This site uses cookies. A pharmacokinetic approach based on creatinine clearance has been outlined which permits drug dosage regimen adjustments in patients with renal impairment. References 1.

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Renal Impairment; CrCI 10-50 mL/min = Administer 75% of dosage Find out about Lean Library If you have an individual subscription to this content, or if you have purchased this content through This site needs JavaScript to work properly. Chronic or active liver disease: Contraindicated Comments: Members of _ can log in with their society credentials belowCollege of Pharmacy, and Pharmacy Services, University of Cincinnati Medical Center, Cincinnati, Ohio 45229College of Pharmacy, and Pharmacy Services, University of Cincinnati Medical Center, Cincinnati, Ohio 45229Members of _ can log in with their society credentials below By continuing to browse



2009 Nov;86(5):468-70. doi: 10.1038/clpt.2009.187.Rev Esp Geriatr Gerontol. Renal Dose Adjustments. Dose adjustment in renal disease 1. Tinea Corporis, Tinea Cruris (Off-label) 250 mg/day PO in single dose or divided q12hr for 2-4 weeks 2010 Jan-Feb;45(1):50-1; author reply 51. doi: 10.1016/j.regg.2009.09.007.Horio M, Kimura H, Takamatsu N, Nitta K, Hoshino T, Yasuda Y.J Am Soc Nephrol.

Indicated for onychomycosis of the toenail or fingernail owing to dermatophytes (tinea unguium250 mg (1 tablet) PO daily for 6 weeks (fingernail) or 12 weeks (toenail)Renal impairment: Use not recommended if CrCl <50 mL/minHepatic impairment: Use contraindicated in chronic or active liver disease250 mg/day PO in single dose or divided q12hr for 2-6 weeks250 mg/day PO in single dose or divided q12hr for 2-4 weeks500 mg/day PO q12hr for 2-6 weeks; treat for additional 2-4 weeks after resolution of all lesions (resolution may take 3-6 months)Idiosyncratic and symptomatic hepatic injury; more rarely, cases of liver failure, some leading to death or liver transplantSkin and subcutaneous tissue disorders (eg, Stevens-Johnson Syndrome and toxic epidermal necrolysis), drug reaction with eosinophilia and systemic symptoms (DRESS) syndromeSevere neutropenia, thrombocytopenia, agranulocytosis, pancytopenia, anemiaPsoriasiform eruptions or exacerbation of psoriasis, acute generalized exanthematous pustulosis, precipitation and exacerbation of cutaneous and systemic lupus erythematosusMalaise, fatigue, vomiting, arthralgia, myalgia, rhabdomyolysis, reduced visual acuity, visual field defect, hair loss, serum sickness-like reaction, vasculitis, pancreatitis, influenzalike illness, pyrexia, increased blood creatine phosphokinase, photosensitivity reactionsThrombotic microangiopathy (TMA), including thrombotic thrombocytopenic purpura and hemolytic uremic syndromeDiscontinue if the following develop: Liver disease, neutropenia (absolute neutrophil count <1000 mcL); skin rash; signs or symptoms of SLEChanges in ocular lens and retina reported; may require discontinuation of therapyPeriodic monitoring of liver function tests is recommendedAsk patients and caregivers to report immediately to healthcare provider any symptoms or signs of persistent nausea, anorexia, fatigue, vomiting, right upper abdominal pain or jaundice, dark urine, or pale stools; if these symptoms occur discontinue taking oral terbinafine, and immediately evaluate patient’s liver functionSerious skin/hypersensitivity reactions (eg, Stevens-Johnson Syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms [DRESS] syndrome); manifestations of DRESS syndrome may include cutaneous reaction (eg, rash, exfoliative dermatitis), eosinophilia, and 1 or more organ complications (eg, hepatitis, pneumonitis, nephritis, myocarditis, pericarditis)Due to potential toxicity, confirmation of onychomycosis or dermatomycosis recommendedSmell disturbance reported; discontinue therapy if symptoms occurCYP2D6 inhibitor; may also convert CYP2D6 extensive metabolizers to poor metabolizer statusCases of thrombotic microangiopathy (TMA), including thrombotic thrombocytopenic purpura and hemolytic uremic syndrome, some fatal, reported with terbinafine; discontinue terbinafine if clinical symptoms and laboratory findings consistent with TMA occur; the findings of unexplained thrombocytopenia and anemia should prompt further evaluation and consideration of diagnosis of TMAAvailable data from postmarketing cases in pregnant women are insufficient to evaluate drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomesBecause treatment of onychomycosis can be postponed until after pregnancy is completed, it is recommended that oral terbinafine not be initiated during pregnancyAfter oral administration, terbinafine is present in human milk; however, there are no data on effects on breastfed child or on milk production; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy; tablets and any potential adverse effects on breastfed child from therapy or from underlying maternal conditionA: Generally acceptable.

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