Terbinafine solution. Terbinafine analogs are effective and safe drugs for fungus. Auxiliary substances in the composition for the cream

Fungal infections are not only unpleasant, but also a contagious disease. It is quite easily transmitted from animal to person and from person to person.

Today, there are many different drugs that effectively fight fungal infections. One of the most popular of them is the drug "Terbinafine". Analogues of this tool, as well as its release forms, properties and methods of application will be presented below.

Release form, description, packaging, composition

In what form is the antifungal drug "Terbinafine" produced? Cream is far from the only form of this remedy. But it is she who is especially popular with patients.

1% cream "Terbinafine" from nail fungus for external use has a white color, a uniform texture and a slight characteristic odor.

The active ingredient in this drug is terbinafine hydrochloride. Also, cetyl palmitate, sorbitan monostearate, polysorbate 60, isopropyl myristate, purified water and sodium hydroxide are used as auxiliary substances to create the said agent.

In what package is an antifungal agent like Terbinafine sold? The cream goes on sale in aluminum tubes (30.15 g), as well as in orange glass jars.

In addition to the specified form, the mentioned drug is available in the form of a spray, ointment, tablets and solution.

Characteristics of the external agent

Mechanism of action

How does Terbinafine work? The cream specifically changes the early stage of the biological synthesis of sterols, which occurs in mushrooms. Ultimately, this leads to a lack of ergosterol, as well as the accumulation of squalene inside the cells, which contributes to their death.

The mechanism of action of "Terbinafine" is explained by the inhibition of the enzyme squalene epoxidase, located on the cell membrane of the fungus.

It should also be said that the mentioned agent does not affect the cytochrome P 450 system in any way, as well as the metabolism of hormones and other drugs.

Kinetic features

Is the antifungal drug Terbinafine absorbed? The cream, when used topically, is absorbed by 5%. Therefore, this drug is able to have only a slight systemic effect.

Indications

For what purposes can a drug such as Terbinafine be used? Cream, the price of which is indicated below, is prescribed in the following cases:

for the prevention and treatment of fungal infections of smooth skin, fungal infections of the skin, fungus, as well as foot mycoses provoked by dermatophytes;
for the treatment of multi-colored lichen;
for the treatment of yeast infections of the skin, which were caused by fungi of the genus Candida, including diaper rash.

Contraindications

In what cases can not use the drug "Terbinafine"? The cream, the price of which is not very high, should not be used in the presence of hypersensitivity to terbinafine or to any of the auxiliary ingredients that make up the drug.

With caution, the mentioned medication is prescribed for occlusive diseases of the vessels of the legs, oppression of bone marrow hematopoiesis, liver and kidney failure, metabolic diseases, alcoholism, tumors, and in children under 12 years of age.

How is the antifungal agent "Terbinafine" (cream) used?

Reviews of experts report that this drug is intended exclusively for external application. It can only be used by adult patients and adolescents from 12 years of age.

Before applying the drug, it is required to clean and then dry the affected areas. The medication is used once or twice a day. It is applied in a thin layer to the affected areas of the skin, as well as to adjacent areas.

After lightly rubbing the cream, it is left in this form without washing off.

For infections that are accompanied by diaper rash, it is allowed to cover the place of application of the drug with gauze (for the night).

In the presence of extensive fungal infections of the body, the drug is recommended to be used in tubes of 30 g.

The duration of therapy with this remedy depends on the type of fungal disease. With ringworm of the trunk, feet and legs, treatment is carried out for a week, using the cream once a day. With and multi-colored lichen, the drug is recommended to be used for two weeks, lubricating the affected areas with it twice a day.

As a rule, a decrease in the severity of clinical signs of fungal infections is noted in the first days of therapy. With irregular use of the drug or premature termination of the treatment process, there is a risk of re-development of the infection.

If no signs of improvement are observed after 2 weeks after the start of therapy, it is necessary to verify the diagnosis.

The dosage of the drug in elderly patients does not differ from the above.

How to use the spray "Terbinafine"

Spray "Terbinafine" is used by patients as often as the cream. Usually this form of the drug is prescribed for the treatment of fungal diseases of the nails, skin and hair.

Before using the medication, the skin is pre-washed and dried. Next, Terbinafine is applied to the affected area. The spray is sprayed in such a way that it captures a little of the healthy part of the skin.

The duration of therapy with this agent and the frequency of its use depend on the localization of the fungus.

