Terbibest

Indications

Terbinafine is used to treat fungal infections of the skin and nails. Tablets are used for fungal nail infections and for ringworm of the scalp, body, groin or feet when a cream alone is not enough. The cream and spray are used for athlete's foot (fungus between the toes), jock itch (groin), ringworm of the body and pityriasis versicolor (pale or brown patches caused by a yeast).

How It Works

Terbinafine blocks an enzyme the fungus needs to build its cell membrane. Without it, the fungus cannot survive and the infection clears.

Dosage and Administration

Tablets, adults: usually 250 mg once a day, with or without food.

• Skin infections: usually 2 to 6 weeks.
• Fingernail infections: usually about 6 weeks.
• Toenail infections: usually about 12 weeks, sometimes longer, as prescribed.

Cream or spray: apply a thin layer to the clean, dry affected skin and a little around it once or twice a day, usually for 1 to 2 weeks, or as the doctor advises. Keep using it for the full time even if the skin looks better. Children: only as prescribed.

Interactions

Rifampicin can lower terbinafine levels and Cimetidine can raise them. Terbinafine tablets can raise the levels of some medicines, including certain antidepressants (such as Amitriptyline and Nortriptyline), Metoprolol, Flecainide, Propafenone and Dextromethorphan. They may also increase the effect of caffeine and lower Ciclosporin levels. Tell your doctor about all medicines you take.

Contraindications

• Allergy to terbinafine or any ingredient of the product.
• Tablets: active or long-term liver disease, or severe kidney problems.

Side Effects

Tablets: headache, upset stomach, diarrhoea, loss of appetite, rash, and change or loss of taste (which can last for weeks after stopping). Cream or spray: redness, itching or burning where it is applied.

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 (possible liver problem).
• A severe rash with blisters, peeling skin or fever.
• Fever, sore throat, frequent infections or unusual bruising or bleeding.
• Swelling of the face, lips or throat, or difficulty breathing.

Pregnancy and Lactation

Tablets are not recommended during pregnancy unless a doctor decides they are clearly needed, and should not be taken while breastfeeding because the medicine passes into breast milk. The cream may be used on small areas if a doctor advises; do not apply it to the breast.

Precautions and Warnings

Your doctor may check your liver with a blood test before and during tablet treatment. Tell the doctor if you have liver or kidney disease, psoriasis or lupus. Nails take several months to grow out and look normal after treatment. The cream and spray are for use on the skin only; keep them away from the eyes. Keep the affected skin clean and dry.

Overdose

Too many tablets may cause headache, nausea, upper belly pain and dizziness. Seek medical help.

Therapeutic Class

Antifungal (allylamine).

Storage

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