Side Effects of terbinafine: A Synthesis of Findings from 27 Studies

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Original Abstract of the Article

Major Research Findings

Terbinafine is a widely used antifungal medication effective for treating fungal infections like skin mycoses and onychomycosis. Its mechanism involves blocking the synthesis of ergosterol, a crucial component of fungal cell membranes. This disrupts the fungal cell membrane's structure, ultimately causing the fungus to die. 8

Terbinafine is effective both orally and topically. 8 Oral administration offers the advantage of easier access to the fungus compared to topical application, but it places a heavier burden on the liver. Therefore, topical application is recommended for individuals with liver issues or concerns about drug interactions. 8

While terbinafine is an effective treatment for fungal infections like skin mycoses and onychomycosis, several side effects have been reported. 11 These side effects often occur during terbinafine's metabolism in the liver. 11

Reasons for Side Effects

Terbinafine's metabolism in the liver can lead to various side effects. 11 The metabolism process is facilitated by enzymes called cytochrome P450. 11 These enzymes are involved in metabolizing a wide range of medications, including terbinafine. 11 Terbinafine can inhibit cytochrome P450 activity, potentially impacting the metabolism of other medications. 11 Furthermore, terbinafine's metabolites may exhibit toxicity in the liver. 11 Due to these factors, terbinafine should be used cautiously in individuals with liver issues or concerns about drug interactions, as it places a significant burden on the liver. 11

Common Side Effects

Gastrointestinal

Terbinafine can cause side effects in the gastrointestinal system. 21 These side effects can include nausea, vomiting, abdominal pain, and diarrhea. 21

Liver

Terbinafine can cause side effects in the liver. 21 Specific side effects include liver dysfunction and jaundice. 21

Skin

Terbinafine can cause skin side effects. 21 These side effects may include rash, itching, and dry skin. 21

Blood

Terbinafine can cause blood-related side effects. 21 Such side effects may involve a decrease in white blood cell count and platelet count. 21

Other

Besides the gastrointestinal, liver, skin, and blood-related side effects, terbinafine may also cause other side effects. 21 These side effects can vary from person to person, making it crucial to consult with a physician before taking terbinafine. 21

Side Effect Management

Gastrointestinal

Dietary modifications can help manage terbinafine's gastrointestinal side effects. 21 Eating a small meal before taking terbinafine or consuming milk alongside the medication might reduce side effects like nausea and vomiting. 21

Liver

Liver function tests are essential for managing terbinafine's liver-related side effects. 21 Before starting terbinafine, it's crucial to ensure normal liver function through a liver function test. 21 Regular liver function tests are also necessary during terbinafine treatment. 21 If abnormal liver function is detected, discontinuing terbinafine is required. 21

Skin

Using moisturizers can help manage terbinafine's skin side effects. 21 Terbinafine treatment can lead to dry skin, so applying moisturizers to prevent dryness is crucial. 21 Sunscreen use is also recommended during terbinafine treatment to protect against UV radiation. 21

Blood

Blood tests are important for managing terbinafine's blood-related side effects. 21 Before starting terbinafine, it's essential to confirm normal blood function through a blood test. 21 Regular blood tests are also needed during terbinafine treatment. 21 If abnormal blood test results are observed, stopping terbinafine is necessary. 21

Comparison Across Studies

Commonalities Across Studies

Terbinafine is an effective antifungal medication for treating fungal infections, but several side effects have been reported. 11 These side effects frequently occur during terbinafine's metabolism in the liver. 11

Differences Across Studies

Oral terbinafine is associated with a higher risk of side effects like liver dysfunction and jaundice. 21 In contrast, topical terbinafine is considered to have a lower risk of these side effects. 8

Practical Application Considerations

Terbinafine is an effective antifungal medication for treating fungal infections, but several side effects have been reported. 11 It's crucial to use terbinafine cautiously, particularly in individuals with liver issues or concerns about drug interactions. 11

It's vital to consult with a physician before taking terbinafine. 11 The physician will assess your medical history, including current medications, to determine if terbinafine is the appropriate treatment for you. 11 When taking terbinafine, always follow your doctor's instructions and adhere to the prescribed dosage. 11

Current Research Limitations

Terbinafine is an effective antifungal medication for treating fungal infections, but several side effects have been reported. 11 However, a thorough understanding of the specific side effects caused by terbinafine is still lacking. 11

Future Research Directions

Terbinafine is an effective antifungal medication for treating fungal infections, but several side effects have been reported. 11 Future research should focus on understanding the specific side effects caused by terbinafine in greater detail and developing methods to minimize the risk of these side effects. 11

Conclusion

Terbinafine is an effective antifungal medication for treating fungal infections, but several side effects have been reported. 11 It's crucial to use terbinafine cautiously, particularly in individuals with liver issues or concerns about drug interactions. 11 Consult with a physician before taking terbinafine and follow their instructions carefully. 11

Literature analysis of 27 papers
Positive Content
22
Neutral Content
3
Negative Content
2
Article Type
3
0
2
7
27
2.

