Terbinafine

Inhibition of squalene epoxidase, accumulation of fungicidally active squalene. Excretion: 71% renal, 22% faecal.

Infections with dermatophytes ( tinea capitis, tinea corporis, onychomycosis). Effective also for sporotrichosis ( off-label use). In 2 studies the efficiency in sporotrichosis could be shown. Also effective in mixed infections with Candida species (mycelial form) and scopularopsis.

Allergic reactions, rarely Quincke's edema and drug-induced Lyell syndrome, AGEP, disorders of the sense of taste, BB changes (neutropenia, thrombocytopenia), gastrointestinal disorders, arthralgias, myalgias, rarely liver cell damage up to fatal liver cell necrosis.

Deterioration of psoriasis.

Notice! Due to the side effects, systemic use in Sweden has been limited to therapy-resistant onychomycoses!

Topical: e.g. Lamisil Pedisan cream, DermGel and spray.

Systemic: e.g. Lamisil, Terbinafine

In Switzerland and Austria Terbinafine is approved for oral application in children, in Germany however not yet ( off-label use). A careful documentation and education of parents about the off-label use and the effect of Terbinafine in studies should be carried out. The dosage recommendation is: Children with 10-20 kg bw: 62.5 mg/day; 21-40 kg bw: 125 mg/day; > 40 kg bw: 250 mg/day. 2 weeks of therapy are normally sufficient.

In a randomized double-blind study it could be shown that a therapy with Terbinafine cream 1% over 7 days (once/day) is sufficient to cure a Tinea pedis interdigitalis.

1. Seebacher C et al (2006) Tinea capitis. J Dtsch Dermatol Ges 4: 1085-1091
2. Seebacher C et al (2007) Tinea of the free skin. J Dtsch Dermatol Ges 11: 921-926
3. Wilmer A et al (1998) Systemic terbinafine treatment of dermatophytoses in children. Mycoses 41: 54-57