Basic Terbinafine Information

International Nonproprietary Name (INN): **Terbinafine** ATC Code and Classification: - **ATC code:** D01BA02 - **Classification:** This code places Terbinafine under "Antifungals for topical use – Allylamines" while also being utilized systemically for various conditions. Brand Names and Regional Packaging:

Country/Region	Brand Names (exact spelling/packages)	Notable Packagers / Marketers
International	Lamisil, Terbinex	Novartis, Taro, Mylan
USA	Lamisil (tablets, cream, spray); Terbinex (tablets)	Novartis, Breckenridge, Mylan
India	Aerb Allure, Afderm-MX, AF-Ter, Combix	Anglo French, Palsons
Italy	Terbinafina Doc Generici, Terbinafina Hexal, Terbinafina Mylan	DOC Generici, Sandoz, Mylan
Spain	Terbinafina Kern Pharma, Terbinafina Mylan, Terbinafina Pensa, Normon	Kern Pharma, Mylan, Pensa, Normon
Portugal	Terbinafina Generis, Terbinafina Labesfal, Terbinafina Jaba	Generis, Labesfal, Jaba
Romania	Terbinafina Ozone	Slavia Pharm
Lebanon	Apo Terbinafine	Apotex

Dosage Forms & Strengths:

Formulation Type	Strength(s)	Route	Typical Packaging
Tablet	250 mg	Oral	Blisters 7, 14, 28 tablets
Cream	1%	Topical	Tubes 7g, 15g, 30g
Spray	1%	Topical	15 ml, 30 ml bottles
Granules	125 mg, 187.5 mg	Oral	Unit-dose sachets/blister strips

Manufacturers and Major Suppliers: - **Global:** Novartis, Taro, Mylan, Aurobindo Pharma, Cipla, Glenmark, Wockhardt, Apotex. - **Other key distributors:** Orbion Pharms, Chartwell, Breckenridge Pharm, Senores Pharms, Invagen Pharms, Heritage Pharma, Natco Pharma, Gedeon Richter USA. Regulatory and Registration Information: - **Oral tablets:** Prescription-only (Rx) worldwide - **Topical forms:** - Many countries (including the USA and UK): Over-the-counter (OTC) for small package topical use - Some high-dose or large package topical forms: Prescription (Rx) Therapeutic Indications: 1. **Onychomycosis** (fungal nail infection) 2. **Tinea pedis** (athlete's foot) 3. **Tinea cruris** (jock itch) 4. **Tinea corporis** (ringworm) 5. **Tinea capitis** (scalp ringworm) 6. **Cutaneous candidiasis** (off-label/rare)

Morning Vs Evening Dosing In Canadian Routines

Many Canadians face the challenge of fitting their terbinafine treatment into busy daily schedules. Finding the right time to take this medication can significantly impact adherence to treatment. To increase the likelihood of sticking to the regimen, consider these strategies: - **Account for your daily routine:** If mornings are rushed, it may be easier to take the medication in the evening when things settle down. - **Set reminders:** Use your phone or alarm clock to prompt you to take your medication consistently. - **Pair with other daily activities:** Consider taking terbinafine alongside a habitual activity like brushing your teeth or just before bedtime. Key factors to consider include: - Work schedules and commitments may influence the decision for morning versus evening dosing. - Consistency is crucial in maximizing the effectiveness of antifungal treatment.

Taking With Or Without Meals (Canadian Diet Context)

The effectiveness of terbinafine can be influenced by how it is taken in relation to food. For optimal absorption, it’s important to understand the role meals play in this process. - **General Guidance:** Terbinafine can be taken either with or without food. However, taking it with food can sometimes improve how well the body absorbs the medication. In the context of the Canadian diet: - Pairing terbinafine with common meals or snacks, such as yogurt, breakfast cereals, or sandwiches, could be a convenient option. - When choosing foods, consider healthy Canadian staples like whole grains, fruits, and yogurt that can easily complement medication. Potential dietary considerations may include: - Individuals on a low-carb diet should ensure that any accompanying meals still fit within their dietary guidelines. - Those with lactose intolerance may want to opt for lactose-free options for any dairy products consumed with the medication. In conclusion, integrating terbinafine into Canadian daily life can be made easier with a few thoughtful adjustments. Understanding the impact of timing and meals will aid in effective treatment adherence.

Safety Priorities

When considering the use of terbinafine, a widely used antifungal, certain safety priorities must be kept in mind. Terbinafine, available as both a tablet and a topical cream, works effectively against various fungal infections. Like any medication, it comes with its own set of risks, especially for specific populations. Knowing who should avoid it and how to manage potential side effects is crucial for a safe experience.

