Terbinafine tabs 250mg #14

Terbinafine user manual

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Composition

Terbinafine tablets contain the active substance terbinafine hydrochloride, as well as additional components: MCC, lactose monohydrate, potato starch, talc, impellose, aerosil, magnesium stearate.

Form of issue

There are several forms of this drug that are used externally, as well as tablets for oral administration:
    Tablets Terbinafine 250 mg, the package can be 7 or 10 tablets, white tablets, or a yellowish-white color, with a risk and facet;
    cream for outdoor use 1%, white, homogeneous has a characteristic aroma;
    ointment;
    spray.

pharmachologic effect

Terbinafine is a fungicidal, antifungal drug. It shows activity to almost all types of fungus, which can affect the human body. In a small concentration, it demonstrates a fungicidal effect on mold fungi, dermatophytes, some species of dimorphic fungi. On yeast fungi, both fungicidal and fungistatic effects are possible.
Its therapeutic effect is determined by the destructive effect on the membrane of fungal cells, and also due to the specific inhibition of squalene epoxidase (this is an enzyme important for the normal function of the fungal cell membrane).
Under the influence of terbinafine, the production of ergosterol is suspended, due to the lack of which the amount of squalene increases in the fungal cell. As a result, all enzyme systems are inactivated, and the cell dies.
The active component does not affect the cytochrome P450 system, therefore, does not affect the metabolism of hormones or other drugs.

Pharmacokinetics and pharmacodynamics

With oral administration of the drug, rapid absorption of the active substance from the digestive tract occurs. Partial metabolism occurs in the liver, as a result, its bioavailability decreases to 40%. Only slightly on the bioavailability of the medication is the intake of food, so there is no need to adjust the dose.
The highest concentration of the drug in the blood is observed 2 hours after the 250 mg tablet was taken. 99% of the active substance in the blood binds to plasma proteins.
Onycho- and epidermotropism of the drug is noted, that is, its greatest quantity (concentrations optimal for therapeutic effect) accumulates in hair, skin, nails, and also in the subcutaneous tissue.
In the organism terbinafine hydrochloride is biotransformed into metabolites, which do not show antifungal activity. Most of them are excreted in the urine. The half-life is 17 hours.
There is no cumulation of terbinafine on admission. Its effectiveness is the same for all patients, regardless of the age of the individual. In the presence of pathological changes in the liver and kidneys, the biotransformation of the drug may be slowed down. As a consequence, its concentration in biological fluids increases and the period of circulation of the drug in the blood increases.
When Terbinafine is applied locally, no more than 5% of the active ingredient enters the blood.

Indications for use

In the indications for the use of terbinafine, it is indicated that all forms of medication are used in diseases that were provoked by yeast-like, mold fungi, as well as dermatophytes.
The tablet agent is indicated for use in diseases of a fungal origin that are caused by dermatophytes of the genus Trichophyton (T. Mentagrophytes, T. verrucosum, T. Violaceum, T. Rubrum, T. tonsurans), Microsporum canis, Epidermophyton floccosum, and Candida fungi. Tablets are prescribed for trichophytosis, microsporia, onychomycosis, epidermophytosis, candidosis.
As a rule, terbinafine in tablets is prescribed for common and severe symptoms. In doing so, the treatment of multi-colored depriving tablets is ineffective.
For what the cream, ointment and spray, and whether these local remedies should be used, should be determined by a specialist.
As a rule, the cream should be used for fungal diseases provoked by Candida, Microsporum canis, Trichophyton, Pityriasis, Epidermophyton floccosum.
Also, ointment and cream are used for candidiasis, skin lesions, provoked by dermatophytes, multi-colored lichen.

Contraindications

Contraindicated use of drugs in the form of tablets in such diseases and conditions:
    liver disease in chronic or active form;
    renal failure in chronic form (CC less than 50 ml / min);
    the patient's age is up to three years and his weight is up to 20 kg;
    lactose intolerance, lack of lactase, glucosogalactose malabsorption;
    lactation;
    high sensitivity to the components of the remedy.
Caution Tablets Terbinafine should be given to people with chronic renal failure (with a glomerular filtration of more than 50 ml / min on the basis of a sample of Reberg), hematopoiesis, alcoholism, endocrine diseases, psoriasis, narrowing of the vessels of the extremities, tumors, systemic and cutaneous lupus erythematosus.
When taking terbinafine should be a clear control of the liver and kidneys. It is necessary to immediately cancel the pill Terbinafine or Terbinafine Teva if the following symptoms occur:
    abdominal pain;
    nausea;
    deterioration of appetite;
    jaundice;
    weakness;
    darkening of urine;
    light feces.
Forms of the drug for topical use should not be used with hypersensitivity and allergy.

Relative contraindications to the use of such drugs are:

    tumors;
    alcoholism;
    hepatic and renal insufficiency;
    endocrine diseases;
    narrowing of the lumen of blood vessels;
    violation of hematopoiesis;
    age of the patient is up to 12 years.

