Skinabin Cream

Indications for Use

• Skinabin Tablet: Used for treating onychomycosis (nail infections) caused by dermatophytes (Tinea unguium), affecting both fingernails and toenails.
• Skinabin Granules: Indicated for the treatment of Tinea Capitis (scalp fungal infections).
• Skinabin Cream: Effective against skin fungal infections caused by Trichophyton species (T. rubrum, T. mentagrophytes, T. violaceum), Microsporum canis, Epidermophyton floccosum, and yeast infections caused by Candida species (C. albicans). Also treats Pityriasis (Tinea) versicolor due to Malassezia furfur.
• Skinabin 1% Spray: Indicated for treating Tinea infections of the skin and Pityriasis versicolor caused by Malassezia furfur.

Always use as prescribed by a healthcare professional.

Pharmacology

Terbinafine, a potent Allylamine antifungal, works by inhibiting Squalene Epoxidase, an enzyme responsible for ergosterol biosynthesis, a critical component of the fungal cell membrane. This inhibition leads to the accumulation of squalene, disrupting the fungal membrane, ultimately causing cell death. Depending on the concentration and fungal species, Terbinafine may be fungicidal.

Effective against common pathogens, including Trichophyton mentagrophytes and Trichophyton rubrum, Terbinafine offers broad-spectrum activity in treating fungal infections.

Dosage & Administration

• Terbinafine Tablets:
  • Fingernail onychomycosis: 250 mg once daily for 6 weeks.
  • Toenail onychomycosis: 250 mg once daily for 12 weeks.
    The therapeutic effect is often noticed months after the treatment has ended, as the healthy nail grows.
• Terbinafine Granules:
  • <25 kg: 125 mg/day for up to 6 weeks.
  • 25-35 kg: 187.5 mg/day for up to 6 weeks.
  • >35 kg: 250 mg/day for up to 6 weeks.
• Terbinafine Cream:
  Apply once or twice daily to affected areas after cleaning and drying the skin.
  Recommended treatment durations:
  • Tinea corporis/cruris: 1-2 weeks
  • Tinea pedis: 1 week
  • Cutaneous candidiasis: 2 weeks
  • Pityriasis versicolor: 2 weeks

  Consistent application is necessary for effective treatment. If symptoms do not improve within two weeks, re-evaluation of diagnosis is advised.

• Terbinafine 1% Spray:
  Spray onto affected areas once or twice daily.
  Recommended treatment durations:
  • Tinea pedis: Once a day for 1 week
  • Tinea corporis/cruris: Once a day for 1 week
  • Pityriasis versicolor: Twice a day for 1 week

Consult with a healthcare provider for the appropriate treatment plan.

Drug Interactions

Terbinafine inhibits CYP450 2D6, a liver enzyme involved in metabolizing various drugs. Caution should be exercised when co-administering with medications metabolized by this enzyme, such as tricyclic antidepressants, beta-blockers, and antiarrhythmic drugs. Dose adjustments may be required for CYP450 2D6-metabolized drugs.

Contraindications

Skinabin tablets and cream should not be used in patients with known hypersensitivity to Terbinafine.

Side Effects

Common side effects include gastrointestinal symptoms (e.g., diarrhea, abdominal pain), skin reactions (e.g., rash, pruritus), and taste disturbances. Severe side effects, though rare, can include liver damage, skin reactions (e.g., Stevens-Johnson syndrome), and serious allergic reactions (including anaphylaxis).

Pregnancy & Lactation

• Terbinafine Tablets: Not recommended during pregnancy unless absolutely necessary. Terbinafine is present in breast milk, so it is not recommended for nursing mothers.
• Terbinafine Cream: Use only if the benefits outweigh the risks. Terbinafine is excreted in breast milk, so avoid use during breastfeeding.

Precautions & Warnings

• Liver toxicity: Terbinafine tablets have been associated with rare but serious liver injuries, including liver failure. Discontinue treatment if liver damage is suspected. Patients with pre-existing liver disease should be carefully monitored.
• Skin reactions: Serious skin reactions, such as Stevens-Johnson syndrome, may occur. Discontinue use if severe rash develops.
• For external use only: Avoid contact with eyes when using Terbinafine cream.

Use in Special Populations

• Pediatric use: Safety and efficacy in children have not been established.
• Elderly use: No special dosage adjustments are needed for elderly patients.

Overdose Effects

Symptoms of Terbinafine overdose include nausea, vomiting, headache, and abdominal pain. No serious adverse reactions have been reported with doses up to 5 grams (20 times the therapeutic dose).

Therapeutic Class

• Other antifungal preparations
• Topical antifungal treatments

Storage Conditions

Store in a cool, dry place below 30°C, protected from light. Keep away from children.