Terbinafine Pharmacology

Real Life Pharmacology - Pharmacology Education for Health Care Professionals

Eric Christianson, PharmD; Pharmacology Expert and Clinical Pharmacist

Education, Health & Fitness, Medicine

5 • 716 Ratings

🗓️ 12 March 2020

⏱️ 13 minutes

🔗️ Recording | iTunes | RSS

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Summary

Terbinafine can inhibit CYP2D6 which plays an important role in the metabolism of many drugs such as metoprolol, fluoxetine, and clozapine.

With terbinafine's ability to inhibit CYP2D6, it can also increase the risk of treatment failure with drugs like tamoxifen.

When using anti-fungal drugs like terbinafine, remember that fungal infections can often require more time to treat.

Terbinafine has the potential to cause liver impairment. I discuss this further on the podcast.

Transcript

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0:00.0	Hey, all, welcome back to the Real Life Pharmacology podcast.
0:03.9	Thanks so much for listening.
0:06.0	Definitely go to reallife pharmacology.com, take advantage of our free 31-page PDF on the top 200 drugs and clinical pearls.
0:15.9	So with that, let's get into today's podcast, and I'm going to cover turbinophen.
0:22.2	Brand name of this medication is Llamicil, and I'm going to mostly focus on the oral agent.
0:29.3	I've seen that quite a bit in clinical practice. With topical agents, obviously, you tend not to
0:36.2	run into much as far as adverse effects and systemic effects,
0:42.6	because systemic circulation is so much lower for many topical agents when it comes to antifungals there.
0:49.9	So I'm going to focus again mostly on the oral systemic administration here.
0:56.0	So terbinophenyne, antifungal agent, dosing, 250 milligrams or 500 milligram dosing.
1:04.0	This is really going to depend upon the indication that you are using it for.
1:11.0	Most common indications that I have seen this medication used for are oncomicosis.
1:19.5	So that is a fingernail, toenail-type fungal infection.
1:24.4	Very, very difficult or can be difficult to treat. Another indication I have seen it
1:29.7	used for is athlete's foot as well. Now, typically, if you're going the systemic route, that
1:36.9	athlete's foot case is probably pretty serious and severe. Okay, so one really important concept or educational point I want you to remember is that
1:50.2	fungal infections do take a long time to treat when, you know, comparing them to, let's say, you know,
1:59.0	common head cold. Well, we don't really treat a common head cold, but I think you get the point. You know, bacterial infections, like a strep throat, for example. Typically that treatment course is going to be relatively short, you know, a week or so, give or take. And with that, fungal infections can be multiple weeks of treatment so as patients start to get
2:23.9	better it may be tempting for them to to stop taking the medication maybe too soon so fungal
2:32.1	infections and particularly use with urbinophen, for some infections, we could be up in the six to 12 weeks of treatment range.
2:41.6	Again, depending upon that infection, depending upon how it's responding, and that sort of thing.
2:46.3	So definitely keep that in mind with antifungal agents
	...

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