Overdose of an antifungal drug

No cases of Terbinafine overdose have been reported to date. If it was accidentally taken orally, then side effects such as headache, epigastric pain, nausea and dizziness can be expected.

To eliminate such symptoms, the victim is given sorbents, and if necessary, supportive therapy is carried out.

A decrease in the severity of symptoms of a fungal disease is noted on the first day of treatment. With irregular use of the cream or premature termination of therapy, there is a high risk of recurrence of the infection.

The drug "Terbinafine" is intended only for external application. Avoid contact with eyes and other mucous membranes, otherwise it can cause severe irritation.

With the development of allergies, you should immediately stop using the cream.

Price and analogues of an antifungal agent

The price of Terbinafina cream is about 130-160 rubles (per 15 g tube). Other forms of release of the drug may have a higher cost.

What can replace the drug "Terbinafine"? Analogues of this remedy are sold in all pharmacies. These include the following: "Atifin", "Bramisil", "Binafin", "Lamisil", "Lamitel", "Lamikan", "Mikonorm", "Onychon", "Mikoterbin", "Tebikur", "Terbiks", " Terbizil", "Fungoterbin".

Terbinafine is a modern antifungal drug that is used to treat a variety of mycotic lesions of the skin, mucous membranes, and skin appendages (hair and nails). This drug is an allylamine derivative and, therefore, has a negative effect on fungi as a result of blocking the work of special enzymes that synthesize biological molecules that make up cell membranes, followed by the destruction of pathogenic fungal cells and the death of the microorganism. Terbinafine has a wide spectrum of antifungal activity and is effective against dermatophytes (Trichophyton, Epidermophyton floccosum and Microsporum canis), molds (Aspergillus, Scopulariopsis brevicaulis and Cladosporium), yeast fungi (Candida albicans) and some types of dimorphic fungi.

Terbinafine application

This drug is available in a variety of dosage forms - ointments, creams, sprays, tablets and solutions for external use for fungal infections of the nails (onychomycosis), mycoses of the scalp (trichophytosis, microsporia), extensive and severe fungal infections of the skin of the trunk and extremities (dermatomycosis ) and with candidiasis of the skin or mucous membranes.

Terbinafine ointment

Terbinafine in the form of an ointment and cream (Terbinafine - MMF) is a white homogeneous mass with a specific odor with an active substance concentration of 1% in tubes of 15 and 30 grams (cream) and a volume of 10 and 15 grams (ointment). These forms are used only externally for the treatment of mycoses of the feet, inguinal region (epidermophytosis), torso and limbs of the legs or arms, skin candidiasis and mucous diaper rash of fungal origin, as well as for the treatment of multi-colored lichen. Both of these forms are used in adults, adolescents and children over 12 years of age.

Ointment or cream is applied to the affected areas of the skin, previously washed with warm water and dried. The drug is applied in a thin layer, with light massaging movements, slightly capturing intact skin, as a rule, once a day (preferably at night), for severe and recurrent mycoses, the ointment is used twice a day. When applied in the area of the gluteal and inguinal folds, interdigital spaces, skin under the breast, it is necessary to cover the treated area with gauze.

Application of Terbinafine ointment

The frequency and duration of treatment with Terbinafine cream or ointment depends on the localization of the process and the severity of the course of the disease:

with ringworm of the feet, the course of treatment is six to seven days;
with mycosis of the skin of the trunk and calves of the legs - no more than a week;
with candidal lesions of the skin - the course of treatment is from one to two weeks;
in the treatment of multi-colored lichen - up to two weeks once or twice a day.

The appointment of this drug is carried out by the attending physician - a dermatologist, after examination, conducting mycotic studies and clarifying the diagnosis. Self-medication in this case can lead to the formation of resistant forms of fungi and the ineffectiveness of therapy in the future, as well as the transition of the pathological process into a chronic form or generalization of the disease.

Absolute contraindications for the appointment of Terbinafine are individual intolerance to the active active ingredient or excipients of the ointment or cream.

Terbinafine ointment: contraindications

Relative contraindications are:

children under twelve;
kidney or liver failure;
oncological diseases;
pathology of vessels with obstruction or narrowing of their lumen;
endocrine diseases;
alcoholism;
diseases with impaired hematopoiesis;
pregnancy and lactation.

Terbinafine tablets

Terbinafine in the form of tablets is used for the systemic treatment of fungal diseases in the presence of extensive mycotic foci.

