nail grows out. Children: as prescribed.

Cream (1%): apply a thin layer to clean, dry skin once or twice a day, usually for 1 to 2 weeks, or as directed on the pack.

Interactions

• Rifampicin lowers Terbinafine levels; Cimetidine and Fluconazole can raise them.
• Terbinafine can raise levels of some medicines, such as Amitriptyline and other tricyclic antidepressants, Metoprolol, Propafenone and Dextromethorphan.
• Ciclosporin levels may fall.
• Warfarin: the doctor may check the INR (clotting test).
• Creams have no important interactions.

Contraindications

• Allergy to Terbinafine
• Tablets: long-term or active liver disease, or severe kidney impairment

Side Effects

Tablets, common: stomach upset, loss of appetite, diarrhoea, headache, rash, joint or muscle pain, and loss or change of taste (usually returns after stopping). Cream: mild redness, itching or burning.

Get urgent medical help if you have:

• Yellow skin or eyes, dark urine, pale stools, ongoing nausea, unusual tiredness or pain in the upper right belly (liver problems)
• Blistering, peeling skin, or a rash with fever
• Sore throat, fever, mouth ulcers or unusual bleeding (low blood counts)
• Swelling of the face, lips or throat, or difficulty breathing

Pregnancy and Lactation

Tablets should not be used in pregnancy unless the doctor considers them essential, and are best avoided while breastfeeding because they pass into milk. The cream can be used on a doctor's advice, but not on the breast area while breastfeeding.

Precautions and Warnings

• A liver blood test is often done before starting tablets.
• Tell the doctor about liver or kidney disease, psoriasis or lupus.
• Cream: avoid the eyes, mouth and broken skin.
• Keep skin and feet clean and dry, and do not share towels or footwear.

Overdose

Too many tablets can cause headache, nausea, stomach pain and dizziness. Contact a doctor or hospital.

Therapeutic Class

Antifungal (allylamine type).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.