Terbinafine is primarily known as an antifungal medication used to treat fungal infections of the skin and nails. It's available in various formulations including oral tablets, creams, and topical solutions. When used topically, terbinafine works by inhibiting the growth of fungi, effectively treating conditions like athlete's foot (tinea pedis), jock itch (tinea cruris), and ringworm (tinea corporis).

Topical terbinafine is generally applied directly to the affected area once or twice daily, depending on the severity of the infection and the specific product instructions. It's important to follow the prescribed dosage and duration of treatment to ensure effectiveness and reduce the risk of recurrence or resistance.

Topical terbinafine cream (Lamisil cream) is available both as OTC medicine and as a prescription product for the treatment of fungal infections of the skin. Note: For extensive lesions, oral terbinafine tablets should be used.

• Dermatologic fungal infections:
  • It is used in the treatment of tinea pedis (athlete's foot), tinea cruris (jock itch), and tinea corporis (ringworm)
  • It is used in the treatment of dermatologic fungal skin infections (including tinea pedis, tinea cruris, tinea corporis, cutaneous candidiasis, and tinea versicolor) in adults.

Topical Terbinafine cream dose in Adult

OTC labeling:

Topical Terbinafine Dosage in the treatment of Tinea pedis:

• Cream: Put it between your toes and on the affected area twice daily for at least 1 week. Then, use it on the bottom or sides of your feet twice daily for 2 weeks.
• Gel: Apply it to the affected area once daily before bed for at least 1 week.
• Spray: Spritz it on the affected area once daily for at least 1 week.

Topical Terbinafine Dosage in the treatment of Tinea corporis, Tinea cruris:

• Cream: Apply it to the affected area once daily for 1 week.
• Gel: Put it on the affected area once daily for 1 week.
• Spray: Spritz it on the affected area once daily for 1 week.

Canadian products [Rx only]:

Topical Terbinafine Dosage in the treatment of Tinea pedis, Tinea corporis, and Tinea cruris:

• Topical Cream and Spray: Use once daily on the affected area(s) for at least 1 week.

Topical Terbinafine Dose in the treatment of Cutaneous candidiasis:  

• Topical Cream: Apply once or twice daily on the affected area for 1 to 2 weeks.

Topical Terbinafine Dose in the treatment of Tinea versicolor:

• Topical Cream: Apply once or twice daily on the affected area for 1 to 2 weeks.
• Topical Spray: Use twice daily on the affected area for 1 week.

Topical Terbinafine cream dose in Children

Topical Terbinafine dosage in the treatment of Pityriasis (tinea) Versicolor:

For children aged 12 years and older as well as adolescents:

• Topical Solution (Spray): Apply once daily to the affected area for 1 week.

Since there's limited data available, it's crucial to adhere to the recommended dosage and duration.

Topical Terbinafine in the treatment of Tinea corporis (ringworm):  

For children aged 12 years and older as well as adolescents:

• Topical Cream and Gel: Apply once daily to the affected area for at least 1 week.

It's important to follow the prescribed dosage and duration of treatment.

Topical Terbinafine Dose in the treatment of Tinea cruris (jock itch):  

For children aged 12 years and older as well as adolescents:

• Topical Cream, Gel, and Solution (Spray): Apply once daily to the affected area for at least 1 week.

Consistency in applying the medication according to the prescribed regimen is essential for effective treatment.

Topical Terbinafine Dose in the treatment of Tinea pedis (athlete’s foot):  

For children aged 12 years and older as well as adolescents:

• Topical Cream: Apply between the toes to the affected area twice daily for at least 1 week. Then, apply on the bottom or sides of the feet twice daily for 2 weeks.
• Gel: Apply to the affected area once daily at bedtime for at least 1 week.

Following these instructions diligently helps ensure the effectiveness of the treatment.

Terbinafine pregnancy risk category: B

• When you put terbinafine on your skin, only a small amount gets into your body, so it's not likely to affect a pregnancy.
• But if you really need to treat a fungal infection and you're pregnant, your doctor might suggest using terbinafine on your skin because it's safer than taking it by mouth.

Terbinafine use during breastfeeding:

• If you take terbinafine by mouth, it can show up in breast milk.
• But when you use it on your skin, not much of it gets into your body.
• Still, if you're breastfeeding, it's best not to use terbinafine creams or sprays on your breasts.
• And keep treated skin away from your baby, just to be safe.

Topical Terbinafine cream Dose in Renal Disease:

• No dose adjustment is recommended when used for topical purposes.

Topical Terbinafine cream Dose in Liver Disease:

• No dose adjustment is recommended when used for topical purposes.

Less Common Side Effects of Topical Terbinafine cream include:

• Dermatologic:
  • Burning Sensation Of Skin
  • Contact Dermatitis
  • Exfoliation Of Skin
  • Pruritus
  • Skin Irritation
  • Skin Rash
  • Stinging Of The Skin
  • Xeroderma
• Local:
  • Local Irritation

Contraindication to Terbinafine Include:

• The Canadian labeling warns against using terbinafine if you're allergic to it or any part of the product.
• Always check the label for any specific instructions or warnings before using terbinafine or any medication.

Warnings and precautions

Local irritation

• If you notice irritation or sensitivity while using terbinafine, stop using it and talk to your doctor.
• They can suggest a different treatment that might work better for you.

Monitor:

Monitor for the resolution in symptoms.

How to apply topical terbinafine cream?

• Before using the topical terbinafine, make sure to wash the affected area with soap and water, then dry it thoroughly.
•  After using the medication, remember to wash your hands.
• If you're using the spray, hold it about 4 to 6 inches away from your skin when applying it.
• These simple steps help ensure the effectiveness of the treatment and minimize any potential risks.

Mechanism of action of Terbinafine:

• It is a synthetically manufactured allylamine derivative which inhibits squalene-epoxidase. This enzyme is crucial in sterol biosynthesis in yeasts.
• This causes fungal cell death and a defect in the ergosterol in the fungal cell membrane.

International Brands of Topical Terbinafine cream:

• LamISIL Advanced
• LamISIL AT Jock Itch
• LamISIL AT Spray
• LamISIL AT
• Amizil
• Antifan
• Benafin
• Binter
• Derfin
• Dermasil
• Dermifene
• Farbcil
• Farbicil
• Finex
• Fintrix
• Fungasil
• Funginix
• Fungisafe
• Fungizid
• Funide
• Futeshu
• Hifen
• Interbi
• Lamater
• Lamifen
• Lamisil
• Lamisil AT
• Lamisil Once
• Lamisilate
• Lamizyl
• Lan Meishu
• Lisim
• Medisil
• Micoset
• Micozone
• Mujonal
• Murazol
• Mycelvan
• Otenol
• Patir
• Periafin
• Ronasil Derm Gel
• Sebifin
• Skinabin
• SolvEasy Tinea
• Terafan
• Terbasil
• Terbex
• Terbicip
• Terbifin
• Terbin
• Terbinorm
• Terbisan
• Terbisil
• Terbiskin
• Terekol
• Terfex
• Terfina
• Terfine
• Terfung
• Tiersil Once

Brands of topical terbinafine cream in Pakistan: