Terbicare
Generic Name
Terbinafine
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| terbicare 250 mg tablet | ৳ 40.00 | ৳ 400.00 |
Description
Overview of the medicine
Terbinafine is an allylamine antifungal used to treat fungal infections of the skin, hair, and nails.
Uses & Indications
Dosage
Adults
250 mg once daily for 6 weeks (fingernails) or 12 weeks (toenails). For skin infections, 250 mg once daily for 2-4 weeks.
Elderly
No specific dose adjustment generally needed, but monitor renal function.
Renal_impairment
Reduce dose by 50% in severe renal impairment (CrCl < 50 mL/min).
How to Take
Take with or without food. Complete the full course of treatment as prescribed by your doctor.
Mechanism of Action
Terbinafine inhibits squalene epoxidase, an enzyme in the fungal ergosterol biosynthesis pathway, leading to intracellular accumulation of squalene and cell membrane disruption.
Pharmacokinetics
Onset
Clinical improvement often seen within weeks, but full effect for nails can take months.
Excretion
Primarily excreted in urine (70-80%), some in feces.
Half life
Terminal half-life is approximately 17-20 hours.
Absorption
Well absorbed orally, bioavailability approximately 40%.
Metabolism
Extensively metabolized by CYP enzymes in the liver.
Side Effects
Contraindications
- Hypersensitivity to terbinafine or any component of the formulation
- Acute or chronic liver disease
- Severe renal impairment (CrCl < 50 mL/min)
Drug Interactions
Cimetidine
May decrease clearance of terbinafine, increasing its plasma concentration.
Rifampicin
May increase clearance of terbinafine, decreasing its plasma concentration.
SSRIs (e.g., Fluoxetine)
Terbinafine is a moderate inhibitor of CYP2D6, so it can increase concentrations of drugs metabolized by CYP2D6 (e.g., tricyclic antidepressants, beta-blockers, SSRIs).
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include headache, nausea, epigastric pain, dizziness. Treatment is symptomatic and supportive.
Pregnancy & Lactation
Pregnancy Category B. Use only if clearly needed after careful risk/benefit assessment. Not recommended during breastfeeding as it is excreted in breast milk.
Side Effects
Contraindications
- Hypersensitivity to terbinafine or any component of the formulation
- Acute or chronic liver disease
- Severe renal impairment (CrCl < 50 mL/min)
Drug Interactions
Cimetidine
May decrease clearance of terbinafine, increasing its plasma concentration.
Rifampicin
May increase clearance of terbinafine, decreasing its plasma concentration.
SSRIs (e.g., Fluoxetine)
Terbinafine is a moderate inhibitor of CYP2D6, so it can increase concentrations of drugs metabolized by CYP2D6 (e.g., tricyclic antidepressants, beta-blockers, SSRIs).
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include headache, nausea, epigastric pain, dizziness. Treatment is symptomatic and supportive.
Pregnancy & Lactation
Pregnancy Category B. Use only if clearly needed after careful risk/benefit assessment. Not recommended during breastfeeding as it is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
3 years from manufacturing date.
Availability
Pharmacies nationwide
Approval Status
Approved by health authorities worldwide
Patent Status
Generic available
Clinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of terbinafine for the treatment of dermatophyte infections, including onychomycosis, tinea pedis, tinea corporis, and tinea cruris.
Lab Monitoring
- Liver function tests (LFTs) before initiating treatment and periodically during treatment, especially if treatment duration is long or if symptoms suggest liver dysfunction.
Doctor Notes
- Emphasize the importance of completing the full course of treatment to achieve optimal therapeutic outcomes and prevent recurrence.
- Monitor liver function tests (LFTs) regularly, especially in patients with pre-existing liver conditions or during prolonged therapy.
- Advise patients to report any signs of liver dysfunction (e.g., persistent nausea, dark urine, jaundice) or severe skin reactions immediately.
Patient Guidelines
- Take Terbicare as prescribed and complete the full course of treatment, even if symptoms improve, to prevent recurrence.
- Inform your doctor immediately about any severe side effects, especially persistent nausea, abdominal pain, dark urine, or jaundice.
- Avoid alcohol consumption during treatment, as it may increase the risk of liver problems.
Missed Dose Advice
Take the missed dose as soon as you remember. If it's close to the next scheduled dose, skip the missed one and continue your regular dosing schedule. Do not double dose.
Driving Precautions
May cause dizziness or visual disturbances in some patients; advise caution when driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Maintain good hygiene for fungal infections, keep affected areas clean and dry.
- Wear breathable footwear and socks, and avoid sharing personal items like towels or shoes.
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