Who should avoid it (Health Canada advisories)

Health Canada clearly outlines specific populations that should steer clear of terbinafine.

• Individuals with chronic or active liver disease should not use terbinafine, as it can exacerbate liver conditions.
• People who have a known hypersensitivity to terbinafine or any of its components should also avoid this medication.
• Those with existing renal impairment should approach terbinafine with caution and consider alternative therapies.
• Pregnant or breastfeeding women are advised to avoid systemic use of terbinafine, although topical forms may be used cautiously.

The legal status of terbinafine significantly impacts accessibility for these vulnerable groups. In Canada, while topical formulations can often be purchased over-the-counter, oral tablets require a prescription. This means those with specific health issues might find it challenging to access the oral form without consulting a healthcare provider, particularly if they will face limitations due to their health conditions.

Activities to limit (driving, workplace safety)

Understanding the potential side effects of terbinafine is vital for safe living. With any medication, it’s essential to consider how it might affect day-to-day activities like driving or operating heavy machinery.

Common side effects of oral terbinafine include gastrointestinal issues like nausea and diarrhea, headaches, and taste disturbances.

For those using topical forms, mild irritation or rash may occur, but these generally do not impair daily activities significantly.

Here are some practical tips for managing medication schedules to mitigate side effects:

• Plan to take terbinafine during meals to help reduce gastrointestinal discomfort.
• If experiencing fatigue or dizziness, schedule doses for times when rest can follow.
• Stay hydrated and have light snacks on hand to combat nausea.

Being aware of how their body reacts to terbinafine allows individuals to take proactive steps and maintains workplace safety when on this antifungal treatment. Those experiencing significant side effects should consult healthcare providers about alternatives or supportive treatments.

Dosage & Adjustments

General regimen (DIN references)

Determining the right dosage for terbinafine is essential for effective treatment. The Drug Identification Number (DIN) ensures that the medication is both safe and authentic. Here’s a snapshot of dosage recommendations based on its various forms:

Formulation Type	Standard Dosage	Duration
Tablet (250 mg)	One tablet daily	6–12 weeks, depending on the condition
Cream (1%)	Apply 1–2 times daily to affected area	1–4 weeks, varies by specific diagnosis
Spray (1%)	Spray once or twice a day on the infected area	1–4 weeks, based on the extent of infection

Remember, the DIN serves as a safeguard, aiding identification and verifying the medicine’s quality prior to use. Products like Lamisil or Terbinex have their own DINs, ensuring consumers are getting legitimate medication under regulations.

Special cases (elderly, comorbidities)

When it comes to dosage adjustments, special attention must be given to certain populations, especially the elderly and those with comorbidities. They often handle medications differently. Here are vital insights:

• **Elderly Patients**: - While standard dosages may still apply, close monitoring of liver and kidney functions is crucial. - Potential metabolic changes can influence how the body processes the drug, increasing the risk of side effects.
• **Renal Impairment**: - Caution should be taken for individuals with moderate to severe renal issues.
  - If creatinine clearance (CrCl) is below 50 ml/min, consider dosage reductions or alternative treatments.
• **Hepatic Considerations**: - Chronic liver conditions may contraindicate the use of terbinafine. Regular check-ups for liver enzymes are a must.

Combining terbinafine with other medications like fluconazole or clotrimazole is common, especially for mixed infections. Yet, caution is required, as these drugs can interact negatively, leading to an enhanced risk of side effects or reduced effectiveness:

For instance, if taken alongside antibiotics like ciprofloxacin, it’s critical to inform healthcare providers about all prescribed medications to optimise treatment and minimize unexpected interactions.

Delivery Information

City	Region	Delivery Time
Toronto	Ontario	5-7 days
Vancouver	British Columbia	5-7 days
Calgary	Alberta	5-7 days
Montreal	Quebec	5-7 days
Ottawa	Ontario	5-7 days
Edmonton	Alberta	5-7 days
Quebec City	Quebec	5-9 days
Winnipeg	Manitoba	5-9 days
Halifax	Nova Scotia	5-9 days
Victoria	British Columbia	5-9 days
St. John's	Newfoundland and Labrador	5-9 days
London	Ontario	5-9 days
Regina	Saskatchewan	5-9 days
Saskatoon	Saskatchewan	5-9 days
Charlottetown	Prince Edward Island	5-9 days