Terbinafine may cause nausea, diarrhoea, dyspepsia, abdominal pain, headaches and cutaneous reactions.
Br Med J Three compounds could inhibit all pathways of terbinafine metabolite formation at higher concentrations. The contributions of the individual enzymes to in vitro human liver microsomal intrinsic clearance was estimated using the RAFs of enzyme-specific substrates, except for CYP2B6, for which a specific substrate has only recently been identified Ekins et al.
The risk or severity of adverse effects can be increased when Terbinafine is combined with Pregabalin.
Figure 5 Inhibition of dextromethorphan O - demethylation by terbinafine. Recommended durations of treatment for tinea capitis, tinea corporis, tinea pedis and onychomycosis in adults are 4, 2, 6, and 12 weeks, respectively.
For example, ketoconazole is a potent inhibitor of the metabolism of cyclosporine A CsAmidazolam, and warfarin Ferguson et al. Michaelis-Menten kinetics for the pathways revealed mean K m values ranging from 4.
Terbinafine is a member of the allylamine group of antifungals. Disulfiram, an inhibitor of several CYPs Chang et al. The metabolites of terbinafine formed by human liver microsomes, including products of N- demethylation, deamination, alkyl side chain oxidation, and dihydrodiol formation, were found previously in human plasma and urine Jensen, ; Humbert et al. Clinically significant cholestatic liver injury was reported in two patients in a postmarketing surveillance study of 25, patients treated with terbinafine .
Dihydrodiol formation was inhibited by the CYP1A2 inhibitor furafylline. Table 6 Effect of terbinafine on the metabolism of characteristic CYP substrates in human liver microsomes. The reaction was stopped after 20 min by the addition of an equal volume of cold methanol on ice.
The risk or severity of adverse effects can be increased when Terbinafine is combined with Azimilide. The latter was operated with methanol as sheath liquid 0. Terbinafine should be avoided during pregnancy as safety data are lacking and fungal nail infections do not require urgent treatment.
In a meta-analysis of the safety of oral antifungal treatments for superficial dermatophytosis and onychomycosis in immunocompetent patients, the risk of liver injury requiring termination of treatment was 0. IC 50 values were determined graphically by plotting the percentage of the control activity against the inhibitor concentration. Liver failure, some fatal or leading to liver transplantation, have occurred during postmarketing experience.
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