Side effects

When taking tablets, patients may experience such side effects:
    feeling of pain and weakness in the epigastric region;
    deterioration of appetite;
    cholestasis;
    a taste disorder;
    allergic reactions;
    nausea;
    diarrhea;
    a decrease in the level of platelets and neutrophils in the blood.
With local application of funds, itching, burning and hyperemia can occur in places where the product was applied. May develop allergic manifestations in rare cases.
Instructions for use of Terbinafine (Method and dosage)

Terbinafine tablets, instructions for use

The duration of taking the tablets should be determined by the doctor, given the severity of the disease. Children should take the remedy after a meal, you need to do it once a day. When determining the single dose of the drug, it is necessary to take into account the body weight of the child.
Children weighing less than 20 kg receive 62.5 mg of the drug, children weighing 20 to 40 kg 125 mg, children weighing 40 kg 250 mg
Adult patients receive 250 mg tablets Terbinafine Teva or Terbinafine once a day or twice a day for 125 mg.
The duration of treatment depends on the disease. With dermatomycosis stop taking pills should be from 2 to 6 weeks.
With candidiasis of the skin, dermatomycosis of the extremities, trunk, shins, treatment lasts from 2 to 4 weeks.
With infections of the scalp, treatment lasts 4 weeks.
With onychomycosis, effective treatment of the disease is possible if the drug is taken for 6 to 12 weeks. Sometimes, given a reduced rate of nail growth in a patient, treatment may be longer. The effect will be observed a few months after the completion of the course of treatment.

Overdose

If there is an overdose of terbinafine in the form of tablets, the patient may have a rash, nausea, headache, vomiting, dizziness, pain in the epigastric region, frequent urination. It is important to wash the stomach, also practice activated charcoal, symptomatic treatment.
There is no evidence of an overdose of the drug in the form of external agents. If you randomly ingest funds in the form of ointments or creams, you may experience nausea, headache, dizziness, epigastric pain. In this case, symptomatic treatment is carried out, the reception of activated carbon is shown.

Interaction

When Terbinafine is used, there may be an effect on the clearance of drugs in the metabolism of which the cytochrome P450 system participates. This is Tolbutamide, Ciclosporin, oral contraceptives.
Increases the concentration of H2-gistaminoblokatorov in blood plasma.
Slows the excretion of Rifampicin, in turn, Rifampicin doubles its clearance.
In women who use oral contraceptives, menstrual cycle disorders are possible.
Terfenadine inhibits the isoenzyme CYP2P6, which leads to an inhibition of the metabolism of tricyclic antidepressants, beta adrenoblockers, selective serotonin reuptake inhibitors, antiarrhythmic drugs, monoamine oxidase B type inhibitors, antipsychotic drugs.
Under the influence of terbinafine, the clearance of caffeine is reduced by 21%, while its half-life is increased by 31%.
Has no effect on the clearance of digoxin, phenazone, warfarin.
With the simultaneous administration with ethanol or with drugs that have a hepatotoxic effect, the likelihood of drug damage to the liver increases.

Terms of sale

Tablets are released on prescription, external means - without a prescription.

Storage conditions

Store Terbinafine at a temperature not higher than 25 degrees, in a place inaccessible to children.
Shelf life - 2 years.

special instructions

In the treatment of onychomycosis for six weeks, it is not necessary to remove the nail plates that were affected.
It is important to consider that with the occasional use of the drug and the premature termination of its use, a relapse of the disease may occur.
The duration of treatment with terbinafine can be affected by the presence of other diseases in the patient.
Systemic use of the drug in patients with onychomycosis is advisable only with the total defeat of most nails, with subungual hyperkeratosis, and also with no effect after local treatment.
People with liver disease can be lowered terbinafine clearance.
In the process of treatment should monitor the activity of hepatic transaminases in the blood.
There may be hepatitis and cholestasis three months after the start of treatment, but this happens only in rare cases. If a patient shows signs of liver function abnormalities, the medicine is canceled.
Carefully prescribe the drug to patients suffering from psoriasis, since the medicine can provoke an aggravation of this disease.
It is necessary to carefully observe all the rules of personal hygiene in the treatment process to prevent re-infection. After the treatment is completed and in its process (two weeks after the start), it is necessary to practice antifungal treatment of socks, stockings, shoes.
Irritation can provoke a cream or Ointment Terbinafine, so you should not allow these substances to come into your eyes. If the product has got into eyes, rinse immediately with clean water. If irritation symptoms persist, consult a physician.
In case of allergic reactions, the medicine is canceled.

Children

The drug in tablets is not prescribed for children under 3 years of age, whose weight is less than 20 kg. When using tablets, you must strictly adhere to the dosage.
Local forms of the remedy can be used to treat children after 12 years.

In pregnancy and lactation

During the study, no teratogenic properties of the active substance were found. You can use terbinafine in pregnancy if the intended benefit is greater than the likely risk to the fetus. Since the active ingredient is excreted with milk, lactation for the period of treatment should be discontinued.

Reviews of Terbinafine

Both reviews about Terbinafine in tablets, and reviews about cream and ointments on the network appear in most cases positive. Patients write about the rapid effect after the start of taking tablets Terbinafine, Terbinafine Teva. With their help it was possible to get rid of fungal diseases, to restore the structure of the nails.
Those who used the ointment Terbinafine, the reviews also leave positive, noting that the drug is inexpensive, but it allows a few weeks to completely cure fungal diseases, get rid of diaper rash. However, side effects are very rare.