Literature DB >> 10439936

Terbinafine. An update of its use in superficial mycoses.

K J McClellan1, L R Wiseman, A Markham.   

Abstract

UNLABELLED: Terbinafine is an allylamine antifungal agent which has fungicidal activity against a wide variety of dermatophytes, moulds and certain dimorphic fungi, and fungistatic activity against Candida albicans. Oral terbinafine 250 mg/day is effective in the treatment of superficial dermatophyte infections such as onychomycosis, tinea pedis and tinea corporis/cruris, generally achieving mycological cure in > 80% of patients. The drug is also effective in children with tinea capitis when administered orally in the dosage range 62.5 to 250 mg/day for 4 weeks. Comparative data indicate that oral terbinafine is more effective than continuous or intermittent intraconazole in dermatophyte onychomycosis, and is as effective as itraconazole 400 mg/day in tinea pedis. The drug has shown greater efficacy than griseofulvin in dermatophyte onychomycosis, tinea pedis and tinea corporis/cruris, and comparable efficacy in children with tinea capitis. Additionally, oral terbinafine is more effective than ketoconazole 200 mg/day in tinea corporis/cruris. Topical terbinafine 1% formulations are effective when applied once or twice daily for up to 2 weeks, achieving mycological cure in > 80% of patients with tinea pedis, tinea corporis/cruris, cutaneous candidiasis and pityriasis versicolor. Its formulations are at least as effective as miconazole 2% cream and naftifine 1% gel in tinea pedis, and more effective than clotrimazole 1% cream, bifonazole 1% cream and oxiconazole 1% lotion. Mycological cure rates achieved with terbinafine generally improve after treatment cessation, reflecting the drug's fungicidal mechanism of action and its residual effect in tissue. Terbinafine is well tolerated after oral or topical administration and has a relatively low potential for drug interactions. Pharmacoeconomic data support the use of terbinafine in dermatophyte infections of the skin or nails.
CONCLUSIONS: Evidence suggests that oral terbinafine is the treatment of choice for dermatophyte onychomycosis, as it achieves high rates of mycological and clinical cure, is generally well tolerated and has a relatively low potential for drug interactions. It must also be considered a first-line treatment option, along with itraconazole, in cutaneous mycoses which warrant systemic treatment; topical terbinafine is a treatment of choice in less extensive mycoses. The use of terbinafine in non-dermatophyte or mixed infections has not been fully defined.

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Year:  1999        PMID: 10439936     DOI: 10.2165/00003495-199958010-00018

Source DB:  PubMed          Journal:  Drugs        ISSN: 0012-6667            Impact factor:   9.546


  112 in total

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Authors:  V Havu; H Heikkilä; K Kuokkanen; M Nuutinen; T Rantanen; S Saari; S Stubb; R Suhonen; K Turjanmaa
Journal:  Br J Dermatol       Date:  2000-01       Impact factor: 9.302

2.  Oral terbinafine and erythema multiforme.

Authors:  P Todd; S Halpern; D D Munro
Journal:  Clin Exp Dermatol       Date:  1995-05       Impact factor: 3.470

3.  In vitro activities of terbinafine in combination with fluconazole and itraconazole against isolates of Candida albicans with reduced susceptibility to azoles.

Authors:  F Barchiesi; L Falconi Di Francesco; G Scalise
Journal:  Antimicrob Agents Chemother       Date:  1997-08       Impact factor: 5.191

4.  Effect of ketoconazole and terbinafine on the pharmacokinetics of caffeine in healthy volunteers.

Authors:  A Wahlländer; G Paumgartner
Journal:  Eur J Clin Pharmacol       Date:  1989       Impact factor: 2.953

Review 5.  Fungal nail disease: a guide to good practice (report of a Working Group of the British Society for Medical Mycology).

Authors:  D W Denning; E G Evans; C C Kibbler; M D Richardson; M M Roberts; T R Rogers; D W Warnock; R E Warren
Journal:  BMJ       Date:  1995-11-11

6.  Use of terbinafine in HIV-positive subjects: pilot studies in onychomycosis and oral candidiasis.

Authors:  R Nandwani; A Parnell; M Youle; C J Lacey; E G Evans; J Midgley; J Cartledge; D A Hawkins
Journal:  Br J Dermatol       Date:  1996-06       Impact factor: 9.302

7.  Pharmacoeconomic analysis of oral antifungal therapies used to treat dermatophyte onychomycosis of the toenails. A US analysis.

Authors:  A K Gupta
Journal:  Pharmacoeconomics       Date:  1998-02       Impact factor: 4.981

8.  Terbinafine in onychomycosis of the toenail: a novel treatment protocol.

Authors:  A Watson; J Marley; D Ellis; T Williams
Journal:  J Am Acad Dermatol       Date:  1995-11       Impact factor: 11.527

9.  Comparison of terbinafine and clotrimazole in treating tinea pedis.

Authors:  E G Evans; B Dodman; D M Williamson; G J Brown; R G Bowen
Journal:  BMJ       Date:  1993-09-11

10.  Short-duration treatment of fingernail dermatophytosis: a randomized, double-blind study with terbinafine and griseofulvin. LAGOS III Study Group.

Authors:  E Haneke; I Tausch; M Bräutigam; G Weidinger; D Welzel
Journal:  J Am Acad Dermatol       Date:  1995-01       Impact factor: 11.527

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Review 4.  Pharmacokinetics of antifungal agents in onychomycoses.

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Journal:  Clin Pharmacokinet       Date:  2001       Impact factor: 6.447

5.  Therapeutic efficacy of topically applied KP-103 against experimental tinea unguium in guinea pigs in comparison with amorolfine and terbinafine.

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Journal:  Antimicrob Agents Chemother       Date:  2002-12       Impact factor: 5.191

6.  Correlation of In Vitro Susceptibility Based on MICs and Squalene Epoxidase Mutations with Clinical Response to Terbinafine in Patients with Tinea Corporis/Cruris.

Authors:  Ananta Khurana; Aradhana Masih; Anuradha Chowdhary; Kabir Sardana; Sagar Borker; Aastha Gupta; R K Gautam; P K Sharma; Dhruv Jain
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7.  Terbinafine resistance mediated by salicylate 1-monooxygenase in Aspergillus nidulans.

Authors:  Marcia A S Graminha; Eleusa M F Rocha; Rolf A Prade; Nilce M Martinez-Rossi
Journal:  Antimicrob Agents Chemother       Date:  2004-09       Impact factor: 5.191

Review 8.  The role of topical antifungal therapy for onychomycosis and the emergence of newer agents.

Authors:  James Q Del Rosso
Journal:  J Clin Aesthet Dermatol       Date:  2014-07

9.  In vitro activities of the new antifungal drug eberconazole and three other topical agents against 200 strains of dermatophytes.

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Journal:  J Clin Microbiol       Date:  2003-11       Impact factor: 5.948

10.  Sensitization of Candida albicans to terbinafine by berberine and berberrubine.

Authors:  Pikling Lam; Stanton Hon Lung Kok; Kenneth Ka Ho Lee; Kim Hung Lam; Desmond Kwok Po Hau; Wai Yeung Wong; Zhaoxiang Bian; Roberto Gambari; Chung Hin Chui
Journal:  Biomed Rep       Date:  2016-02-23
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