Antifungal therapy for onychomycosis in children.

Author: FeldsteinStephanie, TotriChristine, FriedlanderSheila Fallon

onychomycosis treatment
side effects

This review discussed treatment options for onychomycosis in children.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

In Vitro Combination of Terbinafine with Ketoconazole Against Aspergillus Species with Terbinafine High MIC Values Isolated From Otomycosis.

Author: NosratabadiMohsen, EspahbodiAmirreza, HedayatiMohammad Taghi, ShokohiTahereh, BadaliHamid, SaeediMajid, MoazeniMaryam, AghiliSeyed Reza, JavidniaJavad, FaeliLeila, KhojastehShaghayegh, RoohiBehrad, AbbasiKiana, AbastabarMahdi, HaghaniIman

Otomycosis treatment

Terbinafine and ketoconazole were found to have a synergistic effect in treating otomycosis in 66.67% of the isolates tested. This combination may be a promising new therapeutic strategy for patients with otomycosis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Permeation studies of novel terbinafine formulations containing hydrophobins through human nails in vitro.

Author: VejnovicIvana, HuonderCornelia, BetzGabriele

Onychomycosis treatment

Hydrophobins, a type of protein, can enhance the permeation of terbinafine through the human nail plate. This may offer a potential new treatment for onychomycosis, a fungal infection of the nails.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Eumycetoma.

Author: EstradaRoberto, Chávez-LópezGuadalupe, Estrada-ChávezGuadalupe, López-MartínezRubén, WelshOliverio

Eumycetoma treatment
Amphotericin B side effects

Eumycetoma is a fungal infection treated with surgical removal followed by medical treatment with antifungals.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Pulse itraconazole vs. continuous terbinafine for the treatment of dermatophyte toenail onychomycosis in patients with diabetes mellitus.

Author: GuptaA K, GoverM D, LyndeC W

Onychomycosis treatment

This study discusses the use of terbinafine and itraconazole in treating toenail onychomycosis in diabetic patients.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

7.

Combined oral terbinafine and long-pulsed 1,064-nm Nd: YAG laser treatment is more effective for onychomycosis than either treatment alone.

Author: XuYang, MiaoXu, ZhouBingrong, LuoDan

Effective clearance
Side effects

Combined treatment with a long-pulsed Nd:YAG laser and oral terbinafine produced more rapid and effective mycological and clinical clearance in patients with onychomycosis than either treatment alone.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Effect of a novel penetration enhancer on the ungual permeation of two antifungal agents.

Author: TraynorM J, TurnerR B, EvansC R G, KhengarR H, JonesS A, BrownM B

Nail drug delivery
Systemic side effect reduction

A novel permeation enhancer system enhanced the delivery of terbinafine through human nail samples in vitro, suggesting potential for a topical treatment of nail fungal infections.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Development of a highly sensitive cytotoxicity assay system for CYP3A4-mediated metabolic activation.

Author: HosomiHiroko, FukamiTatsuki, IwamuraAtsushi, NakajimaMiki, YokoiTsuyoshi

Detect drug-induced cytotoxicity

This study constructed a cell-based system to evaluate the cytotoxicity of reactive metabolites produced by CYP3A4. The study found that HepG2 cells showed the highest CYP3A4 protein expression and activity among seven hepatoma cell lines. The cytotoxicity of 23 drugs was evaluated in AdCYP3A4-infected HepG2 cells, with 11 drugs showing significant decrease in cell viability.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

Tinea capitis asymptomatic carriers: what is the evidence behind treatment?

Author: AharazA, JemecG B E, HayR J, SaunteD M L

Asymptomatic Carriage Treatment
Tinea Capitis
Adverse Effects

This review investigated the evidence behind the treatment of asymptomatic carriers of tinea capitis. Topical treatments like ketoconazole, povidone-iodine, and miconazole, as well as systemic antifungals like terbinafine and itraconazole, showed significant effects in eradicating fungal conidia.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

16.

The assessment and management of tinea capitis in children.

Author: AliSamina, GrahamTimothy A D, ForgieSarah E D

Tinea capitis treatment
Side effects

Tinea capitis, a scalp and hair shaft infection caused by dermatophytes, can be challenging to diagnose clinically. Laboratory confirmation is essential before initiating treatment, as systemic antifungal therapy is required and can have potential side effects. Oral griseofulvin remains the standard treatment, with terbinafine and itraconazole as effective alternatives.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

17.

Quinoline-based antifungals.

Author: MusiolR, SerdaM, Hensel-BielowkaS, PolanskiJ

Antifungal activity
Drug resistance
Side effects
Toxicity

This review discusses the development of quinoline-based antifungal agents, highlighting their potential benefits and drawbacks.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

18.