Terbinafine tablets: indications for use

Indications for the use of Terbinafine tablets inside are fungal diseases:

onychomycosis (nail fungus);
trichophytosis and microsporia (extensive lesions of the scalp of fungal origin);
severe fungal infections of the skin of the limbs and trunk - dermatomycosis;
generalized and diffuse candidiasis of the skin and / or mucous membranes.

Contraindications

Contraindications to the appointment of Terbinafine tablets are:

acute and chronic liver diseases with a significant change in functions;
chronic renal failure with damage to the glomerular apparatus;
children under three years of age;
lactose intolerance;
body weight less than 20 kg;
lactation period;
glucose-galactose malabsorption;
allergy to the components of the drug.
pregnancy.

With caution, this drug is used:

with endocrine diseases;
collagenosis and systemic vasculitis;
alcoholism;
oncological diseases and benign tumors;
diseases of the hematopoietic system;
psoriasis;
pathology of vessels with obstruction or narrowing of their lumen.

Side effects

Adverse reactions when using Terbinafine tablets are:

allergic reactions from skin rash, itching, urticaria, angioedema to Steven-Jones syndrome;
nausea;
diarrhea;
dyspeptic disorders;
abdominal spastic pains;
persistent loss of appetite;
jaundice, with dark urine and discoloration of the feces;
weakness and malaise;
pain in joints and muscles.

Features of the use of this drug are long-term use, depending on the severity and localization of the process, previous treatment and concomitant somatic pathologies.

With extreme caution, Terbinafine tablets are prescribed to elderly patients and children.

Instructions for use of Terbinafine tablets

The calculation of a single dose is carried out depending on age and body weight:

For adults, adolescents and children weighing more than 40 kilograms, this drug is prescribed 1 tablet (250 mg) after meals once a day after meals.

Patients with functional lesions of the kidneys or liver Terbinafine begin with a half dose - 125 mg per day with constant dynamic supervision of the attending physician and under the control of laboratory tests (liver transaminases (AST and ALT), creatinine and blood urea). With a deterioration in laboratory parameters or the presence of pathological symptoms - jaundice, dark urine or discoloration of feces, heaviness in the right hypochondrium or abdominal pain - the drug is canceled.

A single therapeutic dose in pediatric dermatology for common fungal diseases is calculated in accordance with body weight - with a child weighing from 20 to 40 kilograms, 125 milligrams (1/2 tablet) of Terbinafine is prescribed once a day. Terbinafine is not used to treat mycoses in children under 3 years of age or weighing less than 20 kilograms.

The duration of the course administration of Terbinafine depends on the severity of the disease, localization and extent of the pathological process.

The average terms of course therapy depending on the localization of the process:

mycosis of nails (onychomycosis) - from six to twelve weeks;
mycosis of the feet according to the type of "socks" with the localization of the plantar surface and between the fingers - from two to six weeks;
mycosis of the calves of the legs - from two to four weeks;
mycosis of the body - from two to four weeks;
candidiasis - from two to four weeks;
mycoses of the scalp (trichophytosis and microsporia) - from four weeks or more.

Overdose

Terbinafine overdose symptoms are:

headache;
dizziness;
frequent urination
vomit;
rash and itching of the skin;
pain syndrome (spastic pain in the stomach).

Interaction with other drugs

The use of Terbinafine while taking it with other drugs is contraindicated:

with tricyclic antidepressants and SSRIs;
with antiarrhythmic drugs (flecainide and propafenone);
with beta-blockers - (propanolol and metaprolol);
with antipsychotic drugs - chlorpromazine and haloperidol.

Dose reduction of Terbinafine is indicated when this medicinal product is co-administered with rifampicin and cimetidine.

Long-term use of oral contraceptives and Terbinafine can cause dyshormonal disorders and menstrual disorders.

Terbinafine solution and spray

Terbinafine in the form of a spray and solution is used only externally for the treatment of extensive fungal infections of the skin and for the treatment of pityriasis versicolor. The main indications for the use of these dosage forms of Terbinafine are fungal infection of the feet, inguinal region, fungal infections of the skin of the trunk and extremities, and versicolor versicolor.

Terbinafine in the form of a spray and solution is quite effective in persistent onychomycosis (nail fungus) and, according to statistics, onychomycosis of the hands is completely cured in 95% of cases, and onychomycosis of the feet - 90%.

