Mycofree
Generic Name
Terbinafine 250 mg tablet
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| mycofree 250 mg tablet | ৳ 38.00 | ৳ 380.00 |
Description
Overview of the medicine
Terbinafine is an antifungal medicine used to treat various fungal infections, particularly those affecting the skin, hair, and nails.
Uses & Indications
Dosage
Adults
Onychomycosis: 250 mg once daily for 6-12 weeks (fingernails) or 12-24 weeks (toenails). Skin infections: 250 mg once daily for 2-6 weeks depending on severity.
Elderly
No specific dose adjustment required, but monitor liver/kidney function, especially if pre-existing conditions are present.
Renal_impairment
Use with caution; consider dose reduction (e.g., 125 mg once daily) in severe impairment (creatinine clearance < 50 mL/min).
How to Take
Mycofree tablets can be taken with or without food. It is crucial to complete the full course of treatment as prescribed by the doctor, even if symptoms improve.
Mechanism of Action
Terbinafine inhibits ergosterol synthesis by selectively inhibiting squalene epoxidase in the fungal cell membrane, leading to squalene accumulation and fungal cell death.
Pharmacokinetics
Onset
Clinical improvement observed within weeks, full effect for nail infections can take months (as new nail grows).
Excretion
Primarily via urine (70-80%) as metabolites, and to a lesser extent via feces.
Half life
Terminal half-life is approximately 17 hours, but effective half-life for tissue accumulation is much longer (200-400 hours).
Absorption
Well absorbed from the gastrointestinal tract (about 70%), but extensive first-pass metabolism reduces bioavailability to about 40%.
Metabolism
Extensively metabolized in the liver by CYP enzymes (primarily CYP2C9, CYP1A2, CYP3A4, CYP2C8, and CYP2D6).
Side Effects
Contraindications
- Hypersensitivity to terbinafine or any other components of the tablet.
- Patients with chronic or active liver disease.
Drug Interactions
Caffeine
Terbinafine inhibits the metabolism of caffeine, leading to increased caffeine levels.
Cimetidine
Increases plasma levels of terbinafine by inhibiting its metabolism.
Rifampicin
Decreases plasma levels of terbinafine by inducing its metabolism.
CYP2D6 inhibitors (e.g., fluoxetine, paroxetine)
May increase terbinafine plasma levels.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include nausea, vomiting, abdominal pain, dizziness, rash, and headache. Management typically involves gastric lavage and symptomatic supportive treatment.
Pregnancy & Lactation
Terbinafine is generally not recommended during pregnancy unless the potential benefits outweigh the risks. It passes into breast milk, so avoid use during breastfeeding.
Side Effects
Contraindications
- Hypersensitivity to terbinafine or any other components of the tablet.
- Patients with chronic or active liver disease.
Drug Interactions
Caffeine
Terbinafine inhibits the metabolism of caffeine, leading to increased caffeine levels.
Cimetidine
Increases plasma levels of terbinafine by inhibiting its metabolism.
Rifampicin
Decreases plasma levels of terbinafine by inducing its metabolism.
CYP2D6 inhibitors (e.g., fluoxetine, paroxetine)
May increase terbinafine plasma levels.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include nausea, vomiting, abdominal pain, dizziness, rash, and headache. Management typically involves gastric lavage and symptomatic supportive treatment.
Pregnancy & Lactation
Terbinafine is generally not recommended during pregnancy unless the potential benefits outweigh the risks. It passes into breast milk, so avoid use during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, depending on manufacturer specifications.
Availability
Pharmacies and hospitals
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Terbinafine has been extensively studied in numerous clinical trials demonstrating its efficacy and safety for various fungal infections, particularly onychomycosis and tinea infections.
Lab Monitoring
- Liver function tests (LFTs) should be performed before initiating treatment and periodically during treatment, especially for patients on prolonged therapy or with pre-existing liver conditions.
- Complete blood count (CBC) if treatment exceeds 6 weeks or if symptoms suggest a hematologic disorder.
Doctor Notes
- Emphasize patient education on adherence to the full treatment course to prevent relapse and development of resistance.
- Monitor liver function tests, especially for patients with pre-existing hepatic conditions or those on extended therapy.
- Counsel patients regarding potential taste disturbances and advise on managing symptoms, reassuring them of reversibility in most cases.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor. Do not stop treatment early, even if your symptoms improve, to prevent recurrence.
- Report any signs of liver problems (e.g., persistent nausea, dark urine, yellowing of skin/eyes, unexplained fatigue) to your doctor immediately.
- Be aware of potential taste disturbances, which are usually reversible upon discontinuation but can be prolonged.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it's almost time for the next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Some individuals may experience dizziness, lightheadedness, or visual disturbances (e.g., blurred vision) while taking terbinafine. Patients should be cautious when driving or operating machinery until they know how the medicine affects them.
Lifestyle Advice
- Maintain good personal hygiene to prevent reinfection, especially for fungal skin and nail infections.
- For fungal foot infections, wear breathable footwear and keep your feet clean and dry.
- Avoid sharing towels, socks, and other personal items to prevent spreading the infection.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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