Terbex Cream (5gm)

Indications

• Terbex Tablet: Used for treating onychomycosis of the toenail or fingernail caused by dermatophytes (tinea unguium).
• Terbex Granules: Effective for managing Tinea Capitis.
• Terbex Cream: Treats fungal skin infections from Trichophyton species, Microsporum canis, Epidermophyton floccosum, and yeast infections like Candida. Also used for Pityriasis (tinea) versicolor caused by Malassezia furfur.
• Terbex 1% Spray: Targets tinea infections of the skin and Pityriasis (tinea) versicolor.

Pharmacology

• Terbinafine: An Allylamine antifungal that inhibits Ergosterol biosynthesis by blocking Squalene Epoxidase. This increases membrane permeability, leading to fungal cell death. Effective against many strains, including Trichophyton species.

Dosage & Administration

• Terbinafine Tablet:
  • Fingernail Onychomycosis: 250 mg daily for 6 weeks.
  • Toenail Onychomycosis: 250 mg daily for 12 weeks.
• 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, depending on infection type. Duration:
  • Tinea corporis/cruris: 1-2 weeks.
  • Tinea pedis: 1 week.
  • Cutaneous candidiasis: 2 weeks.
  • Pityriasis versicolor: 2 weeks.
• Terbinafine 1% Spray: Apply once or twice daily:
  • Tinea pedis: Once daily for 1 week.
  • Tinea corporis/cruris: Once daily for 1 week.
  • Pityriasis versicolor: Twice daily for 1 week.

Interaction

Terbinafine inhibits CYP450 2D6, affecting drugs metabolized by this enzyme. Monitor interactions with drugs such as tricyclic antidepressants and beta-blockers.

Contraindications

Avoid in individuals hypersensitive to terbinafine, with severe hepatic impairment, biliary obstruction, hypotension, or left ventricular outflow tract obstruction. Not recommended during pregnancy or lactation.

Side Effects

Common: Gastrointestinal issues, liver test abnormalities, rash, and taste disturbances. Rare: Severe liver damage, serious skin reactions, and allergic reactions.

Pregnancy & Lactation

• Terbinafine Tablet: Not recommended during pregnancy or lactation. Treatment can be postponed until after pregnancy.
• Terbinafine Cream: Use only if benefits outweigh risks. Avoid during breastfeeding due to potential excretion in milk.

Precautions & Warnings

• Terbex Tablets: Risk of severe liver injury and serious skin reactions. Discontinue if signs of liver damage or severe rash occur.
• Terbex Cream: For external use only; avoid contact with eyes.

Use in Special Populations

• Pediatric Use: Safety and efficacy not established for children.
• Elderly Use: No special dosage adjustments required.

Overdose Effects

Symptoms: Nausea, vomiting, abdominal pain, dizziness. Severe reactions are rare with doses up to 5 grams.

Therapeutic Class

Other Antifungal Preparations, Topical Antifungal Preparations

Storage Conditions

Store below 30°C in a cool, dry place. Protect from light.