The effectiveness of therapy in the treatment of mycoses localized on the smooth skin of the trunk and extremities is completely cured in 75-95% of cases.

These dosage forms are used in adults, adolescents and children over twelve years of age.

The duration of treatment is determined by the attending physician under mycotic control. With self-treatment or self-cancellation of the drug, the transformation of the disease into recurrent and chronic forms often occurs due to the resistance of pathogens of the infectious and inflammatory process.

Due to the fact that the solution and spray are treated topically by applying to large areas of the affected skin, adverse reactions may occur in the form of urticaria, swelling of the skin and aggravation of itching. Therefore, in the presence of hypersensitivity to the active active substance of the drug and its auxiliary components (ethyl alcohol, macrogol or propylene glycol), the use of this drug is contraindicated.

The use of Terbinafine during lactation and pregnancy

With great care, it is necessary to use this drug when breastfeeding a child, due to its possible absorption into the systemic circulation and the development of adverse reactions in the baby - intestinal dysbiosis, anxiety, allergic reactions, impaired kidney and liver function (development of jaundice). In this case, if a course of treatment with Terbinafine is necessary, the feeding of the child is temporarily stopped with the preservation of lactation, and the baby is transferred to artificial feeding. At the end of the course of treatment, feeding the baby is resumed.

Pregnancy is a relative contraindication for the use of any drug. Therapy with antibiotics and antifungal drugs is used in pregnant women only in connection with extreme necessity (especially in tablets), provided that the potential benefit to the mother significantly outweighs the possible harm to the fetus. Any drug can adversely affect the fetus, causing fetopathy and a teratogenic effect with the formation of malformations, even when using local forms of the drug, which can be absorbed into the systemic circulation through damaged skin and accumulate in the body of a pregnant woman. In the pathological course of pregnancy, disrupt

kidney and liver function, therefore the use of this drug is contraindicated.

Terbinafine price

The cost of Terbinafine in the pharmacy network depends on the dosage form and the manufacturer's company and is:

Terbinafine cream - from 61 to 75 rubles;
tablets 250 mg No. 10 - from 217 to 298 rubles.

Terbinafine reviews

Terbinafine is an effective antifungal drug for the treatment of mycoses of various types and localizations with a long course of treatment. It is available in various dosage forms - spray, solution, tablets, cream and ointment and is used for extensive fungal infections of the skin and mucous membranes.

Terbinafine is an antifungal drug for systemic and topical use.

Release form and composition

Terbinafine is produced in the following dosage forms:

Cream for external use 1%: homogeneous, white, with a characteristic low odor (10, 15, 30 g each in aluminum or polymer tubes, 1 tube in a carton pack; 30 g each in dark glass jars, 1 jar in a cardboard pack);
Spray for external use 1%: clear, colorless or light yellow liquid with a characteristic odor of ethanol; slight opalescence is allowed (10 or 20 g in vials with a microspray, 1 vial in a cardboard box);
Tablets: white with a yellowish tinge or white, with a risk and a bevel (0.25 g: 7, 10 pieces in blister packs, 1-4, 5, 10 packs in a carton box; 0.125 g: 7, 10 each pcs in blister packs, 1-4 packs in a carton pack, 14, 28, 50, 100 pcs in polymer cans, 1 can in a carton pack).

The composition of 1 g of cream for external use includes:

Auxiliary components: benzyl alcohol, tween 60 (polysorbate 6), sorbitan monostearate, cetyl alcohol, cetyl palmitate, sodium hydroxide, isopropyl myristate, purified water.

The composition of 1 g of spray for external use includes:

Active substance: terbinafine - 0.01 g (in the form of hydrochloride);
Auxiliary components: macrogol 400, povidone K17, propylene glycol, 95% ethanol, macrogol glyceryl hydroxystearate, purified water.

The composition of 1 tablet includes the active substance: terbinafine - 0.125 or 0.25 g (in the form of hydrochloride).

Auxiliary components of tablets:

0.125 g: Primellose, hydroxypropyl cellulose, microcrystalline cellulose, silicon dioxide, calcium stearate;
0.25 g: microcrystalline cellulose, hydroxypropyl cellulose (hyprolose), croscarmellose sodium, colloidal silicon dioxide, calcium stearate, lactose monohydrate.

