terbinafine (topical)
General
Pronunciation:
ter-bin-a-feen
Trade Name(s)
- Apo-Terbinafine
- Lamisil AT
- Novo-Terbinafine
- PMS-Terbinafine
Ther. Class.
(topical)
Indications
Treatment of a variety of cutaneous fungal infections, including tinea pedis (athlete's foot), tinea cruris (jock itch), and tinea corporis (ringworm).
Action
Affects the synthesis of the fungal cell wall.
Therapeutic Effect(s):
Decrease in symptoms of fungal infection.
Pharmacokinetics
Absorption: Absorption through intact skin is minimal.
Distribution: Distribution after topical administration is primarily local.
Metabolism and Excretion: Highly metabolized; excreted in urine (primarily as metabolites).
Half-life: 21 hr.
TIME/ACTION PROFILE
| ROUTE | ONSET | PEAK | DURATION |
|---|---|---|---|
| Top | unknown | unknown | unknown |
Contraindication/Precautions
Contraindicated in:
- Hypersensitivity to active ingredients, additives, preservatives, or bases
- Some products contain alcohol and should be avoided in patients with known intolerance.
Use Cautiously in:
- Nail and scalp infections (may require additional systemic therapy)
- OB: Lactation: Safety not established.
Adverse Reactions/Side Effects
Local: burning, itching, local hypersensitivity reactions, redness, stinging
* CAPITALS indicate life-threatening.
Underline indicate most frequent.
Interactions
Drug-Drug
Not known.
Route/Dosage
Topical (Adults and Children ≥12 yr): Apply twice daily for 1 wk for tinea pedis. Apply once daily for 1 wk for tinea cruris or tinea corporis.
Availability (generic available)
Cream: 1%
Gel: 1%
Spray liquid: 1%
Assessment
- Inspect involved areas of skin and mucous membranes before and frequently during therapy. Increased skin irritation may indicate need to discontinue medication.
Implementation
- Consult physician or other health care professional for proper cleansing technique before applying medication.
- Topical Apply small amount to cover affected area completely. Avoid the use of occlusive wrappings or dressings unless directed by physician or other health care professional.
Patient/Family Teaching
- Instruct patient to apply medication as directed for full course of therapy, even if feeling better. Emphasize the importance of avoiding the eyes.
- Caution patient that some products may stain fabric, skin, or hair. Check label information. Fabrics stained from cream can usually be cleaned by handwashing with soap and warm water.
- Patients with athlete's foot should be taught to wear well-fitting, ventilated shoes, to wash affected areas thoroughly, and to change shoes and socks at least once a day.
- Advise patient to report increased skin irritation or lack of response to therapy to health care professional.
Evaluation/Desired Outcomes
Decrease in skin irritation and resolution of infection. Early relief of symptoms may be seen in 2–3 days.