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
Terbicare 250 mg Tablet is an antifungal medication containing Terbinafine, primarily used to treat various fungal infections of the skin, hair, and nails, including ringworm, athlete's foot, and nail fungal infections (onychomycosis).
Uses & Indications
Dosage
Adults
Onychomycosis: 250 mg once daily for 6-12 weeks. Tinea corporis/cruris/pedis: 250 mg once daily for 2-4 weeks. Tinea capitis: 250 mg once daily for 4 weeks (off-label for children, often weight-based).
Elderly
No specific dose adjustment required, but caution due to potential decreased hepatic/renal function.
Renal_impairment
Reduce dose by 50% if creatinine clearance is <50 mL/min.
How to Take
Take orally once daily with or without food. Complete the full course of treatment as prescribed by the doctor, even if symptoms improve.
Mechanism of Action
Terbinafine is an allylamine antifungal that selectively inhibits squalene epoxidase, a key enzyme in fungal sterol biosynthesis. This leads to an accumulation of squalene within the fungal cell and a deficiency of ergosterol, both of which are toxic to fungal cells, causing cell death.
Pharmacokinetics
Onset
Clinical improvement is often seen within weeks, but complete cure, especially for nail infections, may take several months.
Excretion
Mainly excreted via urine (approximately 70-75%) as metabolites, with a smaller portion excreted in feces.
Half life
Terminal half-life is about 17-36 hours, but accumulation in skin and nails leads to a much longer effective half-life for therapeutic action.
Absorption
Well absorbed from the gastrointestinal tract (oral bioavailability ~40%) after oral administration. Peak plasma concentrations are achieved in about 2 hours.
Metabolism
Extensively metabolized in the liver, primarily by CYP2C9, CYP1A2, CYP3A4, CYP2C8, and CYP2C19, into inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to terbinafine or any component of the tablet
- Chronic or active liver disease
Drug Interactions
Warfarin
Changes in INR have been reported, monitor closely.
Cimetidine
Decreases terbinafine clearance, potentially increasing its plasma concentration.
Rifampicin
Increases terbinafine clearance, potentially decreasing its plasma concentration.
Caffeine, Desipramine, Nortriptyline
Terbinafine inhibits CYP2D6, leading to increased plasma concentrations of these drugs.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include headache, nausea, epigastric pain, and dizziness. Treatment is symptomatic and supportive; gastric lavage and activated charcoal may be considered.
Pregnancy & Lactation
Pregnancy Category B. Use only if clearly needed. Terbinafine is excreted in breast milk; therefore, breastfeeding is not recommended during treatment.
Side Effects
Contraindications
- Hypersensitivity to terbinafine or any component of the tablet
- Chronic or active liver disease
Drug Interactions
Warfarin
Changes in INR have been reported, monitor closely.
Cimetidine
Decreases terbinafine clearance, potentially increasing its plasma concentration.
Rifampicin
Increases terbinafine clearance, potentially decreasing its plasma concentration.
Caffeine, Desipramine, Nortriptyline
Terbinafine inhibits CYP2D6, leading to increased plasma concentrations of these drugs.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include headache, nausea, epigastric pain, and dizziness. Treatment is symptomatic and supportive; gastric lavage and activated charcoal may be considered.
Pregnancy & Lactation
Pregnancy Category B. Use only if clearly needed. Terbinafine is excreted in breast milk; therefore, breastfeeding is not recommended during treatment.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date
Availability
Pharmacies, Hospitals
Approval Status
Approved by health authorities worldwide (e.g., FDA, EMA, DGDA)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established terbinafine's efficacy and safety for dermatophyte infections, including pivotal trials supporting its use in onychomycosis and tinea infections.
Lab Monitoring
- Liver function tests (LFTs) should be monitored before starting treatment and periodically during treatment, especially in patients with pre-existing liver conditions.
- Complete blood count (CBC) should be monitored in patients developing signs of blood dyscrasias.
Doctor Notes
- Counsel patients on the importance of completing the full course to prevent recurrence.
- Emphasize potential for taste disturbance and liver enzyme elevation; monitor LFTs.
- Advise patients to report any signs of liver dysfunction or severe skin reactions immediately.
Patient Guidelines
- Take the medicine as prescribed and complete the full course of treatment.
- Report any signs of liver problems (e.g., persistent nausea, dark urine, jaundice) to your doctor immediately.
- Avoid sharing personal items (e.g., towels, shoes) to prevent spreading fungal infections.
- Keep the affected area clean and dry.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
Terbinafine may cause dizziness in some patients. Patients should be advised to exercise caution when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain good personal hygiene.
- Wear breathable footwear and cotton socks for foot infections.
- Avoid prolonged exposure to moist environments.
- Keep nails trimmed for nail infections.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.