Indications for use

Terbinafine in the form of tablets is prescribed for the treatment of the following diseases:

Fungal lesions of the skin and nails (onychomycosis) caused by Epidermophyton floccosum, Microsporum spp. (M. gypseum, M. canis) and Trychophyton spp. (T. mentagrophytes, T. rubrum, T. tonsurans, T. verrucosum, T. violacium);
Candidiasis of the mucous membranes and skin;
Severe, widespread dermatomycosis of the smooth skin of the trunk and extremities that require systemic treatment;
Mycoses of the scalp (microsporia, trichophytosis).

Outwardly Terbinafine is used in the presence of the following indications:

Fungal infections of the skin, including mycoses of the feet ("fungus" of the foot), inguinal epidermophytosis (tinea cruris), fungal lesions of the smooth skin of the body (tinea corporis), caused by dermatophytes such as Trichophyton (including T. mentagrophytes, T. rubrum , T.violaceum, T. verrucosum), Epidermophyton floccosum and Microsporum canis (treatment and prevention);
Pityriasis versicolor caused by Pityrosporum orbiculare (also known as Malassezia furfur);
Yeast infections of the skin, mainly caused by the genus Candida, in particular diaper rash.

Contraindications

All forms of release of the drug are contraindicated in the presence of hypersensitivity to their components.

Additional contraindications to the use of Terbinafine in the form of tablets are the following diseases/conditions:

Liver disease (active or chronic);
Chronic renal failure (creatinine clearance less than 50 ml per minute);
Lactose intolerance, lactase deficiency, glucose-galactose malabsorption;
Children's age up to 3 years and body weight up to 20 kg;
Pregnancy and lactation.

Terbinafine cream is not prescribed to children under 12 years of age (due to the lack of sufficient data on the efficacy and safety of its use for this age group).

Alcoholism;
Hepatic and / or renal insufficiency (creatinine clearance greater than 50 ml per minute);
Occlusive diseases of the vessels of the extremities;
Inhibition of bone marrow hematopoiesis;
Metabolic diseases;
tumors;
Cutaneous lupus erythematosus or systemic lupus erythematosus.

Method of application and dosage

Terbinafine tablets are taken orally after meals.

The usual daily dose is:

Adults and children over 3 years old weighing more than 40 kg: 0.25 g;
Children from 3 years old weighing less than 40 kg: 0.125 g.

The frequency of taking Terbinafine is 1 time per day.

The duration of the therapeutic course is determined individually based on the severity of the disease and the localization of the process:

Onychomycosis: 6-12 weeks (some patients with reduced nail growth may require longer treatment);
Interdigital, toe-like, or plantar localization of infection: 2-6 weeks;
Mycoses of other parts of the body (legs and trunk), as well as mycoses caused by fungi of the genus Candida: 2-4 weeks;
Mycosis of the scalp caused by fungi of the genus Microsporum: longer than 4 weeks (if infected with Microsporum canis, longer therapy may be required).

For elderly patients, Terbinafine is prescribed without dose adjustment, for patients with renal or hepatic insufficiency, the dosage should be reduced by 2 times (0.125 g).

Terbinafine in the form of an ointment and spray is applied externally 1-2 times a day. Before applying the drug, the affected areas must be cleaned and dried.

The cream should be applied to the affected skin and adjacent areas in a thin layer and rubbed in lightly. In infections that are accompanied by diaper rash (in the interdigital spaces, inguinal region, between the buttocks, under the mammary glands), the application sites of Terbinafine, especially at night, can be covered with gauze.

The average duration of treatment and the frequency of use of the drug are:

Dermatomycosis of the feet, legs and trunk - 1 time per day for 1 week;
Skin candidiasis - 1-2 times a day for 1-2 weeks;
Multicolored deprive - 2 times a day for 2 weeks.

As a rule, a decrease in the severity of clinical manifestations is noted in the first days of treatment. With irregular use or premature termination of therapy, there is a risk of recurrence of the infection. If improvement does not occur after 1-2 weeks of treatment, it is necessary to verify the diagnosis.