Silicon phthalocyanine 4 phototoxicity in Trichophyton rubrum.

Author: LamMinh, DimaanoMatthew L, Oyetakin-WhitePatricia, RetuertoMauricio A, ChandraJyotsna, MukherjeePranab K, GhannoumMahmoud A, CooperKevin D, BaronElma D

Dermatophytosis treatment

Photodynamic therapy (PDT) using silicon phthalocyanine (Pc) 4 is a potential treatment for dermatophytosis caused by Trichophyton rubrum. PDT effectively reduced fungal cell survival by generating reactive oxygen species.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Voriconazole, but not terbinafine, markedly reduces alfentanil clearance and prolongs its half-life.

Author: SaariTeijo I, LaineKari, LeinoKari, ValtonenMika, NeuvonenPertti J, OlkkolaKlaus T

Drug interactions

This study investigates the potential drug interactions between alfentanil, a short-acting synthetic opioid analgesic, and orally administered voriconazole and terbinafine, both CYP3A inhibitors.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

Cysteine-phenylalanine-derived self-assembled nanoparticles as glutathione-responsive drug-delivery systems in yeast.

Author: ChibhSonika, SuyalShradha, AggarwalNidhi, BachhawatAnand Kumar, PandaJiban Jyoti

Antifungal delivery
Drug efficacy
Reduced toxicity
Antifungal drug toxicity
Antifungal resistance

Self-assembled nanoparticles made from dipeptides were developed to deliver the antifungal drug terbinafine (Terb) to yeast cells. These nanoparticles were biocompatible, effectively delivered Terb to the cells, and completely inhibited yeast growth.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Drug hypersensitivity syndrome.

Author: KumariRashmi, TimshinaDependra K, ThappaDevinder Mohan

Drug hypersensitivity

Drug hypersensitivity syndrome (DHS) is a serious adverse drug reaction that is often associated with aromatic antiepileptic drugs. It is characterized by fever, rash, lymphadenopathy, and internal organ involvement. The syndrome is managed by immediate withdrawal of the culprit drug, symptomatic treatment, and systemic steroids or immunoglobulins.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

23.

Rapid Treatment of Subungual Onychomycosis Using Controlled Micro Nail Penetration and Terbinafine Solution.

Author: BristowIvan, BaranRobert, ScoreMichelle

Onychomycosis treatment

This study presents three cases of toenail onychomycosis treated with topical terbinafine 1% solution using a novel intelligent nail drill system. The study highlights the potential of the device for improving drug penetration and treatment effectiveness.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

24.

A Case Report of Majocchi's Granuloma Associated with Combined Therapy of Topical Steroids and Adalimumab.

Author: ChouWan-Yi, HsuChih-Jung

Autoimmune disorder treatment
Atypical infections
Cutaneous side effects

Adalimumab, a TNF-alpha inhibitor, can cause immunocompromised status and atypical infections, including Majocchi's granuloma. This case report describes a 43-year-old male with psoriasis who developed Majocchi's granuloma after adalimumab injection. The nodules responded poorly to bacterial folliculitis treatment but improved dramatically after adalimumab withdrawal and terbinafine treatment for 12 weeks. It is crucial to examine psoriasis patients for latent dermatophyte infection before and during treatment with TNF-alpha inhibitors to prevent atypical infections and treatment failures.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

25.

Safety and efficacy of allylamines in the treatment of cutaneous and mucocutaneous leishmaniasis: A systematic review.

Author: BezemerJacob M, van der EndeJacob, LimpensJacqueline, de VriesHenry J C, SchalligHenk D F H

This systematic review evaluated the efficacy and safety of allylamine drugs, like terbinafine, for cutaneous and mucocutaneous leishmaniasis. Despite the safety of these drugs, there is no evidence of efficacy for monotherapy against these conditions. A well-designed randomized controlled trial comparing terbinafine to meglumine antimoniate showed a lower cure rate for terbinafine. Further trials are needed to explore the potential synergistic effects of allylamines combined with triazole drugs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

26.

Adverse Events in Twitter-Development of a Benchmark Reference Dataset: Results from IMI WEB-RADR.

Author: DietrichJuergen, GattepailleLucie M, GrumBritta Anne, JiriLetitia, LerchMagnus, SartoriDaniele, WisniewskiAntoni

Safety information

This article summarizes the activities undertaken and challenges encountered in creating a benchmark reference dataset for evaluating automated methods and systems for adverse event recognition in social media.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

27.

Efinaconazole in Onychomycosis.

Author: GuptaAditya K, TalukderMesbah

Onychomycosis treatment
Dermatitis
Ingrown toenails
Pain
Vesicles

Efinaconazole 10% topical solution is an effective and safe treatment for onychomycosis, a fungal nail infection, in adults and children. It is recommended as first-line treatment for mild-to-moderate cases.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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