Side effects

When Terbinafine is used orally, it is possible to develop disorders from some body systems that manifest themselves with different frequencies (more than 1/10 - very often; more than 1/100 and less than 1/10 - often; more than 1/1000 and less than 1/100 - infrequently; more than 1/10000 and less than 1/1000 - rare; less than 1/10000, including isolated cases - very rare):

Digestive system: very often - diarrhea, abdominal pain, feeling of stomach fullness, dyspepsia, loss of appetite, nausea; rarely - impaired liver function; very rarely - liver failure, up to death;
Nervous system: often - headache; infrequently - a violation of taste, including ageusia;
Musculoskeletal system: very often - myalgia, arthralgia;
Skin: very often - skin reactions (including rash and urticaria); very rarely - toxic epidermal necrolysis, Stevens-Johnson syndrome, exacerbation of existing psoriasis, psoriasis-like rash, alopecia;
Hematopoietic organs: very rarely - agranulocytosis, neutropenia, pancytopenia, thrombocytopenia;
Allergic reactions: very rarely - anaphylactoid reactions (including angioedema);
Other: very rarely - fatigue; cutaneous lupus erythematosus, systemic lupus erythematosus or their exacerbation.

Itching, redness or burning may occur at the sites of application of Terbinafine in the form of a cream. It is also possible to develop allergic reactions.

special instructions

If after 2 weeks of using the drug there is no improvement in the condition, it is recommended to re-determine the pathogen and its sensitivity to the action of Terbinafine.

The duration of treatment may be influenced by the presence of concomitant diseases, and in case of onychomycosis, the condition of the nails at the beginning of the course of treatment.

The risk of relapse increases with irregular use of Terbinafine or early termination of treatment.

Systemic use of Terbinafine in onychomycosis is justified only in cases of severe subungual hyperkeratosis, total damage to most nails, and ineffectiveness of previous local treatment.

In the presence of liver disease, the clearance of Terbinafine may be reduced. During therapy, it is necessary to monitor the activity of hepatic transaminases in the blood serum.

In rare cases, hepatitis and cholestasis occur after 3 months of taking Terbinafine. With the development of signs of functional disorders of the liver (decreased appetite, weakness, persistent nausea, jaundice, excessive abdominal pain, discolored stools or dark urine), the drug should be discontinued. When prescribing a remedy for patients with psoriasis, it must be borne in mind that therapy can lead to an exacerbation of the disease.

To prevent re-infection through shoes and underwear during treatment, general hygiene rules must be observed. During therapy (after 14 days) and after its completion, antifungal treatment of stockings, socks and shoes should be performed.

Terbinafine cream is for external use only. Avoid contact with eyes as it may cause irritation. In case of accidental contact of the drug with the eyes, they should immediately be rinsed with running water, and with the development of persistent irritation phenomena, you should consult a doctor. If allergic reactions occur, the drug must be discontinued.

drug interaction

Terbinafine in the form of tablets inhibits the CYP2D6 isoenzyme and can disrupt the metabolism of drugs such as antiarrhythmic drugs (propafenone, flecainide), tricyclic antidepressants and selective serotonin reuptake inhibitors (fluvoxamine, desipramine), beta-blockers (propranolol, metoprolol), antipsychotic drugs (haloperidol , chlorpromazine) and monoamine oxidase B inhibitors (selegiline).

Drugs that induce cytochrome P450 isoenzymes (for example, rifampicin) can accelerate the metabolism and excretion of Terbinafine from the body, and inhibitors of cytochrome P450 isoenzymes (for example, cimetidine) can slow down. Simultaneous use with these drugs may require dose adjustment of Terbinafine.

When combined with ethanol or drugs with a hepatotoxic effect, the risk of developing drug-induced liver damage increases.

With the simultaneous administration of Terbinafine with oral contraceptives, menstrual irregularities are possible.

Terms and conditions of storage

Store in a dark, dry place out of the reach of children.

Best before date:

Tablets - 3 years at temperatures up to 25 ° C;
Cream for external use - 2 years at temperatures up to 25 ° C;
Spray for external use - 2 years at a temperature of 2-20 ° C.

Terbinafine ® is one of the allylamines - antifungal synthetic drugs, a wide spectrum of action which allows them to be used to treat fungal infections of the nails, skin and hair caused by fungi and dermatophytes (a special group of filamentous fungi).

Even low concentrations of the drug can completely destroy almost all types of dermatophytes (dermatomycetes) and mold fungi and some types of dimorphic, yeast-like (most often represented by Candida albicans) and yeast fungi.

The effect of the drug on yeast fungi can be both fungistatic (slowing down their growth) and fungicidal (completely destroying them): it depends on the type of microorganisms being destroyed.

Pharmacological group

The drug belongs to synthetic antifungal agents.

Composition of terbinafine ®

The active ingredient of the drug is terbinafine hydrochloride. In addition to it, a number of auxiliary ingredients are added to terbinafine ® tablets:

magnesium stearate;
microcrystalline cellulose (MCC), which enhances the action of the active ingredient;
croscarmellose sodium;
magnesium stearate;
lactose monohydrate;
silicon dioxide (aerosil);
potato starch;
medical talc.

The active ingredient of the cream is the same terbinafine hydrochloride. Additional components of the chemical composition are presented:

triethanolamine (TEA);
benzyl alcohol;
vaseline;
glycerol (distilled);
octadecanoic acid;
emulsifier;
purified water.

The chemical formula of terbinafine ointment - in addition to the active substance - includes a composition of excipients, consisting of:

purified water;
para-hydroxybenzoic acid methyl ester (referred to as preservative E218);
sodium hydroxide;
vaseline oil;
propylene glycol;
carbopol - a thickener that gives the drug the necessary viscosity;
sodium hydroxide.

The chemical composition of the drug, produced in the form of a spray, along with the active ingredient contains a combination of additional substances, consisting of:

ethyl alcohol;
polyethylene glycol (macrogol 400);
propylene glycol;
water.

Release form of terbinafine ®

The drug has several dosage forms intended for both external and internal use. It is produced in the form:

What does terbinafine ® ointment help with?

This dosage form of the drug is used to treat:

Mycoses affecting the scalp (for example, trichophytosis and microsporia, better known as "ringworm").
Mycotic diseases of the feet (colloquially referred to as "foot fungus").
Epidermophytosis - a fungal infection that affects the epidermis of the smooth skin of the body, feet and hands (with epidermophytosis of the feet, the pathology sometimes extends to the nail plates).
Onychomycosis is a fungal nail infection.
Candidiasis of the mucous membranes and skin, caused by fungi of the genus Candida.
Multi-colored (pityriasis) lichen, caused by one of the three (mycelial, round or oval) forms of a yeast-like fungus.

Indications for use of terbinafine ®

The tablet form of the drug has proven its effectiveness in therapy:

trichophytosis;
onychomycosis;
microsporia;
epidermophytosis;
candidiasis.

The culprits of the above types of fungal infection are dermatophytes, yeast-like and mold fungi. The signal to start taking terbinafine tablets is a high degree of severity and rapid spread of clinical manifestations of the pathology.

It has been established that the use of tablets for the treatment of patients with pityriasis versicolor practically does not bring results.

Contraindications

The use of terbinafine ® in tablet form is absolutely contraindicated for nursing mothers and patients:

suffering from acute or chronic liver diseases;
having hypersensitivity to individual components of its chemical composition;
with a chronic form of renal failure (in which creatinine clearance is less than 50 ml / min);
under the age of three;
having a body weight not exceeding twenty kilograms;
suffering from lactose intolerance;
with glucose-galactose malabsorption;
with congenital lactase deficiency.

Special care when prescribing Terbinafine ® tablets is required in relation to patients suffering from:

alcoholism;
chronic violation of the kidneys (confirmed by the Reberg-Tareev test);
diseases of the endocrine system;
insufficiency of hematopoiesis;
lupus erythematosus (cutaneous and systemic);
all kinds of tumors;
narrowing of the blood vessels localized in the extremities.

Taking tablets should be accompanied by strict monitoring of the condition of the kidneys and liver. The reason for their cancellation is the appearance of:

abdominal pain;
nausea;
decreased appetite;
increased weakness;
yellowness of the skin;
clarification of feces;
dark urine.

Dosage forms of the drug (spray, cream, ointment and solution) intended for external use should not be used by patients who are highly sensitive to its components or allergic to it.

A relative contraindication to the use of the above forms is the young (up to twelve years) age of the patient and the presence of:

endocrine diseases;
hematopoietic disorders;
tumors;
problems in the functioning of the kidneys and liver;
alcoholism;
narrowing in the lumen of blood vessels.

Dosage of terbinafine ®

The duration of the course of treatment, which involves the use of tablets, is determined by the attending specialist, depending on the severity of the disease. When calculating a single dosage of the drug intended for the treatment of a child, it is required to take into account the weight of his body.

Daily dose of terbinafine ® for children:

weighing less than twenty kilograms, is 62.5 mg:
whose weight ranges from 20-40 kg, equal to 125 mg;
with a weight exceeding forty kilograms, is 250 mg.

The medicine is given to children after meals, once a day.

The daily dose of terbinafine MFF (tablets) for adult patients is 250 mg. They may take it in one or two doses.

Duration of the course of treatment:

Ringworm of the feet ranges from 14 days to 6 weeks.
Onychomycosis can take 1.5 to 3 months. Only in this case, therapy will give good results. If the patient's nails grow slowly, the course of treatment may be delayed for a longer period.
Dermatomycosis of the upper and lower extremities, smooth skin of the trunk, candidiasis of the skin is 2-4 weeks.
Fungal infection of the scalp - at least a month.

Side effects

Side effects that accompany the use of tablets can manifest themselves as:

allergies;
pain in the stomach;
cholestasis (decreased flow of bile into the duodenum);
bouts of nausea;
persistent diarrhea;
taste disorders;
thrombocytopenia;
neutropenia.

Side effects that occur with the local use of the drug are sometimes expressed in the appearance of:

severe itching;
burning sensations;
redness (hyperemia) of the skin at the site of application of the drug.

Cases of allergic reactions are quite rare.

Anticipating the question of the compatibility of terbinafine ® and alcohol, we recall that at the time of taking any medication, the use of strong alcoholic beverages should be completely abandoned.

Terbinafine ® ointment - instructions for use

The use of terbinafine ® , which is in the form of an ointment, is somewhat different from the use of a cream of the same name. This is due to the higher fat content in its chemical composition.

Owing to fats, terbinafine ® ointment penetrates poorly into the skin and almost does not dry out. That is why it is recommended to apply it to the surface of the affected nail plates and dry skin. The imposition of a sterile dressing over the problem area treated with ointment enhances the therapeutic effect.

Terbinafine ® cream is based on fats emulsified with an aqueous liquid, due to which the texture of this dosage form is more soft, allowing the active substance to easily penetrate into the deep layers of damaged tissues. Unlike ointment, the cream dries quickly without leaving stains on clothes.

A non-film-creating cream is used to treat:

mucous membranes;
weeping surfaces;
sweaty feet or hands.

According to the instructions for use, the affected surface should be prepared for applying an ointment or cream:

When treating dermatomycosis, all areas affected by a fungal infection (especially the interdigital spaces) should be thoroughly washed and dried.
When treating onychomycosis, the nail plates affected by the fungus should be freed from cosmetic varnish, and their keratinized areas that prevent the penetration of the active substance deep into the tissues should be removed with sterilized scissors or a nail file. This manipulation must be repeated weekly until the end of treatment.

The drug is applied in a thin layer to the surface of the affected skin, lightly rubbing and treating healthy areas adjacent to it: this will prevent the spread of pathogenic microorganisms. After allowing the cream to be absorbed, a bandage is applied to the treated area. The drug should be applied once a day, severe pathologies require double treatment.

Terbinafine ® for thrush is most often used in the form of an ointment, if possible, using it together with tablets. The course of treatment can take from two to six weeks. After the disappearance of the clinical manifestations of thrush, pathology therapy - to consolidate the effect obtained - is recommended to be continued for at least fourteen consecutive days.

Terbinafine ® analogues in tablets

Terbinafine ® has many cheaper analogues, represented by drugs:

"Atifin ®";
"Tebikur ®";
"Terbinox ®";
"Binafin ®";
"Mikoterbin ®";
"Termikon ®";
"Terbinafine-MFF ® ".

Compound

The composition of 1 tablet includes:

The active substance is terbinafine (in the form of hydrochloride) 250 mg.
Excipients: hyprolose, microcrystalline cellulose, calcium stearate, croscarmellose sodium, colloidal silicon dioxide, lactose monohydrate.

pharmachologic effect

Terbinafine tablets have antifungal activity against microorganisms that cause diseases of the skin, nails and hair, including:

yeast-like fungi of the genus Candida (C. albicans, etc.) and Pityrosporum;
dermatophytes (Trichophyton, Microsporum, etc.).

Low concentrations of terbinafine have fungicidal activity against dermatophytes, molds and some dimorphic fungi. Action against fungi may be fungistatic or fungicidal in nature.

Terbinafine is an antifungal drug with a wide range of activity against fungi.

Terbinafine affects the biosynthesis of sterols, suppressing them at an early stage. This leads to a lack of ergosterol, which provokes the arrest of the fungal cell.

What are they used for

Indications for admission:

mycoses on the head under the hair;
onychomycosis (diseases of the nails and skin of a fungal nature);
dermatomycosis of the feet, hands and torso in acute forms requiring systemic therapy;
thrush of mucous tissues and skin;
lichen.